Septal leads V1 and V2

ECG leads / veins · V1 V2

Right precordial leads facing the interventricular septum; ST elevation here points to the LAD septal perforators, while ST depression here is the mirror of the posterior wall.

Traced from the start

  1. Left (posterior) aortic sinus and left main stem
  2. Left anterior descending (anterior interventricular) artery
  3. Septal perforating branches of the LAD
  4. Anterior two-thirds of the interventricular septum
  5. Septal leads V1 and V2

Detail

Territory
Anterior septum (LAD)
STEMI threshold
V2 and V3: 2 mm in men over 40, 2.5 mm in men under 40, 1.5 mm in women; 1 mm elsewhere

When it goes wrong

ST elevation in V1 and V2 with new right bundle branch block

Proximal LAD occlusion involving the septum; watch for complete heart block

ST depression in V1 to V3 with tall R waves

Posterior MI, not anterior ischaemia; record V7 to V9

Practise this structure

1 question in the bank tagged Coronary Circulation.