Lesson 36 / 40 · Reference · The 12 leads
Augmented leads & the frontal axis: aVR, aVL, aVF
The Goldberger augmented leads add three more frontal-plane views. Together with I–III they make the hexaxial reference system used to read the QRS axis (normal −30° to +90°).
Focus leads:
aVR
aVL
aVF
- aVR (right shoulder): normally entirely NEGATIVE (P, QRS and T), it views the heart from the opposite side.
- aVL and aVF are upright in the normal heart.
- Frontal axis: normal −30° to +90°; a quick read is I and aVF both net-positive → normal axis.
The normal 12-lead. The focus leads are highlighted; the rest are dimmed: