Abnormal R wave Poor R-wave progression 2025-01-07T09:05:02Z With normal R wave progression, the amplitude of the R wave gradually increased from V1 to V5 and decreases from V5 to V6. Abnormal R wave progression may be observed with myocardial infarction, cardiomyopathy, right or left ventricular hypertrophy, and other conditions. Absence of the normal increase in size of the R wave in the precordial leads when advancing from lead V1 to V6 of the electrocardiogram.