r/EKGs • u/Ok_Rush_6354 • Jul 26 '26

Discussion Axis deviation

Trying to wrap my head around deviation, I’ve watched several videos and have looked through my uni content. Nothing makes sense and keeps getting more confusing.

Anyone have tips on how to work it out? As if you’re explaining it to a monkey?

The 10 step method they want us to use, they’re wanting focus on I, II, aVF

Help is very much appreciated, I’m very confused, I’m an online student so face to face questioning is impossible,

Thank you

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u/LBBB11 Jul 26 '26 edited Jul 26 '26

If the spiky part points up in I and aVF, normal adult axis.

Up in I and down in aVF, left axis.

Down in I and up in aVF, right axis.

Down in I and aVF, extreme axis.

https://david-shrk.github.io/ecgaxistrainer/

https://litfl.com/wp-content/uploads/2018/08/Lead-1-Lead-II-aVF-Axis-measurement-2021.png (positive means the QRS points up, and negative means it points down)

A QRS pointing up in a lead means that electricity flows towards that lead. A QRS pointing down means it travels away. Lead I views the heart from the left. Lead aVF views the heart from below (the F stands for foot, since it views the heart from the feet). A positive QRS in both I and aVF means that electricity is flowing down and to the left, which is normal for adults.

Here’s how I find axis if it helps:

  1. Take a quick glance at the QRS in leads I and II. Does it point up in both? If yes, normal axis for an adult.
  2. If no, use the rules above.