Using TMC's IECP Device ?Information you may want to know

ECG Electrode placement in ECP

During the IECP therapy patient preparation plays a very important role, preparing the patient by properly securing the cuffs and proper placement of ECG electrodes ensures a good and trouble free IECP therapy. In this section we would discuss about the proper placement of ECG electrodes for an effective IECP treatment.

Selecting the electrodes

Pre-gelled silver/silver chloride electrodes are recommended. Using electrodes of dissimilar metals can prevent obtaining a good ECG trace required for 'IECP' Increased External Counter Pulsation therapy.

Choose Proper electrode site on the patient

Increase muscle artefact due to patient movement greatly affects the IECP monitoring. Place Electrodes in flat areas; avoid fatty or bony areas and avoid major muscles.

Prepare electrode site

  • Shave hair (If any) from the electrode sites.
  • The ECG cable and electrodes should be checked for damage on a regular basis and replaced as necessary.
  • In areas where electrodes will be attached, thoroughly clean skin and lightly rub dry. You may use isopropyl alcohol or special skin preparation pads.
  • To avoid allergic reactions to electrodes, refer to the electrode manufacturer's directions.
  • Attach lead wires to electrodes first, prior to placing the electrodes on the patient.
  • Apply the electrodes to the patient in standard 5 lead configuration also mentioned below.
  • To minimize the motion artifact, make a small stress loop in each lead wire and tape the loop to the patient's skin.

Suggested lead placement

  • Lead preparation and placement should be carefully verified.
  • RA Place near right mid-clavicular line directly below the clavicle
  • LA Place near left mid-clavicular line directly below the clavicle
  • RL Place near 7th intercostal space in line with or lateral to the midpoint of right clavicle
  • LL Place near 7th intercostal space in line with or lateral to the midpoint of left clavicle
  • C Place in the intercostal space equivalent to V1, V2, V3, V4, V5 or V6

Monitoring Instructions

  • Avoid overlapping lead wires in their routing, don't coil or bundle them. Be sure lead wires are tightly secured and not let loose or hanging.
  • If the QRS complex is not twice the amplitude (height) of the P and T waves, a different monitoring lead should be selected for monitoring in the ECG 1 channel. Tall P and T waves may be incorrectly classified as a QRS complex, and/or may generate high heart rate or other alarm condition.

Buy it from TMC

External Counterpulsation (ECP) an effective form of treatment for angina is still finding itself on a back stage and this effective procedure is still to fall into the mainstream of cardiology practice.

For long interventional cardiologists have been avoiding this safe, non-invasive treatment like a plague, but changes in approach to this procedure are lately being noticed.

For more than a decade since ECP was taken up as a treatment method for life threatening disabilities due to CAD, CHF, and stable angina the world over, its effectiveness in treating these cardio-diseases is beyond doubt a success and is well documented in the text book of cardiology and various cardiology journals.

Years ago a randomised trial with ECP, published in the Journal of the American College of Cardiology (1999), showed that ECP significantly improved both the symptoms of angina and exercise tolerance in patients with coronary artery disease. ECP also significantly improved "quality of life" measures, as compared to placebo therapy.

In one of the issue of Cardiology, investigators report that ECP works even better in patients who have not yet had invasive treatment for angina. Among patients participating in the International ECP Patient Registry who received ECP as first-line therapy (instead of receiving it only after other treatments failed,) 89% experienced an immediate improvement in angina, and 84% reported that the improvement persisted at 6 months.

This compares to a 79% improvement rate with ECP among patients who had already received invasive treatments.

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