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Axis Deviation

Axis Deviation. Chapter 5. Definition. Electrical axis... The general direction in the frontal plane or toward which lead the QRS complex is predominately oriented ...the mean direction of depolarization through the frontal plane of the heart. Mean QRS Axis Calculation. Lead II.

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Axis Deviation

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  1. Axis Deviation • Chapter 5

  2. Definition • Electrical axis... • The general direction in the frontal plane or toward which lead the QRS complex is predominately oriented • ...the mean direction of depolarization through the frontal plane of the heart

  3. Mean QRS Axis Calculation Lead II

  4. Mean QRS Axis Calculation • General rules • the mean QRS axis points midway between any two leads that show tall R waves of equal height • the mean QRS axis is oriented at right angles (90°) to any lead showing a bi-phasic complex

  5. Mean QRS Axis Calculation

  6. Mean QRS Axis Calculation

  7. Mean QRS Axis Calculation

  8. Mean QRS Axis Calculation

  9. Mean QRS Axis Calculation

  10. Normal versus Deviation Left 3 ? 1 ? 2 ? Right + 90∘

  11. Axis Deviation Left Right

  12. Axis Deviation Criteria

  13. Axis Deviation • RAD = If R wave in III > R wave in II • LAD = If R wave in aVL > I; and deep S wave in III

  14. Axis deviation ? ?

  15. Axis deviation ?

  16. Axis deviation ?

  17. What is the axis? Right

  18. What is the axis? Left

  19. What is the axis? Normal

  20. What is the axis? Left

  21. What is the axis? Normal

  22. What is the axis? Right

  23. Causes of Left Axis Deviation FYI • left anterior hemiblock • Q waves of inferior myocardial infarction • artificial cardiac pacing • emphysema • hyperkalaemia • Wolff-Parkinson-White syndrome - right sided accessory pathway • tricuspid atresia • ostium primum ASD • injection of contrast into left coronary artery note: left ventricular hypertrophy is not a cause left axis deviation

  24. Causes of Right Axis Deviation FYI • normal finding in children and tall thin adults • right ventricular hypertrophy • chronic lung disease even without pulmonary hypertension • anterolateral myocardial infarction • left posterior hemiblock • pulmonary embolus • Wolff-Parkinson-White syndrome - left sided accessory pathway • atrial septal defect • ventricular septal defect

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