The rsR' pattern in left surface leads in ventricular aneurysm.

A characteristic rsR' pattern or its variants (rSr' or rSR') with normal or prolonged QRS duration in left surface leads including the apex lead and the orthogonal scalar X lead was described in 18 patients with coronary heart disease; in 17 of them a ventricular aneurysm was present. Necropsy in 12 patients showed the ventricular aneurysm to be secondary to an extensive confluent scarring of the anterior and antero-lateral portions of the left ventricle. Explanation of the genesis of the electrocardiographic pattern was attempted and its clinical value was suggested.