ECG #5: The Lewis Lead

In ECG #1 we saw a nice example of atrial flutter. However, sometimes it’s not immediately obvious that flutter is the culprit of a supraventricular tachycardia and if you suspect flutter but cannot fully confirm, then there’s a trick up the sleeve called The Lewis Leads which are eseentially reorganising the limbs leads into an arrangement to better look at the atria.

Typically lead I and II are monitored but in this example you can see the flutter pattern has been emphasised in III and avL.