This article describes the implementation of a simplified system that allows continuous 12-lead ECG monitoring from chest electrodes placed in clinically convenient locations.

The 12-lead electrocardiogram (ECG) is the diagnostic reference standard for evaluating cardiac rhythm and myocardial ischemia. The traditional 12-lead ECG system requires 10 electrodes that are strategically placed on the chest and the extremities (Figure 1). This lead configuration, however, is not practical for ambulatory patients in the telemetry setting. Subsequently, over the years, we have used a tool that captures limited and partial ECG data with just 1 or 2 views of the heart. This tool consists of a portable monitor (commonly referred to as a telemetry box), and 3 or 5 leads (depending on the type of telemetry that the institution has installed). Typically, 4 leads are attached to the patient’s torso (modified extremity leads), and the last lead acts as the precordial or...

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