Mnemonic

Einthoven's Triangle

A memory aid for the arrangement of the limb leads.

Expansion

Three bipolar limb leads forming a triangle around the heart

Expansion

The three bipolar limb leads:

  • Lead I - right arm (negative) to left arm (positive), at 0 degrees
  • Lead II - right arm (negative) to left leg (positive), at +60 degrees
  • Lead III - left arm (negative) to left leg (positive), at +120 degrees

Einthoven’s law: I + III = II.

The three augmented unipolar leads fill in the gaps:

  • aVR at -150 degrees
  • aVL at -30 degrees
  • aVF at +90 degrees

Together the six leads survey the frontal plane at 30 degree intervals, while the six chest leads survey the horizontal plane. The right leg electrode is a neutral reference and contributes no lead.

A negative P wave and inverted complex in lead I, with a normal appearance in the chest leads, suggests arm lead reversal rather than pathology.