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Cardiology Teaching Package

A Beginners Guide to Normal Heart Function, Sinus Rhythm & Common Cardiac Arrhythmias

ECG Lead Placement

The system of positioning of leads for performing a 12-lead ECG is universal. This helps to ensure that, when a person's ECGs are compared, any changes on the ECG are due to cardiac injury, not a difference in placement of leads, this is extremely important with the increasing use of foreign travel. There are universal standards in place throughout the world.

Interpretation of the findings can vary from doctor to doctor but methods for obtaining the information are the same the world over.

These positions may differ slightly when a patient is on continuous cardiac monitoring. The leads routinely attached to wrists and ankles will be placed on shoulders and lower abdomen so that movement of limbs has minimal effect on the rhythm trace.

These positions may also differ if a patient is shaking (maybe due to Parkinson's Disease or hypothermia) or has muscle tremors. In this situation the leads may be moved onto the thighs and forearms.

Seeing an ECG being performed will look something like the scene below. As you can see, the peripheral leads are correctly placed on wrists and ankles.

Image: Patient undergoning and ECG

Patient undergoing an ECG
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