Common ECG Lead Placement Errors. Part II: Precordial Misplacements


  • Allison V. Rosen Queen’s University School of Medicine, Kingston, Ontario, Canada
  • Sahil Koppikar Department of Internal Medicine, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada.
  • Catherine Shaw Heart Rhythm Service, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada
  • Adrian Baranchuk Heart Rhythm Service, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada.



Cardiology, Electrocardiography, Medical Errors, Precordial Lead Placement, Medical Education


Background: Electrocardiography is a very useful diagnostic tool. However, errors in placement of ECG leads can create artifacts, mimic pathologies, and hinder proper ECG interpretation. This is the second of a two-part series discussing how to recognize and avoid these errors.

Methods: 12-lead ECGs were recorded in a single male healthy subject in his mid 20s. Various precordial lead misplacements were compared to ECG recordings from correct lead placement.

Results: Precordial misplacements caused classical changes in ECG patterns. Techniques of differentiating these ECG patterns from true pathological findings were described.

Conclusion: As in Part I of this series, recognition and interpretation of common ECG placement errors is critical in providing optimal patient care.


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Author Biography

Allison V. Rosen, Queen’s University School of Medicine, Kingston, Ontario, Canada

Allison Rosen is currently in her third year of medical school at Queen’s

University, Kingston, Canada. She is the Editor-in-Chief of the Queen’s Medical Review

and an active member of the Class Council.


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How to Cite

V. Rosen, A., Koppikar, S., Shaw, C., & Baranchuk, A. (2014). Common ECG Lead Placement Errors. Part II: Precordial Misplacements. International Journal of Medical Students, 2(3), 99–103.

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