Lesson 40 / 40 · Reference · The 12 leads

Putting it together: one dipole, twelve views

All twelve leads are projections of a single cardiac dipole (the VCG) onto different axes, eight measured (I, II, V1–V6) and four derived (III, aVR, aVL, aVF). One heartbeat, twelve viewpoints. Every diagnosis from here on is a deviation from this normal projection.

Focus leads: I II III aVR aVL aVF V1 V2 V3 V4 V5 V6
  • Frontal plane: I, II, III, aVR, aVL, aVF (the limb leads).
  • Horizontal plane: V1–V6 (the precordial leads).
  • One dipole projected many ways, hold this picture as the baseline for Phase 2.
The normal 12-lead. The focus leads are highlighted; the rest are dimmed:
Vent. rate 62 bpm PR interval 200 ms QRS dur 88 ms QT/QTc 416/423 ms P-QRS-T axes 87 63 69 SYNTHETIC 12-LEAD ECG for training only — not for diagnosis I aVR V1 V4 II aVL V2 V5 III aVF V3 V6 II · rhythm strip (10 s) 25 mm/s · 10 mm/mV · 0.05–150 Hz · ~50/60 Hz · 10 s
Open simulator