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How many electrocardiographic leads are required for exercise treadmill tests?

Journal of Electrocardiology, 01 Apr 1987, 20(2):131-137
https://doi.org/10.1016/s0022-0736(87)80102-4 PMID: 3598454 

Abstract 

Forty-four consecutive patients who had perfusion defects on thallium-201 scanning and positive exercise treadmill tests were prospectively studied. Thirty-eight (86%) subjects had diagnostic ST segment changes in lead V5, 37 (84%) in lead V4, and 44 (100%) in either lead V4, V5 or both. Thirty patients had ST segment changes in the inferior leads, 20 in lead aVR, and only four in lead I and/or aVL. All of these latter subjects had diagnostic ST segments in lead V4 and/or V5. It is concluded that: combined electrocardiographic leads V4 and V5 detect the vast majority of ischemic changes during exercise treadmill testing, regardless of the site of perfusion defects detected by thallium-201 scanning; and monitoring the inferior and lateral leads rarely provides more diagnostic information.

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Read article at publisher's site: https://doi.org/10.1016/s0022-0736(87)80102-4

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