The 12 lead ECG
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Phone:617-525-7431
Standard 12-lead ECG recorded with 25 mm/second rate:
Total of 10 electrodes are required to record the standard ECG. One on each wrist and ankle, and 6 across the precordium as follow;
- V1 in 4th inter costal space at right sternal border,
- V2 in 4th inter costal space at left sternal border,
- V3 midway between V2 and V4,
- V4 in 5th inter costal space at left midclavicular line,
- V5 in left anterior axillary line at 5th inter costal space,
- V6 at left midaxillary line at 5th inter costal space.
Ultimately, 12 waveforms are derived from the 10 electrodes for a standard ECG recording. Any variation in electrode placement from that of the standard 12 lead positions will result in altered waveforms.
Although this may not be important nor has little effect on arrhythmia monitoring, it is important in evaluation of ST resolution. All electrocardiograms should obtain from same and proper electrode placements for comparison and monitoring of ST resolution when necessary.
References
1. Drew BJ, Califf RM, Funk M, et al. Practice Standards for ECG Monitoring in Hospital Settings; An AHA Scientific Statement From the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: Endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical Care Nurses. Circulation 2004,110,2721-46
2. Zorkun C, The Effects of Primary Coronary Angioplasty Techniques and Pharmacotherapy on Left Ventricular Function and Myocardial Perfusion, Doctoral Thesis, CM UJ, Krakow, 2006
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
