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<span role="heading" aria-level="2">An electrocardiogram (ECG or EKG) can be used to diagnose bundle branch block and left ventricular hypertrophy (LVH):</span><span class="UV3uM"> </span>
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<div class="Gur8Ad">Bundle branch block</div>
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During an ECG, electrodes are attached to the chest, arms, or legs to record the heart's electrical activity. The ECG can show which side of the heart has the bundle branch block. Characteristic ECG findings for right bundle branch block include:<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">QRS duration of 120 milliseconds or more<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">RSR in leads V1 and V2<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">S wave longer than the R wave in leads 1 and V6, or S wave longer than 40 milliseconds<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">Normal R wave peak time in leads V5 and V6<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">R wave peak time longer than 50 milliseconds in lead V1<span class="UV3uM"> </span>
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<div class="Gur8Ad">LVH</div>
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ECG changes associated with LVH include:<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">Increased QRS complex amplitude and duration<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">Leftward shift of the QRS electrical axis in a frontal plane<span class="UV3uM"> </span>
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 	<li class="PZPZlf" data-attrid="SGEListItem">ST-segment deviation with T wave changes associated to the left ventricular strain<span class="UV3uM"> </span>
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However, diagnosing LVH in the presence of altered intraventricular conduction can be challenging. In these cases, a combination of limb and precordial lead voltage criteria and/or other nonvoltage ECG criteria may be required.<span class="UV3uM"> </span>
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