Electrocardiographic applications of lead aVR

Williamson, Kelly; Mattu, Amal; Plautz, Claire U.; Binder, Allan; Brady, William J.

doi:10.1016/j.ajem.2006.05.013

« Previous Next »American Journal of Emergency Medicine
Volume 24, Issue 7 , Pages 864-874, November 2006

Electrocardiographic applications of lead aVR

Kelly Williamson
- School of Medicine, University of Virginia, Charlottesville, VA, USA
Amal Mattu, MD
- Department of Emergency Medicine, University of Maryland, Baltimore, MD, USA
Claire U. Plautz, MD
- Department of Internal Medicine (Cardiology), University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Emergency Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Department of Internal Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA
Allan Binder, MD
- Department of Internal Medicine (Cardiology), University of Virginia School of Medicine, Charlottesville, VA, USA
William J. Brady, MD
- Department of Internal Medicine (Cardiology), University of Virginia School of Medicine, Charlottesville, VA, USA
- Department of Emergency Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Department of Internal Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA
- Corresponding author. Department of Emergency Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA.

Received 26 May 2006; accepted 28 May 2006.

Abstract

Lead aVR, 1 of 12 electrocardiographic leads, is frequently ignored in clinical medicine. In fact, many clinicians refer to the 12-lead electrocardiogram (ECG) as the 11-lead ECG, noting the commonly held belief that lead aVR rarely offers clinically useful information. In this report, we discuss the findings in lead aVR, which are potentially of value, including ST-segment elevation in the patient with acute coronary syndrome suggestive of left main coronary artery occlusion, PR-segment elevation in the patient with acute pericarditis, prominent R wave in the patient with significant tricyclic antidepressant poisoning, and ST-segment elevation in narrow complex tachycardia suggestive of Wolff-Parkinson-White syndrome.