Sokolow-Lyon criteria
Also calledSokolow-Lyon index · Sokolow Lyon · SV1 + RV5/V6 · Sokolow-Lyon voltage
Definition
The Sokolow-Lyon criteria are a voltage-based ECG method for diagnosing left ventricular hypertrophy from QRS amplitudes. The main index diagnoses LVH when the S wave in V1 plus the R wave in V5 or V6 is 35 mm (3.5 mV) or more. Sokolow and Lyon (1949) also proposed a limb-lead criterion of an R wave in aVL of 11 mm (1.1 mV), and a separate right-ventricular index of R in V1 plus S in V5 or V6 of 10.5 mm (1.05 mV).
Clinical noteVoltage criteria as a group are fairly specific but insensitive: sensitivity is usually under 50 percent while specificity is often 85 to 90 percent. Voltage alone is less accurate under age 35 and in highly trained athletes (the index is not recommended in athletes, and a 40 mm threshold has been suggested for young people), and in obese people the Sokolow-Lyon index reaches the LVH range less often.
Sources
- Hancock EW, Deal BJ, Mirvis DM, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy. Circulation. 2009;119(10):e251-e261. doi.org/10.1161/CIRCULATIONAHA.108.191097
- Samesima N, God EG, Kruse JCL, et al. Brazilian Society of Cardiology guidelines on the analysis and issuance of electrocardiographic reports - 2022. Arq Bras Cardiol. 2022;119(4):638-680. doi.org/10.36660/abc.20220623
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.