R Wave Peak Time

AKA “Intrinsicoid deflection”


  • The time from the onset of the earliest Q or R wave to the peak of the R wave in the lateral leads (aVL, V5-6).
  • Represents the time taken for excitation to spread from the endocardial to the epicardial surface of the left ventricle.
  • R-wave peak time is said to be prolonged if > 45ms.

Causes of Prolonged RWPT

late intrinsicoid deflection

Prolonged R-wave peak time in aVL due to left anterior fascicular block


Further Reading

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