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Which lead is created between the left arm and the right arm plus the left leg?

  1. Lead aVF

  2. Lead 3

  3. Lead 2

  4. Lead aVL

The correct answer is: Lead aVL

The correct choice is based on the understanding of the standard and augmented limb leads used in electrocardiography. Lead aVL is an augmented unipolar lead that is derived from the left arm. It measures the electrical potential difference between the left arm and the midpoint of the right arm and left leg, effectively capturing the heart's electrical activity from the perspective of the left arm. In ECG recordings, the augmented leads (aVR, aVL, aVF) are created by taking the potential at one limb and comparing it to the average potential of the other two limbs. For lead aVL, the left arm acts as the positive electrode, while the average of the right arm and left leg serves as the negative electrode. This configuration enhances the signal coming from the left arm, allowing better visualization of the heart's electrical activity from that viewpoint. Understanding this configuration is critical for interpreting ECG results accurately, particularly in assessing the orientation of the heart's electrical axis and identifying potential abnormalities.