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
As discussed in Part I of this series, electrocardiography (ECG) has been established as a useful diagnostic tool.[1,2,3] Accuracy in ECG recording, whether from trained experts or other medical professionals, is essential in order to reliably interpret medical information.[4]
The high position of these electrodes causes the R wave amplitude to decrease by approximately 0.1mV in leads V1-V2 along with poor R wave progression across the precordial leads (Figure 2).[16,17,18,19]
Precordial electrode misplacements can lead to morphological changes on ECG that could potentially be interpreted as pathologic
Summary
As discussed in Part I of this series, electrocardiography (ECG) has been established as a useful diagnostic tool.[1,2,3] Accuracy in ECG recording, whether from trained experts or other medical professionals, is essential in order to reliably interpret medical information.[4]. About the Author: Allison Rosen is currently in her third year of medical school at Queen’s University, Kingston, Canada. She is the Editor-in-Chief of the Queen’s Medical Review and an active member of the Class Council. 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. 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
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