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The standard 11-lead ECG. Neglect of lead aVR in the classical limb lead display

Pahlm, U S; Pahlm, Olle LU and Wagner, G S (1996) In Journal of electrocardiology 29 Suppl. p.270-274
Abstract
This study investigates how the format of limb lead display influences electrocardiographic (ECG) interpretation. The positive aspect of lead aVR (included in the classical display) is directed opposite to that of the other leads. This could lead to an ECG interpreter's disregard of lead aVR, thus providing a "standard 11-lead ECG." It is hypothesized that when using the classical limb lead display, ECG interpreters often ignore lead aVR, even when considering complex ECGs. Thirty-five of the participants attending this International Society of Computerized Electrocardiology meeting were asked to interpret five complex ECGs, displayed in the classical format. Lead aVR had been replaced by lead -aVR on all of these recordings. Second, the... (More)
This study investigates how the format of limb lead display influences electrocardiographic (ECG) interpretation. The positive aspect of lead aVR (included in the classical display) is directed opposite to that of the other leads. This could lead to an ECG interpreter's disregard of lead aVR, thus providing a "standard 11-lead ECG." It is hypothesized that when using the classical limb lead display, ECG interpreters often ignore lead aVR, even when considering complex ECGs. Thirty-five of the participants attending this International Society of Computerized Electrocardiology meeting were asked to interpret five complex ECGs, displayed in the classical format. Lead aVR had been replaced by lead -aVR on all of these recordings. Second, the participants were asked if they (1) used all 12 leads, (2) used lead aVR, and (3) noticed that lead aVR had been changed. The results indicate that a vast majority of interpreters (80-94%) did not detect when lead aVR had been reversed. This suggests that interpreters only use 11 of the standard leads when presented with the classical display method to evaluate clinical problems. (Less)
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author
organization
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type
Contribution to journal
publication status
published
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in
Journal of electrocardiology
volume
29 Suppl
pages
270 - 274
external identifiers
  • Scopus:0030450019
language
English
LU publication?
yes
id
1bb120dd-1376-4799-a44b-4f2acae2ae32 (old id 1296371)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed?term=The%20standard%2011-lead%20ECG.%20Neglect%20of%20lead%20aVR%20in%20the%20classical%20limb%20lead%20display
date added to LUP
2012-12-12 14:54:35
date last changed
2016-04-16 10:57:22
@misc{1bb120dd-1376-4799-a44b-4f2acae2ae32,
  abstract     = {This study investigates how the format of limb lead display influences electrocardiographic (ECG) interpretation. The positive aspect of lead aVR (included in the classical display) is directed opposite to that of the other leads. This could lead to an ECG interpreter's disregard of lead aVR, thus providing a "standard 11-lead ECG." It is hypothesized that when using the classical limb lead display, ECG interpreters often ignore lead aVR, even when considering complex ECGs. Thirty-five of the participants attending this International Society of Computerized Electrocardiology meeting were asked to interpret five complex ECGs, displayed in the classical format. Lead aVR had been replaced by lead -aVR on all of these recordings. Second, the participants were asked if they (1) used all 12 leads, (2) used lead aVR, and (3) noticed that lead aVR had been changed. The results indicate that a vast majority of interpreters (80-94%) did not detect when lead aVR had been reversed. This suggests that interpreters only use 11 of the standard leads when presented with the classical display method to evaluate clinical problems.},
  author       = {Pahlm, U S and Pahlm, Olle and Wagner, G S},
  language     = {eng},
  pages        = {270--274},
  series       = {Journal of electrocardiology},
  title        = {The standard 11-lead ECG. Neglect of lead aVR in the classical limb lead display},
  volume       = {29 Suppl},
  year         = {1996},
}