Axis deviation around the vertical axis

V6 then the heart is rotated clockwise. Conversely if the R/S transition occurs at V1 or V2 then the heart is rotated anticlockwise. Axis deviation in the vertical axis is usually not significant, by itself. The main concern is that the changes can mimic other diseases and in particular anterior myocardial infarctions. Examples of clockwise and anticlockwise rotation are shown in (17).