# US 10,863,943 B2 · Methods and devices for placement of electrocardiogram leads

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- Number: US 10,863,943 B2
- Document ID: US10863943B2
- Status: Granted
- Kind: B2
- Application number: 16/184,030
- Filed: 2018-11-08
- Published: 2019-05-09
- Granted: 2020-12-15
- Earliest claimed: 2017-11-08
- Assignees: Arizona Board of Regents on Behalf of the University of Arizona
- Applicants: Arizona Board of Regents On Behalf of the University of Arizona
- Inventors: Frank I. Marcus; Trina D. Hughes
- Web page: https://patentgrep.com/patent/US10863943B2

## CPC

- A61B 5/684: {Indicating the position of the sensor on the body}
- A61B 5/1072: {measuring distances on the body, e.g. measuring length, height or thickness (A61B5/1076 takes precedence)}
- A61B 5/6823: {Trunk, e.g., chest, back, abdomen, hip}
- A61B 2010/0093: {slide rules}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Methods and devices for identifying the 4th and the 5th intercostal spaces for the purpose of proper placement of ECG precordial leads, regardless of the patient's height and/or weight. By calculating the sternal length, the distance between the sternal notch and the xiphoid process, the locations of the 4th and 5th intercostal spaces can be determined. The present invention also features devices for measuring the length and to indicate to a user the location of the 4th and 5th intercostal spaces based on the measured sternal length. The methods and devices provide a more accurate identification of the 4th and the 5th intercostal spaces resulting in proper ECG lead placement, which then facilitates accurate ECG interpretation.

## Claims

### Claim 1

A sternal measurement device (100) comprising:
a. a ruler base (110) having a first end (111), a second end (112) and a first set of sternal length measurements (118a) disposed along a surface (115) of the ruler base in ascending order from the first end (111) to the second end (112), said sternal length measurements (118a) corresponding to a length of the ruler base (110);
b. a slide base (120) slidably connected to the ruler base (110), the slide base (120) having a first end (121), a second end (122), and a second set of sternal length measurements (118b) disposed along a surface (125) of the slide base, wherein a first sternal length measurement (118b) disposed at the second end (122) of the slide base is a unit of length greater than a last sternal length measurement (118a) disposed on the second end (112) of the ruler base, wherein the second set of sternal length measurements (118b) are in ascending order from the second end (122) to the first end (121) of the slide base; and
c. a set of intercostal length measurements (128) disposed on the surface (125) of the slide base, each intercostal length measurement (128) positioned next to one of the sternal length measurements (118b) such that each sternal length measurement (118b) has a corresponding intercostal length measurement (128);
wherein the sternal measurement device (100) measures a sternal length between a sternal notch and a xiphoid process, wherein the sternal length is the maximum sternal length measurement displayed by the device (100) when the first end (111) of the ruler base is placed at the sternal notch and the second end (122) of the slide base is placed at the xiphoid process, wherein the intercostal length measurement is determined by the maximum sternal length measurement.

### Claim 2 (depends on 1)

The device (100) of claim 1, wherein the intercostal length measurements (128) correspond to a 4th intercostal placement length, the 4th intercostal placement length being a distance from the sternal notch to a 4th intercostal space, wherein the 4th intercostal placement length indicates the location of the 4th intercostal space for placement of an electrode.

### Claim 3 (depends on 2)

The device (100) of claim 2, wherein the intercostal length measurement (128) corresponding to the 4th intercostal placement length is selected from the following table depending on the sternal length measurement.
Sternal length
4th Intercostal length
measurement (cm)
measurement (cm)
15
11.8
16
12.1
17
12.3
18
12.6
19
12.9
20
13.1
21
13.4
22
13.7
23
13.9
24
14.2
25
14.5
26
14.8.

### Claim 4 (depends on 1)

The device (100) of claim 1, wherein the intercostal length measurements (128) correspond to a 5th intercostal placement length, the 5th intercostal placement length being a distance from the sternal notch to a 5th intercostal space, wherein the 5th intercostal placement length indicates the location of the 5th intercostal space for placement of an electrode.

### Claim 5 (depends on 4)

The device (100) of claim 4, wherein the intercostal length measurement (128) corresponding to the 5th intercostal placement length is selected from the following table depending on the sternal length measurement.
Sternal length
5th Intercostal length
measurement (cm)
measurement (cm)
15
13.8
16
14.2
17
14.6
18
14.9
19
15.4
20
15.7
21
16.1
22
16.5
23
16.9
24
17.3
25
17.2
26
18.

### Claim 6 (depends on 1)

The device of claim 1 further comprising flanges (130) disposed on the first end (111) of the ruler base (110) and the second end (122) of the slide base (120).

### Claim 7 (depends on 1)

The device of claim 1 further comprising one or more intercostal length measurements (128) disposed on the surface (115) of the ruler base and positioned adjacent to the sternal length measurements (118a).

### Claim 8 (depends on 1)

The device of claim 1 further comprising a stopper mechanism (116) that stops the first end (121) of the slide base from sliding out of the ruler base, thereby preventing the slide base from completely separating from the ruler base.

### Claim 9 (depends on 1)

The device of claim 1, wherein the ruler base (110) is a tube and the slide base (120) is disposed within the ruler base (110) such that the device is telescoping.

### Claim 10 (depends on 1)

The device of claim 1, wherein the slide base (120) slides underneath the ruler base (110) such that the ruler base (110) overlaps the slide base (120).

### Claim 11 (depends on 1)

The device of claim 1, wherein the sternal length measurements and intercostal length measurements are in centimeters.

### Claim 12 (depends on 1)

A method of identifying a 4th intercostal space in a subject, comprising:
a. providing a sternal measurement device (100) according to claim 1;
b. placing the first end (111) of the ruler base at a sternal notch of the subject and the second end (122) of the slide base at a xiphoid process of the subject;
c. viewing the maximum sternal length measurement displayed by the device (100), wherein the maximum sternal length measurement corresponds to a sternal length of the subject;
d. viewing an intercostal length measurement (128) corresponding to the maximum length measurement, wherein the intercostal length measurement is a 4th intercostal placement length, which is a distance from the sternal notch to the 4th intercostal space; and
e. measuring the 4th intercostal placement length from the sternal notch to identify the location of the 4th intercostal space in the subject.

### Claim 13 (depends on 12)

The method of claim 12, wherein the maximum sternal length measurement is either the last sternal length measurement (118a) at the second end (112) of the ruler base or the sternal length measurement (118b) on the slide base (120) that is closest to the second end (112) of the ruler base.

### Claim 14 (depends on 1)

A method of identifying a 5th intercostal space in a subject, comprising:
a. providing a sternal measurement device (100) according to claim 1;
b. placing the first end (111) of the ruler base at a sternal notch of the subject and the second end (122) of the slide base at a xiphoid process of the subject;
c. viewing the maximum sternal length measurement displayed by the device (100), wherein the maximum sternal length measurement corresponds to a sternal length of the subject;
d. viewing an intercostal length measurement (128) adjacent to the corresponding maximum length measurement, wherein the intercostal length measurement is a 5th intercostal placement length, which is a distance from the sternal notch to the 5th intercostal space; and
e. measuring the 5th intercostal placement length from the sternal notch to identify the location of the 5th intercostal space in the subject.

### Claim 15 (depends on 14)

The method of claim 14, wherein the maximum sternal length measurement is either the last sternal length measurement (118a) at the second end (112) of the ruler base or the sternal length measurement (118b) on the slide base (120) that is closest to the second end (112) of the ruler base.

### Claim 16 (depends on 1)

A method of correctly placing ECG leads on a subject, said method comprising:
a. providing a sternal measurement device (100) according to claim 1;
b. measuring a length of a sternum of the subject using the sternal measurement device (100) by placing the first end (111) of the ruler base at a sternal notch of the subject and the second end (122) of the slide base at a xiphoid process of the subject;
c. determining an intercostal length measurement (128) corresponding to the sternal length measurement, wherein the intercostal length measurement (128) is a 4th intercostal placement length, which is a distance from a sternal notch to a 4th intercostal space of the subject;
d. measuring the 4th intercostal placement length from the sternal notch to identify the location of the 4th intercostal space in the subject; and
e. placing a V1 lead at the 4th intercostal space right of the sternum, and placing a V2 lead at the 4th intercostal space left of the sternum.

### Claim 17 (depends on 16)

The method of claim 16 further comprising:
a. determining a second intercostal length measurement (128) corresponding to the sternal length measurement, wherein the second intercostal length measurement (128) is a 5th intercostal placement length, which is a distance from a sternal notch to a 5th intercostal space of the subject;
b. measuring the 5th intercostal placement length from the sternal notch to identify the location of the 5th intercostal space in the subject; and
c. placing a V4 lead at the 5th intercostal space at a left midclavicular line.

### Claim 18 (depends on 17)

The method of claim 17 further comprising:
a. placing a V3 lead midway between the V2 and V4 leads;
b. placing a V5 lead at a left mid axillary line horizontal with the V4 lead; and
c. placing a V6 lead at a left anterior axillary line horizontal with the V4 lead.

### Claim 19 (depends on 17)

The method of claim 17, wherein the 4th intercostal placement length is selected from the following table depending on the sternal length measurement:
Sternal length
4th Intercostal length
measurement (cm)
measurement (cm)
15
11.8
16
12.1
17
12.3
18
12.6
19
12.9
20
13.1
21
13.4
22
13.7
23
13.9
24
14.2
25
14.5
26
14.8.

### Claim 20 (depends on 17)

The method of claim 17, wherein the 5th intercostal placement length is selected from the following table depending on the sternal length measurement:
Sternal length
5th Intercostal length
measurement (cm)
measurement (cm)
15
13.8
16
14.2
17
14.6
18
14.9
19
15.4
20
15.7
21
16.1
22
16.5
23
16.9
24
17.3
25
17.2
26
18.