Precordial electrode placement in women

Precordial ECG electrode positioning was standardised in the early 1940s. However, it has been customary for the V₃ to V₆ electrodes to be placed under the left breast in women rather than in the correct anatomical positions relating to the 4th and 5th interspaces. For this reason, a comparison between the two approaches to chest electrode positioning in women was undertaken.

In total 84 women were recruited and ECGs recorded with electrodes in the correct anatomical position and also in the more commonly used positions under the breast. As a separate study, 299 healthy women were recruited to study normal limits of leads V₃ to V₆ recorded with electrodes in the correct anatomical positions and compare them with published normal limits with electrodes in the more commonly used locations.

It was shown that there was less variability with electrodes in the correct anatomical positions and that there were significant differences between the new limits of normality compared with the old established limits.

Expansion of the database and further analysis of the data is required to make a definitive recommendation with respect to precordial electrode placement in women.