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ECG | EKG | Chest Leads | Cardiology | Dr Najeeb

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E.C.G: Mastering Chest Leads (Precordial leads)

00:00:00 Start
00:00:15 Definition Of Chest Leads
00:01:10 Visual Representation
00:06:50 Unipolar Leads
00:07:40 Placement
00:08:50 Wilson Central Terminal
00:10:35 Central Potential
00:14:47 Functions Of Chest Leads
00:19:00 Potential Determine By Chest Leads
00:22:31 Placement Of Chest Leads
00:25:33 Bony Landmarks
00:30:22 Placement Of V1 And V2
00:32:56 Placement Of V4
00:33:23 Position Of V3
00:34:40 Position Of V5
00:35:23 Position Of V6
00:36:35 Preference Of Bony Landmarks Over Nipples Position
00:39:30 Artefacts
00:42:45 Classification Of Chest Leads
00:52:33 Mi And Chest Leads
00:58:22 Orientation Of Chest Leads

The electrical activity of the heart can be observed from the horizontal plane and the frontal plane. The ability of a lead to detect vectors in a certain plane depends on how the lead is angled in relation to the plane, which in turn depends on the placement of the exploring lead and the reference point.

For pedagogical purposes, consider a lead with one electrode placed on the head and the other electrode placed on the left foot. The angle of this lead would be vertical, from the head to the foot. This lead is angled in the frontal plane and it will primarily detect vectors traveling in that plane. Refer to Figure 17 panel A. Now consider a lead with an electrode placed on the sternum and the other electrode placed on the back (on the same level). This lead will be angled from the back to the anterior chest wall, which is the horizontal plane. This lead will primarily record vectors traveling in that plane. A schematic illustration is provided in Figure 15. Refer to Figure 17 panel B.

The limb leads, of which there are six (I, II, III, aVF, aVR and aVL), have the exploring electrode and the reference point placed in the frontal plane. These leads are therefore excellent for detecting vectors traveling in the frontal plane. The chest (precordial) leads (V1, V2, V3, V4, V5 and V6) have the exploring electrodes located anteriorly on the chest wall and the reference point located inside the chest. Hence, the chest leads are excellent for detecting vectors traveling in the horizontal plane.

As noted previously only three leads, namely leads I, II and III (which are actually Willem Einthoven’s original leads) are derived by using only two electrodes. The remaining nine leads use a reference which is composed of the average of either two or three electrodes. This will be clarified shortly.


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