Pediatric ECGs

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Heart Axis

Normal heart axis values[1]

Age QRS Axis Normal Values Abnormal Values Description
Adult -30° to 90°
<-30°
-30° to -45°
-45° to -90°
90° to 120°
90° to 180°
Left-axis deviation
Moderate left-axis deviation
Marked left-axis deviation
Moderate right-axis deviation
Marked right-axis deviation
8 to 16 years 0° to 120° >120° Right-axis deviation
5 to 8 years 0° to 140° >140°

<0°

Right-axis deviation

Left-axis deviation

1 year to 5 years 5° to 100° >100° Right-axis deviation
1 mo to 1 y 10° to 120° >120°
<10° to -90° 
Right-axis deviation

Left-axis deviation

Neonate 30° to 90° >190° to -90°
<30° to <-90°
Extreme right axis deviation

Left axis deviation

References

  1. Surawicz B, Childers R, Deal BJ, Gettes LS, Bailey JJ, Gorgels A, Hancock EW, Josephson M, Kligfield P, Kors JA, Macfarlane P, Mason JW, Mirvis DM, Okin P, Pahlm O, Rautaharju PM, van Herpen G, Wagner GS, Wellens H, American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology, American College of Cardiology Foundation, and Heart Rhythm Society. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part III: intraventricular conduction disturbances: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology. Circulation. 2009 Mar 17;119(10):e235-40. DOI:10.1161/CIRCULATIONAHA.108.191095 | PubMed ID:19228822 | HubMed [aha]