Limb leads of the electrocardiogram: sequencing revisited

Clin Cardiol. 1990 May;13(5):346-8. doi: 10.1002/clc.4960130508.


The six limb leads are normally presented in a format the logic of which is traditional rather than anatomical and does not allow visual interpolation such as is customary with the six chest leads. The sequence: a VL, I, -aVR, II, aVF, III was suggested years ago, and is used in some European countries, particularly Sweden. It provides a better impression of the extent of the changes of inferior infarction and makes the rather neglected lead aVR much more useful, though reversed in polarity. It also provides a more direct indication of the electrical axis, and simplifies comparisons with the frontal plane vectorcardiogram. Because modern digital electrocardiographs can provide the sequenced format, this seems a good time to review the advantages of adopting it.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Electrocardiography / instrumentation*
  • Electrocardiography / methods
  • Equipment Design
  • Humans
  • Myocardial Infarction / diagnosis*
  • Software