![]() ECG Lead Placement on Women: Nuances to Understand For this reason, ECG professionals should consider how physiological differences can affect lead placement as they look to position ECG leads for diagnostic accuracy. While electrode misplacement can and does affect most patients-occurring in more than 50 percent of cases, and often in V1 and V2, according to the papers in Circulation and Cardiology and Cardiovascular Medicine-certain errors linked to sex can drive inequities in cardiovascular medicine and worsen existing disparities. That same review also notes that paramedics could make errors in lead placement due to fears or embarrassment about exposing female patients' breast tissue, emphasizing the underlying dynamics of sex-based differences in cardiac care and their lasting impacts on women's health. ![]() ![]() For instance, according to a review in Cardiology and Cardiovascular Medicine, challenges with lead placement can arise in cases where patients have large breast tissue or are overweight, as ECG professionals may not be able to locate bone landmarks in the chest. While misplacement occurs across both sexes, anatomical differences can complicate correct ECG placement lead placement on women versus men. Positioning problems are both well-documented and common, affecting waveform morphology, the potential for misreading, and the risk of misdiagnosis. 1 Positioning errors can also disrupt stratification and management efforts for patients with known cardiac disease. As a paper in Circulation notes, misplacements can lead to incorrect readings of waveforms, potentially causing false-positive or false-negative diagnoses of conditions such as arrhythmias or myocardial infarction. As with any diagnostic tool, accurate utilization of ECG is critical-and that includes correct ECG lead placement on women and men.
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