ArticleBMC cardiovascular disorders2019
Why complicate an important task? An orderly display of the limb leads in the 12-lead electrocardiogram and its implications for recognition of acute coronary syndrome.
Article in BMC cardiovascular disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Improved Detection of Acute Coronary Occlusion Myocardial Infarction by an Artificial Intelligence Electrocardiogram Model in Swedish Emergency Departments.Journal of the American College of Emergency Physicians open · 2026Article
- Heat map visualization for electrocardiogram data analysis.BMC cardiovascular disorders · 2020Article
- A groundbreaking electrocardiographic observation: "Isoelectric horizontal ST-segment with sharp ST-T angle" a novel sign for acute coronary syndrome.Indian heart journalArticle
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Authors and funding
6 authors.
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Abstract
backgroundIn the standard ECG display, limb leads are presented in a non-anatomical sequence: I, II, III, aVR, aVL, aVF. The Cabrera system is a display format which instead presents the limb leads in a cranial/left-to-caudal/right sequence, i.e. in an anatomically sequential order. Lead aVR is replaced in the Cabrera display by its inverted version, -aVR, which is presented in its logical place between lead I and lead II. MAIN TEXT: In this debate article possible implications of using the Cabrera display, instead of the standard, non-contiguous lead display, are presented, focusing on its use in patients with possible acute coronary syndrome. The importance of appreciating reciprocal limb-lead ECG changes and the diagnostic and prognostic value of including aVR or lead -aVR in ECG interpretation in acute coronary syndrome is covered. Illustrative cases and ECGs are presented with both the standard and contiguous limb lead display for each ECG. A contiguous lead display is useful when diagnosing acute coronary syndrome in at least 3 ways: 1) when contiguous leads are present adjacent to each other, identification of ST elevation in two contiguous leads is simple; 2) a contiguous lead display facilitates understanding of lead relationships as well as reciprocal changes; 3) it makes the common neglect of lead aVR unlikely. CONLUSIONS: It is logical to display the limb leads in their sequential anatomical order and it may have advantages both in diagnostics and ECG learning.
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