Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 7 Issue 10

Simple Method to Determine the Normal Cardiac Axis with I (D1) and aVF

Dragutin Novosel1*, Petar Žuljević2, Matija Alanović3, Robert Žunac4 and Tina Bečić5

1Glaserbergstrasse 23, CH - 4056 Basel, Switzerland
2Ulica dr. Franje Tuđmana 8c, HR - 21220 Trogir, Croatia
3SIPA Elektronika d.o.o., Ruđera Boškovića 17, HR - 47000 Karlovac, Croatia
4Petra Kržića 8, HR - 47000 Karlovac, Croatia
5University of Split, Faculty of Medicine, Department of Cardiology, Spinčićeva 1, HR - 21000 Split, Croatia

*Corresponding Author: Dragutin Novosel, Glaserbergstrasse 23, CH - 4056 Basel, Switzerland.

Received: September 07, 2023; Published: September 29, 2023


Background: A recently published paper argues that calculating the mean electrical axis of the heart in the frontal plane may lead to inaccuracies when using leads I (also known as lead D1) and aVF when the axis is within the range of -30° to 0° or between 90° and 110°.

Methods: Based on our previous reports we present counterarguments and demonstrate there is no compelling reason to avoid using the combination of leads I (D1) and aVF within these ranges.

Results: In cases where the value of aVF is negative and less than half (precisely 50.00%) of the value of I (D1), which is positive, the axis is between -30° and 0°. Similarly, when the value of I (D1) is negative and less than a third (precisely 31.52%) of the value of aVF, which is positive, the axis is between 90° and 110°. When both the I (D1) and aVF values are positive, the axis is between 0° and 90°. Therefore, we assert that there are no mathematical limitations preventing the use of leads I (D1) and aVF within the axis range of -30° to 110°.

Interpretation: In aligning with the currently valid criteria for the "normal axis values", which are for adults according to the American Heart Association between -30° and 90°, we described two rules to determine it as follows: (1) The value of the I (D1) is positive. (2) The value of the aVF is positive, or the value of the negative aVF is less than half the I (D1) value.

 Keywords: Electrical Heart Axis; Electrocardiography; Novosel Formula


  1. Anderson J and Dicarlo S. “"Virtual” experiment for understanding the electrocardiogram and the mean electrical axis”. Advances in Physiology Education1 (2000): 1-17.
  2. Laiken S., et al. "A rapid method for frontal plane axis determination in scalar electrocardiograms". American Heart Journal 5 (1973): 620-623.
  3. Okamoto N., et al. "Reliability of individual frontal plane axis determination". Circulation2 (1971): 213-219.
  4. Gao Q., et al. "A new method to determine the QRS axis—QRS axis determination“. Clinical Cardiology 43 (2020): 1534-1538.
  5. Parrales López HD. "Fast method to determine the cardiac axis with D1 and D3". Alerta 2 (2023):172-178.
  6. Novosel D., et al. "Corrected formula for the calculation of the electrical heart axis”. Croatian Medical Journal 1 (1999): 77-79.
  7. Dahl R and Berg R. “Trigonometry of the ECG. "A formula for the mean electrical axis of the heart". Physiology News 120 (2020): 25-27.
  8. Novosel D., et al. "Visualising the Novosel Formula: Comments on Dahl and Berg’s A for the mean electrical axis of the heart“. Physiology News 123 (2021): 7-8.
  9. Novosel D., et al. "The challenges and pitfalls of limb-leads and heart-axis calculations. The differences between the overall magnitudes of bipolar and augmented unipolar leads naccot be explained with the Ohm's law“. PARIPEX 11 (2022): 55-60.
  10. Surawicz B., et al. "AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram”. Circulation 119 (2009): e235-e240.


Citation: Dragutin Novosel., et al. “Simple Method to Determine the Normal Cardiac Axis with I (D1) and aVF”.Acta Scientific Medical Sciences 7.10 (2023): 86-88.


Copyright: © 2023 Dragutin Novosel., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US