Why the s wave is negative in V1 chest lead when it views the right side of the heart and the vector of s wave is rightward and upwards
electrocardiography AND precordial leads
ECG precordial lead V1 QRS vector S wave negative explanation
The large normal S wave in V1 is not primarily due to a rightward, upward vector. It reflects the dominant ventricular depolarization vector traveling leftward and posteriorly, away from V1.
V1 electrode: right anterior chest
anterior
V1
|
right <---------+---------> left
|
posterior
Normal dominant LV vector: leftward + posterior
Therefore: away from V1 -> negative S wave
I am talking about S wave not R. S wave represents basal depolarisation the vector of which is right and upwards
ECG terminal QRS basal ventricular depolarization vector rightward superior posterior V1 S wave
electrocardiography AND ventricular activation
V1 QRS:
small r deep S caused chiefly by LV activation
/\ |
__/ \_________________|____
\ /
\/ <- terminal basal vector may make
the S wave rise toward baseline
The basal vector can make the terminal S in V1 become less negative or rise upward, but the deep S in V1 mainly reflects the preceding leftward-posterior LV-dominant activation. The terminal vector usually does not create a positive deflection large enough to cross baseline.