Question 1

Why are both Sokolow-Lyon and Cornell criteria used together?

Accepted Answer

They detect different electrocardiographic manifestations of LVH. Sokolow-Lyon captures mainly the increased precordial voltage, while Cornell adds a limb-lead component. Using both increases overall sensitivity to approximately 50–60% while maintaining acceptable specificity.

Question 2

Can I rely on Sokolow-Lyon in the presence of left bundle branch block?

Accepted Answer

LBBB itself produces high QRS voltages, making the Sokolow-Lyon criteria less specific. In LBBB, alternative markers such as the Romhilt-Estes point score or the Cornell product with LBBB-specific thresholds should be used.

Question 3

How does the tool handle different calibration standards?

Accepted Answer

Standard calibration is 10 mm/mV. If the ECG is recorded at half-standard (5 mm/mV), amplitudes must be doubled before applying the criteria. The tool assumes standard calibration unless otherwise specified.