aVR, aVL and aVF Leads

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By changing settings on the ECG machine, we can make the negative electrode on the right arm become the single existing positive electrode, and make the negative electrodes consist of both the left arm and left leg leads together. In this configuration the flow of positive charge is at an angle between Leads I and II and is referred to as the aVR lead, "a-augmented, V-voltage, R-right arm" lead.

In contrast, the aVL lead has its positive electrode at the left arm. Together with its two negatives, right arm and left foot, its reading will result in a vector bisecting limb Leads I and III.

The aVF lead has its positive electrode at the left foot or lower left chest and its negative electrodes at the shoulders.

If the triangle produced by leads aVR, aVL and aVF had its sides collapsed to intersect at the AV node, we would also have external angles of 60ø as seen in leads I, II and III. In addition, if all limb lead vectors were superimposed, it would be possible to study electrical activity from 6 different directions 30ø apart from the frontal view.


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