Katz-Wachtel phenomenon

Katz-Wachtel phenomenon: Tall diphasic QRS complexes (>50 mm in height) in the mid-precordial leads (leads V2, V3 or V4) typically associated with Biventricular Hypertrophy.

Katz-Wachtel phenomenon Biventricular hypertrophy in a child with VSD
Katz-Wachtel phenomenon

History of Katz-Wachtel phenomenon

1937 – Katz and Wachtel suggested that large diphasic complexes in the standard limb leads were pathognomnic of congenital heart disease. They proposed that the QRS contour may represent combined right and left ventricular ‘strain

1963 – Elliott reviewed electrographic and vectorcardiographic criteris for biventricular hypertrophy. They found…

..large diphasic complexes over 50 mm. in either leads V2, V3, V4 were observed in the electrocardiogram of each case of biventricular hypertrophy studied (Katz-Wachtel phenomenon).

Associated Persons

Alternative names
  • Katz-Wachtel sign


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the names behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books |

MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner

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