Augmented limb leads
Also calledaVR aVL aVF · augmented unipolar leads · Goldberger leads · augmented voltage leads
Definition
The three frontal-plane limb leads aVR, aVL and aVF, introduced by Goldberger in 1942. Each compares one limb electrode with the average of the other two limb electrodes (Goldberger's central terminal): aVR uses the right arm, aVL the left arm and aVF the left leg. They are called augmented because leaving the recording limb out of the reference makes them 50 percent larger in amplitude than the same leads recorded against Wilson's central terminal. Measured from the lead I axis, aVL lies at minus 30 degrees, aVR at minus 150 degrees and aVF at plus 90 degrees.
Clinical noteThey are often called unipolar, but every lead pairs two inputs, and the AHA describes that term as imprecise.
Sources
- Madias JE. On recording the unipolar ECG limb leads via the Wilson's vs the Goldberger's terminals: aVR, aVL, and aVF revisited. Indian Pacing Electrophysiol J. 2008;8(4):292-297. pubmed.ncbi.nlm.nih.gov/18982138/
- Kligfield P, Gettes LS, Bailey JJ, et al. Recommendations for the standardization and interpretation of the electrocardiogram: part I: the electrocardiogram and its technology. Circulation. 2007;115(10):1306-1324. doi.org/10.1161/CIRCULATIONAHA.106.180200
- Riera AR, Ferreira C, Ferreira Filho C, et al. Clinical value of lead aVR. Ann Noninvasive Electrocardiol. 2011;16(3):295-302. doi.org/10.1111/j.1542-474X.2011.00435.x
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.