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This has to do with where on the body the positive electrode is placed..in aVR the positive is on/near the right leg...a positive deflection, upright wave, is seen if the electrical activity, heart depolarization, is traveling towards the positive electrode...since the heart is rotated towards the left in the chest, normally electrical activity trends left...so in lead aVR the electrical activity is traveling away from the right so it gives a downward deflection of the waves

Welch Allyn... | Answered on May 18, 2013

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