PDF 12 Lead EKGs
12 Lead ECG Interpretation:
Using A Systematic Approach (Part 2= Axis)
Leslie L Davis, PhD, RN, ANP-BC, FAANP, FAHA
UNC Greensboro, School of Nursing
No disclosures relevant to this presentation.
What is Meant by Axis?
?Net direction of electrical
vector during ventricular
depolarization
¨C Average direction of current
flow
¨C As the ventricles depolarize
the direction of current flows
leftward & downward b/c
most of the ventricular mass
is on the left
Source: Author: Rob Kreuger Medical illustrator, AMC, The Netherlands
avail at:
Systematic Interpretation of 12 Lead EKGs
¨C Step 2: Determine axis
? Determined by looking at 6 frontal plane leads
? Leads I & aVF most often used
¨C Some sources use Leads I & II
? Variable among individuals
Courtesy of Dr. Nicholas Patchett. Available through creative commons via Wikipedia at:
Determining Axis
The QRS axis is determined by overlying a circle, in the frontal plane. By
convention, the degrees of the circle are as shown.
The normal QRS axis lies between -10o and +110o.
A QRS axis that falls between -10o
and -90o is abnormal and called left
axis deviation.
A QRS axis that falls between +110o
and +180o is abnormal and called
right axis deviation.
A QRS axis that falls between +180o
and -90o is abnormal and called
extreme right axis deviation.
Courtesy of Dr. De Voogt &
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