Usefulness of Measuring Total 12-Lead QRS Voltage in Diagnosing Cardiovascular Disease

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When in medical school (1954-1958), I became interested in the electrocardiogram. I wondered why the definition of "low QRS voltage" included only three leads (I, II, III) when the electrocardiograms at the time included 12 leads. I learned that the definition of "low QRS voltage" was created when the standard electrocardiogram consisted of only three leads (I, II, III) and it was defined as total QRS voltage as 1000 g) had the highest QRS voltage, and patients with the smallest hearts, in general, had the lowest 12-lead QRS voltage. Total 12-lead QRS voltage was particularly helpful in diagnosing cardiac sarcoidosis, arrhythmogenic right ventricular cardiomyopathy, the carcinoid syndrome, and, of course, cardiac amyloidosis. The obesity epidemic has reduced total QRS voltage in many of us. This volume collects 18 articles on this topic published between 1982 and 2021. -William C. Roberts, MD