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Diagram showing the contiguous leads in the same color in the standard 12-lead layout. Each of the 12 ECG leads records the electrical activity of the heart from a different angle, and therefore align with different anatomical areas of the heart. Two leads that look at neighboring anatomical areas are said to be contiguous. [43]
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 ...
If lead b is positive, the electrical heart axis can be estimated to lie within the quadrant between axis of lead a and lead b. A simple tool to quickly identify axis deviation (Figure 3) is the popular mnemonic; R eaching for R ight Axis Deviation and L eaving for L eft Axis Deviation.
The typical meaning of an "ECG" is the 12-lead ECG that uses 10 wires or electrodes to record the signal across the chest. Interpretation of an ECG is the basis of a number of cardiac diseases including myocardial infarction (heart attack) and arrhythmias such as atrial fibrillation .
The standard 12 lead ECG does not directly examine the right ventricle, and is relatively poor at examining the posterior basal and lateral walls of the left ventricle. In particular, acute myocardial infarction in the distribution of the circumflex artery is likely to produce a nondiagnostic ECG. [ 10 ]
The use of additional ECG leads like right-sided leads V3R and V4R and posterior leads V7, V8, and V9 may improve sensitivity for right ventricular and posterior myocardial infarction. In spite of these limitations, the 12 lead ECG stands at the center of risk stratification for the patient with suspected acute myocardial infarction.
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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