Observations on the use of the aVR-V6 relationship to recognize limb lead error.

Electrocardiograms are subject to technical errors that confound interpretation, and although some are readily apparent, others are overlooked by experienced physicians. Thus, failure to recognize a recording error can lead to faulty clinical actions. By exploiting the reciprocal relationship of leads aVR and V6, this article provides a simple and useful way to quickly and confidently determine whether a tracing was properly recorded.

Einthoven's triangle: lead errors and an algorithm for solution.

The three bipolar leads (I, II, and III) of the 12-lead electrocardiogram are subject to technical errors that not only confound interpretation but may lead to faulty clinical actions. While some errors are readily recognized, even experienced electrocardiographers overlook others. This paper reviews the nature of limb lead errors and offers what we think is a generally useful method to deduce the observed, but erroneous, lead configurations.