In: Anatomy and Physiology
The shape and polarity of P,Q,R,S and T waves will vary in different leads due to differences in the orientation of each lead with respect to the heart.
Configuration - QRS Complex : QRS complex consists of three consecutive waves. Q wave is a small negative wave which may be absent normally (quite often). It continued as a tall positive R wave which is followed by a small negative S wave. QRS complex is caused by a ventricular depolarization.
(Note :QRS complex from the precordial leads are more important than the limb leads.)
In the bipolar limb leads (Lead I , Lead II and Lead III ) ,the Q wave and the S wave are usually negative and low-amplitude compared to the dominant positive R wave
In electrocardiography, electrical current flowing toward a positive electrode results in a positive (upright) waveform display. Electrical current flowing away from the positive electrode results in a negative (downward) waveform display. In Lead II , the R wave is therefore positive.
The closer the mean QRS axis is to the electrical axis of Lead II, the larger the amplitude of the R wave.
Amplitude : Q wave is 0.1-0.2 mV
R wave is 1.0 mV
S wave is 0.4 mV
Tall R wave (more than 1.3 mV) is seen in ventricular hypertrophy.