Authors

Affiliations

1. Male-nurse. «Centro de Salud Valle del Golfo». El Hierro (Canary Islands).

Original title

Imágenes electrocardiográficas derivadas de una incorrecta colocación de los electrodos V1-V2.

Abstract

The placement of precordial derivations to perform an electrogram (EKG) requires specific anatomic identification, internationally set in 1938. V1 and V2 precordial electrodes are keys to identify different diagnostic entities.
Our paper was intended to point out how relevant the correct placement of precordial electrodes is and our aim was to identify the electrocardiographic images found when the V1 and V2 electrodes are out of their assigned places.
From November, 2003, to February, 2004, and on the basis of a series of 62 EKGs performed on patients at Centro de Salud “Valle del Golfo”, El Hierro, a descriptive study was carried out. A data recording sheet was designes in order to register changes happening in V1 derivation of the different EKG waves considered key to place V1-V2 in the second intercostal space (2IE). Not only was V1 taken into account for images related to ischemic cardiopathy but also V2.
From all the patients enrolled, 14.5% showed rsr’ morphology in V1. QS complex was present in 1.6%
along with 3 other cases (4.8%) where there was a small outline of initial r. ST-segment rise was present in 6.4% of patients. The 3rd vector became apparent as a notch in the ascending branch of S wave in 13%. In 80% T wave voltage decreased, negativized or presented an increase in the negative voltage. In 79% of cases P wave came into a predominant negative phase or such a phase increased considerably.  In 69% initial r reduced its voltage. The most frequent changes in P, R and T were associated in 53.2% of patients.
Undoubtedly, the correct placement of V1 and V2 electrodes turned out to be fundamental for an adequate EKG assessment. The most frequent changes were those affecting a decrease in the voltage of P, R and T waves, suggesting therefore an incorrect placement of the electrodes.

Key words

electrocardiogram · electrodes · placement.

Bibliographical reference

García Niebla J. Imágenes electrocardiográficas derivadas de una incorrecta colocación de los electrodos V1-V2. Enferm Cardiol 2004; Año XI: (32-33):38-44.

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