Abstract

A flatline lead I plus P and T inversions in leads II, III, and aVF in a 31-year-old male patient suggested interchange of the arm and leg electrodes bilaterally. Prompt repetition of the ECG with corrected lead placement resulted in a normal ECG and prevented incorrect diagnosis, workup, and treatment.

© 2008 Elsevier Inc. All rights reserved.

Keywords: Flatline lead I; Bilateral arm-to-leg electrode interchange

Introduction

Bilateral arm-to-leg electrode interchange is a rare occurrence. It results in a predictable and characteristic electrocardiogram (ECG). A literature search on ECG technical errors and lead switches uncovered no published illustration of this phenomenon. ...