Abstract

Background: Electrocardiography is a very useful diagnostic tool. However, errors in placement of ECG leads can create artifacts, mimic pathologies, and hinder proper ECG interpretation. This is the second of a two-part series discussing how to recognize and avoid these errors. Methods: 12-lead ECGs were recorded in a single male healthy subject in his mid 20s. Various precordial lead misplacements were compared to ECG recordings from correct lead placement. Results: Precordial misplacements caused classical changes in ECG patterns. Techniques of differentiating these ECG patterns from true pathological findings were described. Conclusion: As in Part I of this series, recognition and interpretation of common ECG placement errors is critical in providing optimal patient care.

Highlights

  • Electrocardiography (ECG) remains a very useful diagnostic tool in the 21st century.[1]

  • Proper ECG recording is of utmost importance in order to ensure an accurate interpretation of findings.[3]

  • A series of lead reversals were conducted in order to recreate these classic patterns

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Summary

Introduction

Electrocardiography (ECG) remains a very useful diagnostic tool in the 21st century.[1]. Errors in placement of ECG leads can create artifacts, mimic pathologies, and hinder proper ECG interpretation. It is important for members of the health care team to be able to recognize the common patterns resulting from lead placement errors. Six different limb lead reversals were compared to ECG recordings from correct lead placement. Results: Classic ECG patterns were observed when leads were reversed. Methods of discriminating these ECG patterns from true pathologic findings were described. Conclusion: Correct recording and interpretation of ECGs is key to providing optimal patient care. It is crucial to be able to recognize common ECG patterns that are indicative of lead reversals

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