Which V lead is typically chosen for an ECG admission with atrial fibrillation with rapid ventricular response (AFIB with RVR)?

When monitoring a patient with atrial fibrillation with rapid ventricular response (AFIB with RVR), the choice of lead is crucial for accurately assessing the heart's electrical activity. The V1 lead is positioned at the fourth intercostal space to the right of the sternum, allowing it to capture data from the right side of the heart. This positioning is essential for differentiating between normal and abnormal rhythms, particularly in cases of AFIB where the P wave is typically lost, and understanding the ventricular response is critical.

V1 enables clear visualization of the QRS complexes, which represent ventricular depolarization. In AFIB with RVR, the QRS complexes may be narrow or wide, and the V1 lead can help in discerning these patterns and any potential underlying conduction abnormalities.

While the other leads (V2, V3, V4) also provide important information about the heart's activity, V1’s strategic placement makes it particularly valuable in this scenario to maximize diagnostic accuracy during an episode of AFIB with rapid ventricle response. This is why it is often chosen for initial monitoring in such situations.