A dominant R wave in lead V1 has several causes, including right ventricular hypertrophy, right bundle branch block, myocardial infarction, Wolff-Parkinson-White syndrome, lead misplacement or dextrocardia. It can be normal in young people.
See also: QRS shapes
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- Thaler, MS (2018) - The Only EKG Book You'll Ever Need, 9th edn, Lippincott Williams and Wilkins