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Discussion

It is
difficult to discuss the significance of these results especially in a clinical
setting. The difficulty lies in the absence of relevant studies which involve
the electrodes being moved up the arm at specific intervals. There are a few
studies which discuss the implications of ECG electrodes being moved onto the
torso. This alteration in position seems to be mainly done in emergencies but
it is also feasible to suggest that this is probably a not in-frequent occurrence
due to lack of staff training (Derek Rowlands, 2014).  One study found that moving the limb leads onto
the torso caused abnormalities on the ECGs of  36% of patients who were deemed previously to
have ‘abnormal’ ECGs (Jowett et al, 2005).  A recent article also concluded that electrodes
placed in a Mason-Likar formation do not produce an ECG which should be used
for general diagnosis’ due to the possibility of Q waves becoming more obscure
in inferior leads and the mild shift to the right on the QRS axis (Francis,
2016).
This recent article supports the findings of a study done in 1992 which showed
a reduced Q wave amplitude in aVF and a rightward axis shift (Pahlm et al,
1992). In contrast to these studies, another study showed that moving the limb
leads onto the torso showed no clinically significant change in healthy adults
(Sheppard, 2011).

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The results
in the present study suggest

 

Limitations

The results
of this experiment are likely to be representative of our group however they
may not be representative of the wider population. The conclusions that can be
drawn from this experiment are limited firstly by the small sample size. Our
group consisted of 5 individuals which is clearly not a large enough group to be
able to confidently predict that these results would be reproducible if a
larger study was done. Secondly in our experiment we did not take steps to make
sure it was totally representative. Four out of five members of the group were
female and four out of five were under 30. We cannot assume that the one male
member of the group will produce the same results as every other male nor can
we assume that the one member of the group over 30 will produce the same
results as the rest of the population of the same age.

Another
major limiting factor is that our study does not include any individuals who
have a (known) cardiac condition. Without doing this experiment on numerous
people including a variety with existing cardiac conditions including
structural and electrical abnormalities. Due to the fact that we did not use
patients who had an underlying condition we must conclude that these results
are unlikely to be clinically relevant. 

 

Conclusion

In
conclusion, the results of this experiment produced a result I had not expected
due to my knowledge of cardiac anatomy and ECG interpretation. Although the
results may not be fully representative of the wider population it is quite
possible that these results are what you would expect from healthy, young
adults. It is likely that If this experiment was repeated with a group of
similar proportions of age, gender and race the results would show a similar
pattern. There were no clinically significant changes seen when we moved the
arm electrodes further up and a similar result is seen in a previous study
although the method was not the same (Sheppard, 2011). 

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