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Houghton, Andrew R; Gray, David (2012). Making Sense of the ECG, Third Edition. Hodder Education. p.214. ISBN 978-1-4441-6654-5. In other words, if the output were traced by needles on paper, each row would switch which leads as the paper is pulled under the needle.

Thus, the overall direction of depolarization and repolarization produces positive or negative deflection on each lead's trace. A 12-lead ECG paints a complete picture of the heart's electrical activity by recording information through 12 different perspectives. Think of it as 12 different points of view of an object woven together to create a cohesive story - the ECG interpretation. If it is not a sinus rhythm, then determining the rhythm is necessary before proceeding with further interpretation. Volume Conductor Principles and ECG Rules of Interpretation". CV Physiology . Retrieved 22 October 2019. By using 6 chest electrodes, you get 6 transverse leads that provide information about the heart’s horizontal plane: V1, V2, V3, V4, V5, and V6.

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Unless you're performing a stress ECG test, ask the patient to lie still and quietly until the test is done.

Rivera-Ruiz M, Cajavilca C, Varon J (29 September 1927). "Einthoven's String Galvanometer: The First Electrocardiograph". Texas Heart Institute Journal. 35 (2): 174–78. PMC 2435435. PMID 18612490. Following depolarization of the interventricular septum, the depolarization travels towards the apex of the heart. This is depicted by frames 15–17 and results in a positive deflection on all three limb leads, which creates the R wave. Frames 18–21 then depict the depolarization as it travels throughout both ventricles from the apex of the heart, following the action potential in the Purkinje fibers. This phenomenon creates a negative deflection in all three limb leads, forming the S wave on the ECG. Repolarization of the atria occurs at the same time as the generation of the QRS complex, but it is not detected by the ECG since the tissue mass of the ventricles is so much larger than that of the atria. Ventricular contraction occurs between ventricular depolarization and repolarization. During this time, there is no movement of charge, so no deflection is created on the ECG. This results in the flat ST segment after the S wave. [74] Prabhakararao, Eedara; Dandapat, Samarendra (August 2020). "Myocardial Infarction Severity Stages Classification From ECG Signals Using Attentional Recurrent Neural Network". IEEE Sensors Journal. 20 (15): 8711–8720. Bibcode: 2020ISenJ..20.8711P. doi: 10.1109/JSEN.2020.2984493. ISSN 1558-1748. S2CID 216310175.Segura-Sampedro, Juan José; Parra-López, Loreto; Sampedro-Abascal, Consuelo; Muñoz-Rodríguez, Juan Carlos (2015). "Atrial Flutter EKG can be useful with the proper Electrophysiological Basis". International Journal of Cardiology. 179: 68–69. doi: 10.1016/j.ijcard.2014.10.076. PMID 25464416. Reduce electrical resistance minus the skin redness with 5 to 10 gentle strokes. This will help ensure that the heart's electrical signals are transmitted to the electrodes. Mangalmurti, Sandeep; Seabury, Seth A.; Chandra, Amitabh; Lakdawalla, Darius; Oetgen, William J.; Jena, Anupam B. (2014). "Medical professional liability risk among US cardiologists". American Heart Journal. 167 (5): 690–696. doi: 10.1016/j.ahj.2014.02.007. PMC 4153384. PMID 24766979. Ultimately, an echocardiogram or other anatomical imaging modality is useful in assessing the mechanical function of the heart. [55]