ECG Leads – The Premier EKG Resource for Medical Professionals

Question of the day

LECTURES:
1. Vectors & Electrodes
2. EKG Paper
3. Standard Leads
4. Right-Sided Leads
5. Posterior Leads
6. Localizing ECG Leads
7. Full ECG Course
8. The EKG Guy Lectures

Overview:

Positive end gets lead name
2 lead systems: (1) hexaxial & (2) precordial

Hexaxial System (Limb/Extremity Leads)

Coronal view
6 limb leads: I, II, III, aVR, aVL, aVF

I – from R-arm to L-arm
II – from R-arm to L-leg
III – from L-arm to L-leg

Note: I + III = II (eg, if QRS in I is 4 mm & in III is 8 mm, then QRS in II is 12 mm)

aVL – points to L-arm
aVR – points to R-arm
aVF – points to feet

a = augmented, V = voltage
aVR = AVL + aVF = 0

Each lead is 30° apart

Precordial System (Precordial/Chest Leads)

Sagittal view (frontal plane)
Perpendicular to limb leads
6 precordial leads: V1, V2, V3, V4 ,V5, V6 (from R => L)

R-precordials = V1-V2 (closest to RA & RV)
L-precordials = V5-V6 (closest to lateral wall of LV)

Each lead is 20° apart

Lead Systems Combined

Represents standard 12-lead ECG
Allow for localizing pathology

Special Leads

Right-sided leads (V3R-V6R): R-lateral view (eg, dx RV MI)
Posterior leads (V7-V9): posterior wall view (eg, dx posterior MI)

Abbreviations: L, left; R, right; RA, right atrium; RV, right ventricle; LV, left ventricle; dx, diagnose

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DID YOU KNOW?

Dr. Anthony Kashou (The EKG Guy) is a physician resident at the Mayo Clinic in Rochester, Minnesota. He is on a mission to transform ECG education and filling the gap exists around the world. Dr. Kashou has taught and developed curriculum for medical students, including 500+ lectures and 100+ hours of adult and pediatric ECG lessons.

At the Mayo Clinic, he pursues innovative ECG research and was awarded first place for his research at the Minnesota American College of Cardiology Conference 2018. His passion for medical education and innovation led to the development of EKG.MD, which provides a convenient and accessible forum to learn the fundamentals and foundations of ECG interpretation. He has also authored dozens of peer-reviewed articles for medical journals and textbooks, along with multiple ECG books for learners at all levels.

Dr. Kashou continues to lead and teach weekly ECG sessions and weekend seminars for residents, nurses, ECG interpreting technicians, and physician assistants at the Mayo Clinic. He has been asked and is currently developing an ECG board review course for cardiology fellows. He has an online following of over 275,000 individuals and is the founder of the largest, fastest growing ECG community in the world. His clinical research focuses on developing innovative ECG algorithms that can be integrated and implemented into clinical practice.

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