Is left axis deviation ecg dangerous

Related articles: Extreme axis deviation, also known as extreme right axis deviation, northwest axis or “no-man's land” axis, is a rare electrocardiographic finding, and it represents an extreme right- or left-axis deviation 1. In adults, the normal QRS axis is considered to be within -30° and 90°. Extrem axis deviation is when the QRS axis is between -90° and -180º. The situations in which extreme axis deviation may be seen are as follows: Right Arm and Left Leg Leads Reversal Reversal of the right arm and left leg leads is the most common cause of extreme axis deviation. When the right arm and left leg leads are reversed, the EKG reveals the following changes 2: • Lead I is actually upside-down lead III. • Lead II becomes upside down. • Lead III is actually upside-down lead I. • Leads aVR and aVF are reversed. • Lead aVL is unchanged. When all the deflections, including the Pwave, are negative in lead aVF, a right arm and left leg leads reversal should be suspected 2. Ventricular Rhythms Related article: Ectopic ventricular rhythms ( Ventricular Tachycardias Related article: Ventricular tachycardias are a group of arrhythmias characterized by the presence of three or more consecutive ventricular beats with a high heart rate. Ventricular tachycardias with right superior axis (extreme axis deviation) usually arise from the apex or septal regions of the left ventricle. Ventricular tachycardias arising from the apex have More information: Accelerated Idioventricular Rhythm A...

While the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding patients with a QRS duration of ≥ 110 ms, pacemaker placement, and an QRS-axis − 90° to − 180° (northwest axis). The study population was categorized into three groups depending on the mean frontal plane QRS axis as follows: patients with left axis deviation (N = 171), those with right axis deviation (N = 94), and those with normal axis (N = 3088). The primary outcome was a composite of all-cause death and major adverse cardiovascular events. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the left axis deviation group (26.4% in the left axis deviation, 22.7% in the right axis deviation, and 18.4% in the normal axis groups, log-rank P = 0.004). After adjusting for confounders, the excess risk of primary outcome measure remained significant in the left axis deviation group (hazard ratio [HR] 1.44; 95% confidence interval [CI] 1.07–1.95; P = 0.02), while the excess risk of primary outcome measure was not significant in the right axis deviation group (HR 1.22; 95% CI 0.76–1.96; P = 0.41). Left axis deviation was asso...

Continuing Education Activity One of the key steps in interpreting an electrocardiogram (EKG) is determining the electrical axis of the heart. Being able to determine the electrical axis can provide insight into underlying disease states and help steer the differential diagnosis towards or away from certain diagnoses. This activity describes what makes up the electrical axis, ventricular (QRS) axis classifications, various approaches to determining the electrical axis, and causes of axis deviation. Objectives: • Identify the clinical benefits of interpreting the axis on an EKG. • Describe the issues of concern regarding the interpretation of the electrical axis on an ECG. • Summarize the causes of electrical axis deviation. • Review the role of an interprofessional team in improving care coordination in patients with electrical axis deviation. Introduction One of the key steps in interpreting an electrocardiogram (EKG) is determining the electrical axis of the heart. Being able to determine the electrical axis can give insight into underlying disease states and help steer the differential diagnosis towards or away from certain diagnoses. Herein, we will discuss what makes up the electrical axis, ventricular (QRS) axis, axis classifications, various approaches to determining the electrical axis, and causes of axis deviation. Function Electrical Axis In electrocardiology, a vectorrepresents both the magnitude and direction of the action potential generated by an individual m...

Additional resources and citations Left axis deviation (LAD) is a condition in electrocardiography in which the average electrical axis of the ventricular contraction of the heart rests in a frontal plane direction between 30° and 90°. This is mirrored by a positive QRS complex in lead I and a negative complex in leads aVF & II. LAD can be caused by a number of factors. Normal variation, pre-excitation syndrome, conduction defects, inferior wall myocardial infarction, congenital Left Axis Deviation (LAD) – Defining it Left axis deviation (LAD) is a condition in electrocardiography in which the average electrical axis of the ventricular contraction of the heart rests in a frontal plane direction between 30° and 90° https://en.wikipedia.org/wiki/Left_axis_deviation. This is mirrored by a positive QRS complex in lead I and a negative complex in leads aVF & II. In electrocardiography, the cardiac axis is the total of the depolarization vectors created by each cardiac myocyte. To understand the cardiac axis, one must first discover the connection between both the QRS axis and the ECG limb leads. Because the left ventricle makes up the majority of the heart muscles, a typical cardiac axis is downward but also slightly to the left. QRS is somewhere between -30° & +90° on a normal axis. In contrast, LAD is defined as a QRS axis between 30° and 90°, right axis deviation (RAD) is defined as a QRS axis higher than +90°, and extreme axis deviation (EAD) is defined as a QRS axis betwee...

Additional resources and citations Left axis deviation (LAD) is a condition in electrocardiography in which the average electrical axis of the ventricular contraction of the heart rests in a frontal plane direction between 30° and 90°. This is mirrored by a positive QRS complex in lead I and a negative complex in leads aVF & II. LAD can be caused by a number of factors. Normal variation, pre-excitation syndrome, conduction defects, inferior wall myocardial infarction, congenital Left Axis Deviation (LAD) – Defining it Left axis deviation (LAD) is a condition in electrocardiography in which the average electrical axis of the ventricular contraction of the heart rests in a frontal plane direction between 30° and 90° https://en.wikipedia.org/wiki/Left_axis_deviation. This is mirrored by a positive QRS complex in lead I and a negative complex in leads aVF & II. In electrocardiography, the cardiac axis is the total of the depolarization vectors created by each cardiac myocyte. To understand the cardiac axis, one must first discover the connection between both the QRS axis and the ECG limb leads. Because the left ventricle makes up the majority of the heart muscles, a typical cardiac axis is downward but also slightly to the left. QRS is somewhere between -30° & +90° on a normal axis. In contrast, LAD is defined as a QRS axis between 30° and 90°, right axis deviation (RAD) is defined as a QRS axis higher than +90°, and extreme axis deviation (EAD) is defined as a QRS axis betwee...

While the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding patients with a QRS duration of ≥ 110 ms, pacemaker placement, and an QRS-axis − 90° to − 180° (northwest axis). The study population was categorized into three groups depending on the mean frontal plane QRS axis as follows: patients with left axis deviation (N = 171), those with right axis deviation (N = 94), and those with normal axis (N = 3088). The primary outcome was a composite of all-cause death and major adverse cardiovascular events. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the left axis deviation group (26.4% in the left axis deviation, 22.7% in the right axis deviation, and 18.4% in the normal axis groups, log-rank P = 0.004). After adjusting for confounders, the excess risk of primary outcome measure remained significant in the left axis deviation group (hazard ratio [HR] 1.44; 95% confidence interval [CI] 1.07–1.95; P = 0.02), while the excess risk of primary outcome measure was not significant in the right axis deviation group (HR 1.22; 95% CI 0.76–1.96; P = 0.41). Left axis deviation was asso...

Continuing Education Activity One of the key steps in interpreting an electrocardiogram (EKG) is determining the electrical axis of the heart. Being able to determine the electrical axis can provide insight into underlying disease states and help steer the differential diagnosis towards or away from certain diagnoses. This activity describes what makes up the electrical axis, ventricular (QRS) axis classifications, various approaches to determining the electrical axis, and causes of axis deviation. Objectives: • Identify the clinical benefits of interpreting the axis on an EKG. • Describe the issues of concern regarding the interpretation of the electrical axis on an ECG. • Summarize the causes of electrical axis deviation. • Review the role of an interprofessional team in improving care coordination in patients with electrical axis deviation. Introduction One of the key steps in interpreting an electrocardiogram (EKG) is determining the electrical axis of the heart. Being able to determine the electrical axis can give insight into underlying disease states and help steer the differential diagnosis towards or away from certain diagnoses. Herein, we will discuss what makes up the electrical axis, ventricular (QRS) axis, axis classifications, various approaches to determining the electrical axis, and causes of axis deviation. Function Electrical Axis In electrocardiology, a vectorrepresents both the magnitude and direction of the action potential generated by an individual m...

Related articles: Extreme axis deviation, also known as extreme right axis deviation, northwest axis or “no-man's land” axis, is a rare electrocardiographic finding, and it represents an extreme right- or left-axis deviation 1. In adults, the normal QRS axis is considered to be within -30° and 90°. Extrem axis deviation is when the QRS axis is between -90° and -180º. The situations in which extreme axis deviation may be seen are as follows: Right Arm and Left Leg Leads Reversal Reversal of the right arm and left leg leads is the most common cause of extreme axis deviation. When the right arm and left leg leads are reversed, the EKG reveals the following changes 2: • Lead I is actually upside-down lead III. • Lead II becomes upside down. • Lead III is actually upside-down lead I. • Leads aVR and aVF are reversed. • Lead aVL is unchanged. When all the deflections, including the Pwave, are negative in lead aVF, a right arm and left leg leads reversal should be suspected 2. Ventricular Rhythms Related article: Ectopic ventricular rhythms ( Ventricular Tachycardias Related article: Ventricular tachycardias are a group of arrhythmias characterized by the presence of three or more consecutive ventricular beats with a high heart rate. Ventricular tachycardias with right superior axis (extreme axis deviation) usually arise from the apex or septal regions of the left ventricle. Ventricular tachycardias arising from the apex have More information: Accelerated Idioventricular Rhythm A...

While the prognostic impact of QRS axis deviation has been assessed, it has never been investigated in patients without conduction block. Thus, we evaluated the prognostic impact of QRS-axis deviation in patients without conduction block. We retrospectively analyzed 3353 patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in a hospital-based population, after excluding patients with a QRS duration of ≥ 110 ms, pacemaker placement, and an QRS-axis − 90° to − 180° (northwest axis). The study population was categorized into three groups depending on the mean frontal plane QRS axis as follows: patients with left axis deviation (N = 171), those with right axis deviation (N = 94), and those with normal axis (N = 3088). The primary outcome was a composite of all-cause death and major adverse cardiovascular events. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the left axis deviation group (26.4% in the left axis deviation, 22.7% in the right axis deviation, and 18.4% in the normal axis groups, log-rank P = 0.004). After adjusting for confounders, the excess risk of primary outcome measure remained significant in the left axis deviation group (hazard ratio [HR] 1.44; 95% confidence interval [CI] 1.07–1.95; P = 0.02), while the excess risk of primary outcome measure was not significant in the right axis deviation group (HR 1.22; 95% CI 0.76–1.96; P = 0.41). Left axis deviation was asso...

Additional resources and citations Left axis deviation (LAD) is a condition in electrocardiography in which the average electrical axis of the ventricular contraction of the heart rests in a frontal plane direction between 30° and 90°. This is mirrored by a positive QRS complex in lead I and a negative complex in leads aVF & II. LAD can be caused by a number of factors. Normal variation, pre-excitation syndrome, conduction defects, inferior wall myocardial infarction, congenital Left Axis Deviation (LAD) – Defining it Left axis deviation (LAD) is a condition in electrocardiography in which the average electrical axis of the ventricular contraction of the heart rests in a frontal plane direction between 30° and 90° https://en.wikipedia.org/wiki/Left_axis_deviation. This is mirrored by a positive QRS complex in lead I and a negative complex in leads aVF & II. In electrocardiography, the cardiac axis is the total of the depolarization vectors created by each cardiac myocyte. To understand the cardiac axis, one must first discover the connection between both the QRS axis and the ECG limb leads. Because the left ventricle makes up the majority of the heart muscles, a typical cardiac axis is downward but also slightly to the left. QRS is somewhere between -30° & +90° on a normal axis. In contrast, LAD is defined as a QRS axis between 30° and 90°, right axis deviation (RAD) is defined as a QRS axis higher than +90°, and extreme axis deviation (EAD) is defined as a QRS axis betwee...