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# ECG leads: The Dirty Dozen

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Mr. EasyG, a cartoon character, shows you the easy way to remember the direction and polarity of the 6 limb leads - the dirty half-dozen- important to localize the part of heart affected by the disease process(e.g. inferior infarct) and to determine the electrical axis of the heart.

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### ECG leads: The Dirty Dozen

1. 1. ECG leads: The DirtyECG leads: The Dirty DozenDozen Conventionally, 12 leads or sets of electrodes nyunt_wai@imu.edu.mynyunt_wai@imu.edu.my victor.nwai@gmail.comvictor.nwai@gmail.com 20132013
2. 2. ECG leads: TheECG leads: The DirtyDirtyDozenDozen Direction Polarity Why do I need to know these details ??
3. 3. Because theBecause the DirtyDirtyDozenDozen Direction Polarity 1. determine deflections of the ECG 2. detect direction of depolarization wave Deviation of cardiac axis 3. detect (or localize) the diseased or disordered part of the heart
4. 4. Hi, I’m EasyG. I’ll show you to work out the ofof DirtyDirty half-Dozenhalf-Dozen Direction & Polarity the 6 limb leads in the frontal plane
5. 5. the 6 limb leads in the frontal plane Lead I aVL Lead III Lead II aVR aVF monitoring the heart from different electrical perspectives It’s not fair to label us the dirty half-dozen The other half-dozen are on the chest – the 6 chest leads
6. 6. Where shall we start forming a triangle? The top, of course, since we always read from top downwards
7. 7. Which arm shall we move first ? Ah!! The right arm!! as most of us are right-handed
8. 8. So, make a fist. And make your 1st move. Swing up your arm.
9. 9. The 1st move, the top border of a triangle so its Lead I The fist always is the (+)ve electrode The shoulder the (-)ve electrode
10. 10. The 2nd move, swing your arm down to form the 2nd border … its Lead II
11. 11. Now it’s the left arm’s job to make a 3rd move and close the triangle … its Lead III
12. 12. Raise the right fist like this … its aVR
13. 13. Raise the left fist like this, it’s…
14. 14. Stomp the ground with your left foot, it’s…
15. 15. Once more!!! Action!
16. 16. I
17. 17. II
18. 18. III
19. 19. aVR
20. 20. aVL
21. 21. aVF