[ECG artefacts after electrode misplacements].
Artefacts due to electrode misplacement occur in 0.4 to 4% of all performed electrocardiograms (ECG). They can lead to the clinically important false diagnosis of myocardial ischemia. Lateral and inferior myocardial ischemia can be mimicked by an electrode exchange between right and left arm and between right arm and left leg, respectively. Misplaced anterior leads suggest damage of the anterior wall. ECG criteria proposed in this review article will help to identify such artefacts. They include abnormal QRS axis (-90 degrees to +180 degrees), positive P-waves in aVR, negative P-waves in I or II, low voltage in lead I, II or III as well as an irregular R-wave progression in V1 to V6.
Thaler
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Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich.
Rudiger
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D016477:Artifacts; D003951:Diagnostic Errors; D004562:Electrocardiography / Q000592:standards; D004566:Electrodes; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis*; D011787:Quality of Health Care