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Revision as of 11:18, 23 September 2011

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→‎Special Leads
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''Example'': V1 is close to the right ventricle and the right atrium. Signals in these areas of the heart have the largest signal in this lead. V6 is the closest to the lateral wall of the left ventricle.
''Example'': V1 is close to the right ventricle and the right atrium. Signals in these areas of the heart have the largest signal in this lead. V6 is the closest to the lateral wall of the left ventricle.


==ECG variants==
Besides the standard 12 lead ECG a couple of variants are in use:
*The '''3 channel ECG''' uses 3 or 4 ECG electrodes. Red is on the right, yellow on the left arm, green on the left leg ('sun shines on the grass') and black on the right leg. These basic leads yield enough information for rhythm-monitoring. For determination of ST elevation, these basic leads are inadequate as there is no lead that gives (ST) information about the anterior wall. ST changes registered during 3-4 channel ECG monitoring should prompt acquisition of a 12 lead ECG.
*The '''5 channel ECG''' uses 4 extremitiy leads and 1 precordial lead. This improves ST segment accuracy, but is still inferior to a 12 lead ECG.  <cite>drew</cite><cite>Klootwijk</cite>
*In '''vector electrocardiography''' the movement of electrical acitivity of the P, QRS and T wave is described. Additional X,Y and Z leads are recorded. Vector electrocardiography is rarely used nowadays, but is sometimes useful in a research setting.
*In '''body surface mapping''' several arrays are used to accurately map the cardiac electrical wavefront as it moves over de body surface. With this information the electrical acitivity of the heart can be calculated. This is sometimes used in a research setting.
==Color coding of the ECG leads==
Two systems for ECG lead color coding are used: the AHA (''American Heart Association'') system and the IEC (''International Electrotechnical Commission'') system:
{| class="wikitable" cellpadding="7"
||
| colspan="2" | AHA (''American Heart Association'')
| colspan="2" | IEC (''International Electrotechnical Commission'')
|-
!| Location
!| Inscription
!| Colour
!| Inscription
!| Colour
|-
|-
| | Right Arm
!| RA
| | White
!|R
| | Red
|-
| | Left Arm
!|LA
| | Black
!|L
| | Yellow
|-
| | Right Leg
!|RL
| | Green
!|N
| | Black
|-
| | Left Leg
!|LL
| | Red
!|F
| | Green
|-
| | Chest
!|V1
| | Brown/Red
!|C1
| | White/Red
|-
| | Chest
!|V2
| | Brown/Yellow
!|C2
| | White/Yellow
|-
| | Chest
!|V3
| | Brown/Green
!|C3
| | White/Green
|-
| | Chest
!|V4
| | Brown/Blue
!|C4
| | White/Brown
|-
| | Chest
!|V5
| | Brown/Orange
!|C5
| | White/Black
|-
| | Chest
!|V6
| | Brown/Purple
!|C6
| | White/Violet
|}
==Special Leads==
==Special Leads==
Throughout history extra lead positions have been tried. Most are rarely used in practice, but they can deliver very valuable diagnostic clues in specific cases.
Throughout history extra lead positions have been tried. Most are rarely used in practice, but they can deliver very valuable diagnostic clues in specific cases.
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===Lead positioning to enhance detection of Brugada syndrome===
===Lead positioning to enhance detection of Brugada syndrome===
[[Image:Brugada_lead_placement.png|thumb|Changed lead positions of leads V3 and V5 to increase the sensitiviy to 'catch' a [[Brugada]] pattern on the ECG. ]]
[[Image:Brugada_lead_placement.png|thumb|Changed lead positions of leads V3 and V5 to increase the sensitiviy to 'catch' a [[Brugada]] pattern on the ECG. ]]
===Other lead systems===
Vector cardiography using 15 leads and body surface mapping using multiple electrode-arrays are systems that are mostly used in research settings only.
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