• Precordial leads initial R first smaller and then taller
  • R wave predominantly positive in V4
  • Transition zone between V3 and V4
    • - V2 is negative and V5 is positive


The small Q wave in aVL, and the wide Q in aVR and V1 may be considered normal. Notice especially that in the precordial leads, the initial R wave is first small and then becomes progressively taller, becoming predominantly positive by V4. The transition zone is between V3 and V4, with V2 appropriately negative and V5 appropriately positive; that is, there is normal R wave progression and normal QRS transition.