12-Lead ECG Placement Guide
What is ECG Lead Placement?
ECG lead placement involves attaching electrodes to the patient’s body to record the heart’s electrical activity, with each lead capturing signals from a specific area.
Correct lead placement can ensure accurate ECG readings and provide insight into a patient’s heart health, such as detecting various heart conditions and previous heart attacks.
A Guide to 12-Lead ECG Placement
12-lead ECG’s include 12 leads obtained with 10 electrodes. These 10 electrodes consists of 4 limb leads (RA, RL, LA, LL) and 6 precordial (chest) leads (V1, V2, V3, V4, V5, and V6). Here is a step-by-step guide on how to correctly place ECG leads:
Preparing the Patient
Before placing the ECG leads, ensure that the patient is adequately prepared. Be sure to:
- Place patient is in a supine position, with arms at their sides
- Shave hair that can interfere with electrodes
- Remove clothes that can interfere with electrodes
- More
Placing the Leads
In a 12-lead ECG, there are 10 electrodes that provide various angles on the heart’s activity. Place the limb leads on the patient’s arms and legs, and place the precordial leads on the patient’s chest. Use the graphic below as a reference. For a 3 and 5-electrode system guide, click here.
Chest Electrodes and Placement
- V1 – 4th intercostal space on the right margin of the sternum
- V2 – 4th intercostal space at the left margin of the sternum
- V3 – Midway between V2 and V4
- V4 – 5th intercostal space, mid-clavicular line
- V5 – 5th intercostal space, anterior axillary line (same level as V4)
- V6 – 5th intercostal space, mid-axillary line (same level as V4 and V5)
Limb Electrodes and Placement
- RA (Right Arm) – Anywhere between the right shoulder and right elbow
- RL (Right Leg) – Anywhere below the right torso and above the right ankle
- LA (Left Arm) – Anywhere between the left shoulder and the left elbow
- LL (Left Leg) – Anywhere below the left torso and above the left ankle
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