Certified EKG Technician (CET) Practice Exam 2025 – Comprehensive Test Prep

In cases of dextrocardia, the heart is positioned on the right side of the thorax instead of the left. This anatomical variation means that the standard placement of EKG leads must be adjusted to accurately capture the electrical activity of the heart.

Lead V1 is typically placed at the right sternal border in the fourth intercostal space for patients with dextrocardia. This placement allows clinicians to obtain a correct representation of the electrical signals originating from the right side of the heart, particularly focusing on the right atrium and right ventricle, which are now oriented toward the right chest.

In contrast, the other placements for lead V1 would not be appropriate for a patient with dextrocardia, as they are based on a standard heart position. For example, the left sternal border would be the placement for a normal heart, and the midclavicular line in the second intercostal space is also not designed for the right-sided heart orientation. The location over the xiphoid process is more aligned with lead placement for abdominal ECG readings rather than the chest lead placement required for a 12-lead EKG.

By positioning lead V1 at the right sternal border in the fourth