Poor R-wave progression (PRWP) is a common ECG finding that is often inconclusively interpreted as suggestive, but not diagnostic, of anterior myocardial infarction (AMI). PRWP is defined by R wave height ≤ 3 mm in V3 Causes of PRWP The major causes associated with PRWP include: Prior anteroseptal MI Left Ventricular Hypertrophy (LVH)

Overview. Poor R wave progression across the precordium refers to an electrocardiographic finding where the normal increase in R wave amplitude as one progresses from V1 to V6 is lost. Although non-specific, this finding is consistent with a prior anterior myocardial infarction .

Normal R-wave progression is where normally, from lead V1 to lead V6, the pattern is that of a change from the S wave being prominent to the R wave being prominent. So when looking at V1 you should have a mostly downward deflecting axis and in V6 you should have a mostly upward inflecting QRS axis.