Right Sided ECG (EKG) Lead Placement

Right sided ECG or electrocardiogram (as opposed to the standard left-sided ECG) are used when a right ventricular infarct or MI is suspected.

They are considered the single most accurate rapid assessment tool in determining is a right ventricular heart attack has occurred and are 90% sensitive and specific for this condition.

Because right-sided ECG’s are not as frequently used as the standard, left-sided ECG there is often confusion about where the chest leads are placed. The key fact to remember is that the positions of V1 and V2 are the same for both left and right-sided ECG’s.

In right sided ECG leads V3-V6 are placed along the right anterior chest wall in a mirror position as the V3-V6 leads in a normal left-sided ECG.

right sided ecg

Right-sided ECG lead placement

V1 for both right and left-sided ECG’s is placed to right fifth intercostal space at the sternal junction and in both ECG’s V2 is placed to the left of the sternum at the fifth sternocostal margin.


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1 Comments to “Right Sided ECG (EKG) Lead Placement”

  1. J. Sese, RN says:

    I’m just trying to get a consensus on the right placements for the right-sided EKG leads. The oldest version is that of the “mirror image’ with all the leads switched to the right side, including V1 and V2.
    Yours is to switch V3-V6.
    The one we use in our ED is based on this- (http://ehced.org/wp-content/site/tutorials/other-ekg-leads.pdf) which just moves V3 and V4.
    Is there any huge discrepancy if any way is used?

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