PMID: 11320465Apr 26, 2001Paper

Use of the sinus P wave in diagnosing electrocardiographic limb lead misplacement not involving the right leg (ground) lead

Journal of Electrocardiology
K K Ho, S K Ho

Abstract

No general approach has been established for the diagnoses of the various types of electrocardiograms of limb lead misplacement not involving the right leg (ground) lead. We have developed a 3-step algorithm for such differential diagnosis that can be applied without having to rely on the comparison with a reference electrocardiogram. It is based on the observation that the frontal plane sinus P vector loop is almost invariably inscribed counterclockwise. The 5 types of electrocardiograms of limb lead misplacement can be differentiated according to the P wave axis, the location of the lead aVR in the electrocardiogram, and specifically any apparent reversal of the direction of inscription of the frontal plane P vector loop due to lead misplacement. Characteristic limb lead P wave patterns provide 6 signs capable of inferring from the electrocardiogram alone the direction of inscription about 94% of the time. P wave axis itself is diagnostic in an additional 4%.

Citations

May 20, 2004·British Journal of Nursing : BJN·Ehsan Khan
Apr 12, 2006·Pacing and Clinical Electrophysiology : PACE·Reginald T HoG Thomas Evans
Oct 7, 2009·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Javier García-NieblaAntonio Bayés de Luna
Jan 7, 2011·Journal of Clinical Pharmacology·Vaibhav SalviDhiraj Narula
Aug 21, 2012·Physiological Measurement·Henian XiaXiaopeng Zhao
May 25, 2013·Journal of Medical Engineering & Technology·H NaseriH Pourkhajeh
Jul 4, 2019·Sensors·Vessela KrastevaRamun Schmid
May 14, 2003·Journal of Cardiovascular Electrophysiology·Jeffrey Green, Eugen Palma
Dec 5, 2002·Angiology·Mumtaz A Siddiqui, Ijaz A Khan

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