PEPconnect

MR Cardiac Lead Placement (E-line and Numaris X)

This job aid will show how to prep the patient and position the ECG leads for cardiac triggering.

MR Cardiac Lead Placement (E-line and Numaris X) syngo MR Systems with E -line or Numaris X Software 1. Place patient in a supine position on the MRI table (Patient must always be screened prior to entering MRI room) 2. Patient Preparation: A. In cases of hairy chest, shave chest (outside of MRI suite) B. Clean skin surface/area using NuPrep Gel (Do not use alcohol) C. Clean/dry area appropriately Nuprep | Nuprep tij Nuprep !! EiNuprep!! Noprepy 3. Position ECG leads as shown on the picture (see below). If possible, avoid placing leads on top of ribs (in between ribs best placement). A. White lead must be to the right of the sternum (decreases magneto- hydrodynamic effects), avoid placement on top of sternum. Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Job Aid | MR Cardiac Lead Placement (E-line and Numaris X) Effective Date: 07/22/2020 | HOOD05162003086701 B. Use MR Safe ECG leads such as Conmed Cleartrace 2700 CLEARTRACE WRF] 2700-030 Adua tod Electrode 300/2/ Derides Itil per adulti CE Derence is Clear" IVAEDBLUS CONMED C. Position the PERU box/ECG box across the patient’s abdomen, down along the patient left side (ensures near isocenter) i. Always use the grey cushion provided for the PERU box/ECG box 4. After ECG lead placement, confirm accuracy by checking signal and ECG on scanner display A. Each ECG channel (red arrow) has a signal bar (orange circle) which must have at least two bars New Patient registered ECGI ECG EGG ! -6 - . : 1000 HR 58'mh RR-I: 1020ms alll ECG II 00 :1000 ... ECG III i Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 2 of 5 Job Aid | MR Cardiac Lead Placement (E-line and Numaris X) Effective Date: 07/22/2020 | HOOD05162003086701 B. After confirming ECG signal is good, ask the patient not to move (do not move table). The system will do learning phase (“clean ECG signal”) i. Learning Phase runs three consecutive heartbeats. The system will use the Learning Phase as reference pattern (R wave) once the patient is inside the bore/magnetc field ii. The triangles (red) show the proper R wave recognition (R wave should be the highest iii. The image/ECG below shows an example of bad ECG tracing; do not start the exam with a bad ECG trace/signal iv. Here is an example of a complete cardiac cycle one cardiac cycla R Characteristic ECG Waveform: P - atria contract QRS - atria relax & ventricles contract T wave - ventricles relax Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 3 of 5 Job Aid | MR Cardiac Lead Placement (E-line and Numaris X) Effective Date: 07/22/2020 | HOOD05162003086701 5. Always place PERU/ECG Box in charging station when not in use Helpful Hints:  If there is bad signal or tracing of ECG, ensure the electrode are not loose  Do not re-use ECG electrodes. When electrodes are removed throw them away and use new electrodes Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 4 of 5 Job Aid | MR Cardiac Lead Placement (E-line and Numaris X) Effective Date: 07/22/2020 | HOOD05162003086701 Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2020 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 5 of 5