1 / 11

Determining AXIS : 12 Lead ECG's

Determining AXIS : 12 Lead ECG's. Using the Hexaxial Diagram to find the degree of Axis Deviation This technique is a little hard to learn but it is very accurate (+ or – 10 0 to 15 0 ) Emily Koch, RN, BSN, ACNPc Clinician III 4 East UVA Health System.

bena
Download Presentation

Determining AXIS : 12 Lead ECG's

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Determining AXIS: 12 Lead ECG's Using the Hexaxial Diagram to find the degree of Axis Deviation This technique is a little hard to learn but it is very accurate (+ or – 100 to 150) Emily Koch, RN, BSN, ACNPc Clinician III 4 East UVA Health System

  2. Basics of 12 Lead ECG'sDetermining AXIS To determine the axis a scale must be used such as the one at the left. Each physician uses a slightly different degree as the upper limit of normal, but typically 105-110 degrees.

  3. Basics of 12 Lead ECG'sDetermining AXIS First you must find the most equiphasic QRS complex in the six limb leads. This is done by adding and subtracting the number of squares each QRS complex has above the baseline and below the baseline in each lead.

  4. Basics of 12 Lead ECG'sDetermining AXIS Locate the lead perpendicular to the lead with the most isoelectric QRS. If the perpendicular lead has a positive QRS, orient the axis to the positive pole of this lead. If it is negative then orient it to the negative Pole of this lead.

  5. Basics of 12 Lead ECG'sDetermining AXIS If there is a lead with a QRS that is taller than the lead perpendicular to the most isoelectric, the axis is the mean of the two. Remember: If the tallest lead has a positive QRS, orient the axis to the positive pole of this lead.If it is negative then orient it to the negative pole.

  6. Causes of Abnormal Axis Left Axis Deviation = An axis between -30 and -90 • May be normal in the elderly and very obese • Due to high diaphragm during pregnancy, ascites, or ABD tumors • Left Anterior Hemiblock • Left Bundle Branch Block • WPW Syndrome • Congenital Lesions • Right Vent. Pacer or ectopic rhythms • Emphysema

  7. Causes of Abnormal Axis Right Axis Deviation = An axis between +120 and +180 • Can be normal variant • Right Vent. Hypertrophy • Right Bundle Branch Block • Left Posterior Hemiblock • Left Ventricular ectopic rhythms • Some right Vent. Ectopic rhythms • WPW Syndrome

  8. Causes of Abnormal Axis Extreme Right Axis Deviation = An axis between -90 and +180 • Ventricular ectopic rhythms • Right Vent. Paced rhythms • Less commonly seen in patients with cardiomyopathies and in those with multiple MI's

  9. Normal ECG

  10. Determine Axis

More Related