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There are three basic "laws" of Electrocardiography. These "laws" have to do with the direction of flow of electrical conduction in the heart or what we term as vector.
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+ =
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5. If both leads are downward then the Axis is extreme Right Shoulder and most often is Vent. Tachy
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LEAD 1
LEAD 2
LEAD 3
UPRIGHT
UPRIGHT UPRIGHT
UPRIGHT
NEGATIVE NEGATIVE
NEGATIVE
UPRIGHT
NEGATIVE
NEGATIVE
NEGATIVE
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-60
LAD
-30 aVL 0 I
180
To determine the axis a scale must be used such as the one at the left.
RAD
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-60
LAD
-30 aVL 0 I
180
First you must find the most equiphasic QRS complex in the six limb leads. This is done by adding and subtracting the number of squares each QRS complex has above the baseline and below the baseline in each lead.
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RAD
-60
LAD
-30 aVL 0 I
180
The axis will be perpendicular (right angle) to this lead. If the perpendicular lead has a positive QRS, orient the axis to the positive pole of this lead. If it is negative then orient it to the negative pole.
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RAD
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