03/08/2025
A 12-lead ECG is a non-invasive diagnostic tool that records the electrical activity of the heart from 12 different perspectives. It is essential in diagnosing heart rhythm abnormalities, myocardial infarction (heart attack), conduction disorders, and other cardiac conditions.
Purpose/Uses
– Detect arrhythmias (e.g., atrial fibrillation, bradycardia, tachycardia)
– Diagnose myocardial infarction (MI)
– Monitor effects of cardiac drugs or electrolytes (e.g., potassium)
– Assess heart chamber enlargement
– Identify ischemia or previous heart damage
– Pre-operative cardiac evaluation
– Continuous monitoring in critical care
Lead Placement
Limb Leads (4 electrodes, 6 leads)
– RA (Right Arm) – near the right shoulder
– LA (Left Arm) – near the left shoulder
– RL (Right Leg) – grounding lead
– LL (Left Leg) – on the lower abdomen or leg
Limb Leads Generated:
– I (LA-RA)
– II (LL-RA)
– III (LL-LA)
– aVR, aVL, aVF (augmented leads)
Chest Leads (Precordial Leads – 6 electrodes)
– V1 – 4th intercostal space, right of sternum
– V2 – 4th intercostal space, left of sternum
– V3 – midway between V2 and V4
– V4 – 5th intercostal space, midclavicular line
– V5 – anterior axillary line, same level as V4
– V6 – midaxillary line, same level as V4 and V5
Interpretation Overview
Heart Rate and Rhythm
– Is it regular or irregular?
– Normal HR: 60–100 bpm
– Bradycardia: 100 bpm
P Wave Analysis
– Presence, shape, and consistency (indicates atrial activity)
PR Interval
– Normal: 0.12–0.20 sec
– Longer = heart block
– Shorter = pre-excitation
QRS Complex
– Normal: