- The limb leads are placed as usual, but the chest leads are a mirror image of the standard 12-lead chest placement.
- The ECG machine cannot recognize that the leads have been reversed. It will still print "V1-V6" next to the tracing. Be sure to cross this out and write the new lead positions on the ECG paper.
The Right-Sided 12-Lead ECG
| Chest Leads | Position |
|---|---|
| V1R | 4th Intercostal space to left of sternum |
| V2R | 4th Intercostal space to right of sternum |
| V3R | Directly between V2R and V4R |
| V4R | 5th Intercostal space at right midclavicular line |
| V5R | Level with V4R at right anterior axillary line |
| V6R | Level with V5R at right midaxillary line |
Clinical Tip: Patients with an acute inferior MI should have right-sided ECGs to assess for possible right ventricular infarction.