Title: ECG leads misplacement, artefact and other technical errors

Biography:

Richard Lynch is a consultant in Emergency Medicine. He is a self-confessed ECG enthusiast and has a particular interest in ECG lead misplacement. In 2013 he wrote a very popular ECG interpretation book, ECG interpretation: it’s easier when you know how. He is currently working on his second book “ECG lead misplacement, artefact and other technical errors”. He has around 100 numbers of both publications and conference presentations in his account. 

Abstract

The electrocardiogram (ECG) is an essential diagnostic tool in the assessment and management of acutely unwell patients. Lead misplacement rates between 0.4% and 4% have been reported. Bond et al reported that, in the presence of lead misplacement or artefact, there is a 17-24% chance that the ECG diagnosis will be different. Despite this, few ECG textbooks adequately address this topic. When errors occur, it is important that they are recognised and corrected to avoid spurious diagnosis and unnecessary, potentially harmful, treatment. The most commonly encountered ECG lead misplacements, in clinical practice, are demonstrated and clues to their presence are emphasised. Training is required for recognition of lead misplacement; otherwise, the eyes will not see what the mind does not know.