Poor R wave progression refers to the absence of the normal increase in size of the R wave in the precordial leads when advancing from lead V1 to V6. In lead V1, the R wave should be small.

The ECG findings of an old anterior wall MI include the loss of anterior forces, leaving Q waves in leads V1 and V2. This is a cause of poor R wave progression, or PRWP. Here is an example of an ...