Common errors in connection and placement of lead in standard electrocardiogram

Tari Najjar Kolahi , Elaheh; Mirza Ali , Mansour; Hosseini , S.Mehran

[Home ] [Archive]

[ فارسی ]

Journal of Gorgan University of Medical Sciences

Main Menu

Home

Journal Information

Editorial Board

Executive Members

Instruction to Authors

Peer Review

Articles Archive

Indexing Databases

Contact Us

Site Facilities

Search in website

Receive site information

Volume 19, Issue 4 (12-2017)

J Gorgan Univ Med Sci 2017, 19(4): 80-85

Back to browse issues page

Common errors in connection and placement of lead in standard electrocardiogram

Elaheh Tari Najjar Kolahi¹

, Mansour Mirza Ali²

, S.Mehran Hosseini ^*

1- General Physician
2- Assistant Professor, Department of Internal Medicine, Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
3- Associate Professor, Department of Physiology, Neuroscience Research Center, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran , hosseini@goums.ac.ir

Abstract: (13653 Views)

Background and Objective: ECG is one of the most common diagnostic procedures. Errors related to incorrect placement of electrodes and/or inaccurate connection of them in their standard anatomical location will cause some changes in the ECG waves. These errors may cause therapeutic or diagnostic mismanagements. This study was done to determine the common errors in connection or placement of leads in standard electrocardiograms.
Methods: This descriptive-analytical study was performed on 315 patients admitted to an educational and therapeutic hospital in Gorgan, Iran during 2014. The recorded variables included the distance between the positions of the V1, V2, V5 and V6 leads from the standard location, the displacement of the left and right electrodes in bipolar limb lead I and the incorrect right and left connectivity of V1 and V2, the admission section, the urgency of ECGs and the patient's gender. The gender of ECG operator, the standard ECG voltage, staff shift, the average number of ECGs taken by the personnel, and the precise bonding of wires were observed. In the precordial leads, the distance of more than 2 centimetres from the standard leads location was considered as error threshold.
Results: The misplacement errors were observed in 149 cases (47.3%). In 20 cases (13.42%) of ECGs, the standard voltage was not observed. The highest number of misplacement errors was observed in the V5 (30.2%). Misplacement errors showed a significant differences (P<0.05) for the patient gender (61.77%), the type of department (emergency department 61.67%), the non-urgent application (68.12%), and the average number of ECGs taken by personnel of 5 or less in each shift (11.67%).
Conclusion: Patient's gender and emergency department are the most important factors in misplacement of precordial leads.

Keywords: Electrocardiogram, Misplacement, Misconnection

Full-Text [PDF 231 kb] [English Abstract] (15654 Downloads) | | Abstract (HTML) (892 Views)

Type of Study: Original Articles | Subject: Cardiovascular

References

1. Finlay DD, Nugent CD, Kellett JG, Donnelly MP, McCullagh PJ, Black ND. Synthesising the 12-lead electrocardiogram: Trends and challenges. Eur J Intern Med. 2007 Dec; 18(8): 566-70. doi:10.1016/j.ejim.2007.04.011

2. Peberdy MA, Ornato JP. Recognition of electrocardiographic lead misplacements. Am J Emerg Med. 1993 Jul; 11(4): 403-5.

3. Lynch R. ECG lead misplacement: A brief review of limb lead misplacement. Afr J Emerg Med. 2014; 4(3): 130-39. https://doi.org/10.1016/j.afjem.2014.05.006

4. Rajaganeshan R, Ludlam CL, Francis DP, Parasramka SV, Sutton R. Accuracy in ECG lead placement among technicians, nurses, general physicians and cardiologists. Int J Clin Pract. 2008 Jan;62(1):65-70. doi:10.1111/j.1742-1241.2007.01390..x

5. Xia H, Garcia GA, Zhao X. Automatic detection of ECG electrode misplacement: a tale of two algorithms. Physiol Meas. 2012 Sep;33(9):1549-61. doi:10.1088/0967-3334/33/9/1549

6. Batchvarov VN, Malik M, Camm AJ. Incorrect electrode cable connection during electrocardiographic recording. Europace. 2007 Nov; 9(11): 1081-90. doi:10.1093/europace/eum198

7. Kania M, Rix H, Fereniec M, Zavala-Fernandez H, Janusek D, Mroczka T, et al. The effect of precordial lead displacement on ECG morphology. Med Biol Eng Comput. 2014; 52(2): 109-19. doi:10.1007/s11517-013-1115-9

8. Harrigan RA, Chan TC, Brady WJ. Electrocardiographic electrode misplacement, misconnection, and artifact. J Emerg Med. 2012 Dec; 43(6): 1038-44. doi:10.1016/j.jemermed. 2012.02.024

9. Herman MV, Ingram DA, Levy JA, Cook JR, Athans RJ. Variability of electrocardiographic precordial lead placement: a method to improve accuracy and reliability. Clin Cardiol. 1991 Jun; 14(6): 469-76.

10. Rudiger A, Hellermann JP, Mukherjee R, Follath F, Turina J. Electrocardiographic artifacts due to electrode misplacement and their frequency in different clinical settings. Am J Emerg Med. 2007 Feb; 25(2): 174-8. doi:10.1016/j.ajem.2006.06.018

11. Thaler T, Tempelmann V, Maggiorini M, Rudiger A. The frequency of electrocardiographic errors due to electrode cable switches: a before and after study. J Electrocardiol. 2010 Nov-Dec; 43(6): 676-81. doi:10.1016/j.jelectrocard.2010.05.007

Send email to the article author

Mendeley

Zotero

RefWorks

Tari Najjar Kolahi E, Mirza Ali M, Hosseini S. Common errors in connection and placement of lead in standard electrocardiogram . J Gorgan Univ Med Sci 2017; 19 (4) :80-85
URL: http://goums.ac.ir/journal/article-1-3208-en.html

Rights and permissions
	This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Volume 19, Issue 4 (12-2017)

Back to browse issues page

Persian site map - English site map - Created in 0.04 seconds with 36 queries by YEKTAWEB 4660