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Chest Electrode Placement
A - Angle of Louis
For accurate chest electrode placement and measurement, it is important to locate the fourth
intercostal space.
Locate the second intercostal space by first palpating the Angle of Louis (the little bony
1
protuberance where the body of the sternum joins the manubrium). This rise in the sternum is
where the second rib is attached, and the space just below this is the second intercostal space.
2
Palpate and count down the chest until you locate the fourth intercostal space.
10-Lead Placement
When monitoring 12-leads of ECG, using a 10-Electrode Lead Placement, it is important to correctly
place electrodes and to label all 12-lead ECG reports with the correct lead placement.
6 ECG, Arrhythmia, ST and QT Monitoring
V1 on the fourth intercostal space at the right
sternal border
V2 on the fourth intercostal space at the left
sternal border
V3 midway between the V2 and V4 electrode
positions
V4 on the fifth intercostal space at the left
midclavicular line
V5 on the left anterior axillary line, horizontal
with the V4 electrode position
V6 on the left midaxillary line, horizontal with the
V4 electrode position
V3R -V6R on the right side of the chest in
positions corresponding to those on the left
VE over the xiphoid process
V7 on posterior chest at the left posterior axillary
line in the fifth intercostal space
V7R on posterior chest at the right posterior
axillary line in the fifth intercostal space
V8 posterior lead, level with V7 at the left
midscapular line
V9 posterior lead, level with V7 at the left spinal
border.
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