Limb leads of the electrocardiogram: sequencing revisited.
The six limb leads are normally presented in a format the logic of which is traditional rather than anatomical and does not allow visual interpolation such as is customary with the six chest leads. The sequence: a VL, I, -aVR, II, aVF, III was suggested years ago, and is used in some European countries, particularly Sweden. It provides a better impression of the extent of the changes of inferior infarction and makes the rather neglected lead aVR much more useful, though reversed in polarity. It also provides a more direct indication of the electrical axis, and simplifies comparisons with the frontal plane vectorcardiogram. Because modern digital electrocardiographs can provide the sequenced format, this seems a good time to review the advantages of adopting it.
Dower
G E
GE
Department of Cardiology, Loma Linda University Medical Center, California 92354.
Nazzal
S B
SB
Pahlm
O
O
Haistey
W K
WK
Marriott
H L
HL
Bullington
R H
RH
Bullington
D
D
D004562:Electrocardiography / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis*; D012984:Software