If P waves are absent and there is an irregular rhythm, it may suggest a diagnosis of atrial fibrillation. If P waves are absent, is there any atrial activity? Do the P waves look normal? – check duration, direction and shapeĤ. If so, is each P wave followed by a QRS complex?ģ. The next step is to look at the P waves and answer the following questions:Ģ.

Left axis deviation is associated with heart conduction abnormalities.

Lead I has the most positive deflection.

Typical ECG findings for left axis deviation: Right Axis Deviation (RAD) Left axis deviation

Right axis deviation is associated with right ventricular hypertrophy.

Lead III has the most positive deflection, and lead I should be negative.

Typical ECG findings for right axis deviation:

Lead II has the most positive deflection compared to leads I and III.Typical ECG findings for normal cardiac axis: Read our cardiac axis guide to learn more.

To determine the cardiac axis, you must look at leads I, II and III. In a healthy individual, the axis should spread from 11 o’clock to 5 o’clock. You might also be interested in our OSCE Flashcard Collection which contains over 3000 flashcards that cover clinical examination, procedures, communication skills and data interpretation.Ĭardiac axis describes the overall direction of electrical spread within the heart.

Waves complete bundle 9