Chapter 13 12-Lead ECG Interpretive Analysis
13-6
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Place the precordial electrodes across the chest in the following locations:
Locating the V1/C1 position (fourth intercostal space) is critically important because it is the
reference point for locating the placement of the remaining V-leads. To locate the V1/C1
position:
1. Place your finger on top of the jugular notch (see figure below).
2.
Move your finger slowly downward about 1.5 inches (3.8 centimeters) until you feel a slight
horizontal ridge or elevation. This is the “Angle of Louis,” where the manubrium joins the
body of the sternum.
3.
Locate the second intercostal space on the patient’s right side, lateral to and just below the
“Angle of Louis.”
4.
Move your finger down two more intercostal spaces to the fourth intercostal space which is
the V1 position.
Note:
When placing electrodes on female patients, always place leads V3-V6 under the
breast rather than on the breast.
Electrode
Placement
V1/C1
Fourth intercostal space, at the patient’s right sternal margin.
V2/C2
Fourth intercostal space, at the patient’s left sternal margin.
V3/C3
Midway between V2/C2 and V4/C4.
V4/C4
Fifth intercostal space, on the patient’s midclavicular line.
V5/C5
Patient’s left anterior axillary line, at the horizontal level of V4.
V6/C6
Patient’s left midaxillary line, at the same horizontal level as V4 and V5.
Jugular Notch
Angle of Louis