How to Place ECG Leads For Optimal Cardiac Gating

How to Place ECG Leads for Optimal Cardiac Gating Computed Tomography The use of ECG leads during a prospectively or retrospectively gated Cardiac CTA allows for the real-time acquisition of a patient's cardiac rhythm during the examination. Quality ECG information is critical for the successful reconstruction of diagnostic Cardiac CTA images; therefore, the following guidelines have been established to help optimize an adequate ECG signal. 1. Ensure the patient is lying down on the table with their arms above their head before positioning ECG leads. 2. For male patients, it is highly recommended to shave the area as needed. 3. Clean area where leads will be placed following electrode manufacturer's preparation guidelines. 4. Plug leads into the correct ECG socket (depends on table model): (1) (3) (2) (3) (2) (1) Push button for ECG channel selection (2) ECG socket (3) Respiratory Gating connection 5. Attach the leads to the pad before placing on the patient. SIEMENS siemens.com/healthineers Healthineers Job Aid | How to Place ECG Leads For Optimal Cardiac Gating Effective Date: 8/16/2016 | Quality HOOD05162002539999 6. Making sure the leads are not tangled and the hub is outside of the scan FoV, attach leads to the patient in the following manner:  Black electrode: Left mid-clavicular line, directly below below clavicle  Red electrode: Left mid-clavicular line, at 6th or 7th intercostal space  White electrode: Right mid-clavicualr line, directly below clavicle Green electrode (if present): Right mid-clavicular line, at 6th or 7th intercostal space  Note: Ideally, all pads should be placed above the level of the ribs if possible. 7. Observe ECG trace to ensure a good signal. If the signal is not adequate, adjust leads. Note: If you have to remove a pad, replace it with a new one. Good trace: Heart Rate (bpm) Min: 60 Max: 60 Avg: 60 60 60 60 60 60 60 Signal noise: Heart Rate (bpm) Min: 56 Max: 68 Avg: 61 63 61 60 56 58 58 8. You can cycle through the three ECG channels to change the QRS complex by pressing the ECG channel selection button. While it is possible to obtain an ECG signal with alternative electrode placement, it is strongly recommended that these guidelines be followed for proper functionality of the CT system during Cardiac CTA examinations. Siemens Healthineers Services Page 2 of 4 Job Aid | How to Place ECG Leads For Optimal Cardiac Gating Effective Date: 8/16/2016 | Quality HOOD05162002539999 Additional notes: ECG electrodes are often used hospital wide and are typically intended for long-term use; therefore, it may take up to fifteen minutes for the electrodes to provide maximum conductivity. For best results, use the preparation guidelines provided by the electrode manufacturer. This may involve using a prep strip that is included on the electrode itself or in the electrode packaging. Although alcohol wipes are frequently used to remove oils and lotion from skin prior to placing ECG electrodes, alcohol can dry the skin and even increase resistance between the electrode and skin. More resistance can result in interference in the ECG signal. For best results, use the preparation guidelines provided by the electrode manufacturer. This may involve using a prep strip that is included on the electrode itself or in the electrode packaging. Siemens Healthineers Services Page 3 of 4 Job Aid | How to Place ECG Leads For Optimal Cardiac Gating Effective Date: 8/16/2016 | Quality HOOD05162002539999 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. 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