A simplified method of diagnosing anterior divisional blocks (hemiblocks) at a glance is made possible by using a knowledge of the lead line directions on a hexaxial system. The term ‘divisional block’ is preferred to ‘hemiblock’ because a block of one of the three divisions of the left bundle cannot be a hemiblock. The diagnosis of an anterior divisional block can be simplified by utilization of the concept that it is mainly a terminal conduction abnormality in the frontal plane with a direction between -60° and -90°. Using a hexaxial system the diagnosis can be quickly made regardless of axis by simply noting the presence of a terminal negativity (S wave) in aVF, terminal positivity in aVR (R or R’), and no S in lead 1.
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