ONE-TWO Criteria: Improving the Approach to Electrocardiogram

"nThe electrocardiogram (EKG) is one of the major Para-clinic exams for evaluating patients suspected to cardiac or non-cardiac disease which could be very informative especially when assessed by experienced clinicians. To improve and accelerate the approach to EKG interpretation, simple and accurate criteria are useful and save the physician's time especially in emergent situations."nIn this article, we introduce our criteria which determine whether the electrical axis of heart is normal or not and if abnormal, what kind of deviation it has. These criteria say that "if the mean QRS complex in leads I and II are positive, the axis will be accurately in the normal range (-30 to +90); unless, the axis is abnormal necessitating a more complex evaluation". These criteria could simplify the first step of the approach to EKG interpretation especially in emergent situations. They can also be proper substitute for current methods of heart axis determination in clinical practice and for educational goals.