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The 12-lead ECG has a total of three limb leads and three augmented limb leads arranged like spokes of a wheel in the coronal plane (vertical), and six precordial leads or chest leads that lie on the perpendicular transverse plane (horizontal). [33] Leads should be placed in standard positions.
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 ...
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.
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.
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 .
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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
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