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* Left Axis Deviation (LAD)
Left Axis Deviation = QRS axis less than -30°.
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Hexaxial Reference System
Hexaxial Reference System – relationship between QRS axis and frontal leads of the ECG.
How to recognise left axis deviation
- QRS is POSITIVE (dominant R wave) in Lead I
- QRS is NEGATIVE (dominant S wave) in leads II, III and aVF
Example ECG of LAD
Left Axis Deviation:
- Leads I and aVL are positive; leads II and aVF are negative
Causes of LAD
- Left anterior fascicular block
- Left bundle branch block
- Left ventricular hypertrophy
- Inferior MI
- Ventricular ectopy
- Paced rhythm
- Wolff-Parkinson White syndrome
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