A simple measure to control for variations in chest electrodes placement in serial electrocardiogram recordings

Variations in chest electrodes placement in the 12-lead electrocardiogram (ECG) are a major concern in interpretation of serial ECG changes, especially those changes involving V1 and V2 leads. Documentation of chest electrodes placement will help in controlling for these variations by facilitating comparison of electrodes placement between serial ECG recordings. This can be achieved by recording the distance from suprasternal notch (N) to the position of V1-V2 (V), referred to as the NV measurement and is proposed in this brief communication. When performed after placement of the electrodes, the NV measurement does not in any way interfere with the recommended standardized electrode placement procedure. Combining the proposed NV measurement with the numeric measures of V4 and V6 transverse positions using previously proposed procedures is expected to further reduce errors in interpretation of serial ECG recordings.