Diagnostic ECG Lead Placement

This is an educational poster aimed at reviewing the various ECG lead placement techniques. Furthermore, the poster also covers the steps that must be followed to minimize electrode connection problems and obtain optimal readings.

The poster can be downloaded at the end of the page

Stress

Modified Mason-Likar Electrode Placement

CL Lead Placement

ML Lead Placement

Holter

Two Channel, 5 Electrode Lead Placement

Three Channel, 7 Electrode Lead Placement

Modified aVF Leads

Modified Z Leads

Resting

Traditional 12 Electrode Placement

Traditional 15 Electrode Placement

Hi-Res/Vector

Frank X, Y, and Z Placements

Skin Preparation

Determine electrode placement according to one of the configurations shown on this poster. Use the following procedure to ensure good quality ECG data:

To minimize electrode problems, be sure to use the proper type of electrode. Check the expiration date on any pregelled electrode before using it. Also, check for dry cell pads on any pregelled electrodes that have been left out of their foil package.
Shave hair from the electrode site. This improves conductivity, helps hold the electrode to the skin, and makes removal of the electrode easier.
Rub each electrode site thoroughly with alcohol. This removes oil from the skin.
Mark each electrode with a felt-tip pen. This provides an easy way to determine when the epidermis has been sufficiently abraded.
Use an abrasive pad to remove the epidermal skin layer at each electrode site. The epidermal skin layer has been removed when the mark left from the felt-tip pen has been erased.
Place an electrode on each prepared site.

CAUTION:

Make sure that the electrode’s conducting elements do not contact with each other or other metal parts.
Make sure that the device is not subject to disturbances from the electrical mains.
Use only the specified electrodes for safety. Any other electrode may not give the proper recording and may cause problems with the patient.