Tuesday, September 1, 2020

12 Lead ECG Placement

 

Hi friends!!!


In our previous blogs, we have discussed about Electrocardiogram. Please check out for the link below.


ELECTROCARDIOGRAM


In today's blog we are going to discuss about ECG leads placement.


The ECG leads placement is a important aspect in the ECG signal acquisition. Even a small change in ECG leads placement can change the signal acquisition results. Therefore it is important for every healthcare professionals to know about ECG leads placement.

 

Let's get into the topic. 


WHY ECG LEADS PLACEMENT IS

IMPORTANT?


The ECG leads placement is used to trace the electrical activity of the heart and also to compare the electrical activity of the heart at different time periods. Improper ECG leads placement results in wrong diagnosis and interpretation which results in the wrong treatment. The improper ECG leads placement of 20 – 25 cm can result in wrong signal acquisition.


WHY SHOULD WE HAVE 12 LEAD ECG?


The 12 lead ECG is used to diagnose the cardiac ischemia and possibility of heart attack (ST Elevation). In 12 lead ECG, 12 leads are calculated based on the usage of 10 electrodes.


12 LEAD ECG PLACEMENT


The 12 leads ECG uses 10 electrode namely V1, V2, V3, V4, V5, V6, RA, LA, LL, RL. The names of these leads are as per the American Heart Association (AHA).


Let us discuss about the 12 lead ECG Placement.


V1: Fourth intercostal space on the right sternum.


V2: Fourth intercostal space at the left sternum.


V3: Placed midway between V2 and V4.


V4: Fifth intercostal space at the midclavicular line.


V5: Placed at the anterior axillary line on the same horizontal level as V4.


V6: Placed at the mid axillary line on the same horizontal level as V4 and V5.

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RA (Right arm): Right arm’s inner wrist.

LA (Left arm): Left arm’s inner wrist.

RL (Right leg): Right leg’s inner ankle.

LL (Left leg): Left leg’s inner ankle.



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NOTE: In case of female patients, place V3 and V6 leads under the left breast.


15 LEAD ECG PLACEMENT


The 15 lead ECG placement is same as 12 lead ECG placement but V4, V5, V6 are placed below the left scapula of the patient on the posterior side. These V4, V5, V6 when placed below the scapula are called as V13, V14, V15. Therefore this type of ECG acquisition is called as 15 lead ECG placement.


WHAT IS VERTICAL PLANE?


In vertical plane, 6 frontal leads are generated using 4 limb electrodes.  These 6 leads are as follows.


The first three leads are Lead I, Lead II and Lead III are bipolar. And the other three leads are Augmented vector right (aVR), Augmented vector left (aVL) and Augmented vector foot (aVF) which are unipolar leads.


Are you wondering how 6 leads are produced using 4 electrodes?


Well, it is based on the principle called Einthoven Triangle. The following diagram explains Einthoven’s Triangle.


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WHAT IS HORIZONTAL PLANE?


In horizontal plane, 6 transverse leads are generated using 6 chest electrodes V1, V2, V3, V4, V5, V6. These six electrodes provide information about heart long the horizontal plane.


5 LEAD ECG PLACEMENT


In 5 lead ECG placement, 4 limb electrodes and 1 chest electrode is used. The 5 lead ECG monitor displays a bipolar leads (I, II, III) and a single unipolar lead based on the placement of chest electrode. It also provide information about ST elevation but with lesser details than 12 lead ECG.


3 LEAD ECG PLACEMENT


The 3 lead ECG placement , three chest electrodes are used on the chest wall at equal distance from the heart. The 3 lead ECG monitors displays a bipolar leads (I, II, III). It monitors heart rhythm but does not provide information about ST elevation.


Now I hope you have acquired some knowledge about ECG leads placement. We will discuss in detail about ECG waveform and interpretation, types of ECG machine in our future blogs.


NOTE: Dear friends!!!... Please do comment a topic related to Biomedical, so that we can discuss it in future blogs.


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