Hexaxial reference system
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The hexaxial reference system is diagram based on the first six leads of the 12 lead ECG. It is used to help determine the heart's electrical axis in the frontal plane. To use the hexaxial reference system, locate the most isoelectric (or equiphasic) lead (I, II, III, aVR, aVL, or aVF) on a diagnostic quality ECG with proper lead placement. Then find the corresponding spoke on the hexaxial reference system. The perpendicular spoke will point to the heart's electrical axis. To determine which numerical value should be used, observe the polarity of the perpendicular lead on the ECG. For example, if the most isoelectric (or equiphasic) lead is aVL, the perpendicular lead on the hexaxial reference system is lead II. If lead II is positively deflected on the ECG, the heart's electrical axis in the frontal plane will be approximately +60o.
- Normal axis: -30o to +90o
- Left axis deviation: -30o to -90o
- Right axis deviation: +90o to +180o
- Extreme axis deviation: -90o to -180o
See also
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Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

