Common ECG Lead Placement Errors. Part I: Limb lead Reversals

• Main Authors: Allison V. Rosen (Author), Sahil Koppikar (Author), Catherine Shaw (Author), Adrian Baranchuk (Author)
• Format: Book
• Published: University Library System, University of Pittsburgh, 2014-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2076-6327; 10.5195/ijms.2014.95
• Keywords: cardiology,; electrocardiography; medical errors; limb lead reversal; medical education; Medicine (General); R5-920; Public aspects of medicine; RA1-1270
• Source: International Journal of Medical Students, Vol 2, Iss 3, Pp 92-98 (2014)

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.