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The hexaxial reference system is a diagram that is used to determine the heart's electrical axis in the frontal plane. The hexaxial reference system, better known as the Cabrera system, is a convention to present the extremity leads of the 12 lead electrocardiogram, [1] that provides an illustrative logical sequence that helps interpretation of the ECG, especially to determine the heart's ...
In a 12-lead ECG, all leads except the limb leads are assumed to be unipolar (aVR, aVL, aVF, V 1, V 2, V 3, V 4, V 5, and V 6). The measurement of a voltage requires two contacts and so, electrically, the unipolar leads are measured from the common lead (negative) and the unipolar lead (positive).
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This refers to the appearance of leads I and II. If the QRS complex is negative in lead I and positive in lead II, the QRS complexes appear to be "reaching" to touch each other. This signifies right axis deviation. Conversely, if the QRS complex is positive in lead I and negative in lead II the leads have the appearance of "leaving" each other.
In humans, for an ECG to be described as showing a sinus rhythm, the shape of the P wave in each of the 12 standard ECG leads should be consistent with a "typical P vector" of +50° to +80°. [2] This means that the P wave should be: always positive in lead I, lead II, and aVF; always negative in lead aVR
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The 2018 European Society of Cardiology/American College of Cardiology Foundation/American Heart Association/World Health Federation Universal Definition of Myocardial Infarction for the ECG diagnosis of the ST segment elevation type of acute myocardial infarction require new ST elevation at J point of at least 1mm (0.1 mV) in two contiguous leads with the cut-points: ≥1 mm in all leads ...