Misplacing V1 and V2 can have clinical consequences

Document Type

Article

Publication Title

The American journal of emergency medicine

Abstract

The precordial electrocardiogram (ECG) leads V1 and V2 are often misplaced. Such misplacement usually involves placing these leads too high on the chest. The resulting ECG may generate erroneous ECG patterns: e.g. incomplete right bundle branch block, anterior T wave inversion, septal Q waves, ST-segment elevation. These features may falsely suggest acute or old cardiac ischemia, pulmonary embolism, or a type-2 Brugada pattern. On rare occasion, conversely, high placement of V1 and V2 may reveal a true type-1 Brugada pattern. The emergency clinician needs to be aware of the possibility of lead misplacement, and should know how to suspect it based on unusual P wave morphology in V1 and V2.

First Page

865

Last Page

870

DOI

10.1016/j.ajem.2018.02.006

Publication Date

5-1-2018

Identifier

29472037 (pubmed); 10.1016/j.ajem.2018.02.006 (doi); S0735-6757(18)30126-8 (pii)

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