Your question highlights an important point about ECG interpretation and the complexity of diagnosing right ventricular hypertrophy (RVH). Let me clarify a few key aspects:

1. Lead aVF findings: While deep Q waves followed by tall R waves in lead aVF can be seen in RVH, this pattern alone is not specific or definitive for RVH. In fact, this pattern is more commonly associated with left ventricular hypertrophy (LVH) or normal variant, especially in the inferior leads like aVF.

2. Lead I in RVH: In true RVH, lead I typically shows a different pattern:

   • Small R wave or even an rS pattern (small R, deep S)

   • Possible rightward axis deviation

3. Q waves in lead I: Normal, small Q waves in lead I are common and do not indicate RVH. They're often a normal finding representing normal left-to-right septal depolarization.

4. RVH diagnosis: RVH is typically diagnosed using a combination of criteria, with more emphasis on right-sided chest leads (V1, V2) and right-sided limb leads (aVR, V1), rather than left-sided or inferior leads.

5. Multiple lead assessment: A single lead should never be used to diagnose RVH or any other cardiac condition. A full 12-lead ECG, clinical context, and often imaging studies are necessary for accurate diagnosis.

6. Other causes: The pattern you described in aVF could be due to various causes including normal variant, LVH, or even myocardial infarction, depending on other ECG findings and clinical context.

In summary, it's entirely possible and even expected to have normal Q waves in lead I that do not indicate RVH, even if there are tall R waves in aVF. The aVF pattern you described is not typically characteristic of RVH on its own. For a definitive diagnosis, a comprehensive evaluation of all ECG leads, clinical presentation, and potentially additional diagnostic tests would be necessary.