Aa mentioned earlier, the chest leads are sometimes referred to as semi-direct leads because of their proximity to the heart. The outflow tract of the right ventricle lies just beneath the sternum, quite close to the anterior chest leads, and is one of the last regions to be depolarized. As a result, the anterior and right sided chest leads, particularly V1, may reveal a deflection at the end of the QRS complex which reflects this depolarization. This phenomenon is shown here. The outflow tract component is indicated by the red arrows. This simulates the R' present in incomplete right bunle branch block and is a normal variant. The ECG shown on the next page also illustrates this phenomenon.