
06/08/2025
12-Lead Electrocardiogram (ECG) Electrode Placement
🔹 A 12-lead ECG records the heart’s electrical activity from 12 different angles using 10 electrodes placed on the body.
🔹 Accurate electrode placement is essential for correct diagnosis of arrhythmias, myocardial infarction, and other cardiac conditions.
📌 Limb Electrodes Placement (4 Electrodes)
These form the basis for leads I, II, III, aVR, aVL, and aVF:
🔹 Right Arm (RA): On the right wrist or just above it
🔹 Left Arm (LA): On the left wrist or just above it
🔹 Right Leg (RL): On the right ankle or lower leg (ground electrode)
🔹 Left Leg (LL): On the left ankle or lower leg
👉 Note: In emergency or bed-bound patients, place limb leads on the upper arms and thighs instead.
📌 Chest (Precordial) Electrodes Placement (6 Electrodes)
These record the horizontal plane of the heart:
🔹 V1: 4th intercostal space, right sternal border
🔹 V2: 4th intercostal space, left sternal border
🔹 V3: Midway between V2 and V4
🔹 V4: 5th intercostal space, midclavicular line (left side)
🔹 V5: Same horizontal level as V4, at the anterior axillary line
🔹 V6: Same horizontal level as V4 and V5, at the midaxillary line
📌 Step-by-Step Placement Tips
🔹 Ensure skin is clean and dry – shave or clean excess hair if needed
🔹 Apply gel or adhesive pads to ensure good contact
🔹 Confirm accurate intercostal space location by palpating ribs
🔹 Avoid bony areas or large muscles for limb electrodes
📌 Benefits of Proper Electrode Placement
🔹 Accurate detection of myocardial infarctions, ischemia, and arrhythmias
🔹 Prevents false readings or artifact
🔹 Essential for monitoring high-risk cardiac patients
🔹 Ensures repeatable and comparable results over time
📌 Precautions
🔹 Misplaced leads can mimic or hide critical ECG changes
🔹 Avoid placing over wounds or irritated skin
🔹 Always check for symmetry and correct side placement
🔹 Educate patients to stay still and relaxed during the recording