Twelve-lead electrocardiogram: The advantages of an orderly frontal lead display including lead -aVR

• Background: It is possible that efforts in ECG review by both young experienced clinicians are currently discouraged-and risk to be completely dismissed-by the conventional (ie, disorderly) display of the frontal plane leads, with lead aVR at -150degrees. Methods: We reviewed studies on the usefulness of leads aVR and -aVR as well as on the history of the frontal leads in electrocardiography. Results: Lead aVR and particularly, lead -aVR, provide useful information when systematically analyzed. in addition, if lead -aVR is examined in its anatomically logical sequence, ie, aVL, 1, -aVR, 11, aVF, and 111, the frontal plane of the 12-lead ECG is more easily understood. This "panoramic" or "orderly" display is in common use in countries such as Sweden, but it is rarely seen in the United States. Conclusions: ECG interpretation would be enhanced by displaying the limb leads in an orderly arrangement that starts with lead aVL and ends with lead 111, and many ECG changes would be ideally displayed by a lead -aVR at 30degrees.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

lead minus aVR

panoramic lead display

frontal ECG leads

Publication and Content Type

art (subject category)

ref (subject category)