Recommendation for revision of the standard presentation of the frontal plane ECG leads including reversal of lead aVR (to -aVR): It is time for a change.

摘要

The 12-lead, standardized presentation of the ECG, as determined by the American Heart Association more than 70 years ago, was an important contribution to clinical cardiology and has also become accepted worldwide. Two major improvements can be made to the frontal plane ECG, both of which can be set up simply and quickly. Two inadequacies are present, both of which are entirely the result of the presentation format in which the standard ECG was designed, and these have remained the same to this day. The two possible improvements are: (1) a precise, 180 degree alteration in the configuration of Lead aVR (to -aVR); and (2) a transfer of the entire six-lead frontal plane to an orderly, sequential angular position for each lead. We believe it is time to revise the standard frontal plane ECG presentation with these improvements.