What Is an Electrocardiogram?

By jolene

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6. Technique

Once consent has been obtained from the patient, the ECG leads can be placed as previously explained. The limb leads (RA, LA, RL, and LL) are recommended to be placed distal to the shoulders and hips (but is not required to be as distal as ankles and wrists). The chest leads (V1 to V6) should be carefully placed to be as precise as possible. Placement of the chest leads can be difficult for women with large breasts. In this case, the electrodes should be placed under (instead of overlying) the breast. Accurate lead placement is crucial as improper placement can give the appearance of disease when there is none. Specialized leads such as leads V7, V8, and V9 can be placed to demonstrate a posterior heart attack. Other specialized leads include a Lewis lead, esophageal lead, and more.