MR Cardiac Lead Placement B-Line 1. Electrodes • Positioning of the electrodes varies according to the position of the heart • • • • • 2. Ensure satisfactory contact between the electrodes and the patient’s skin. Thoroughly clean the patient's skin with a dry cloth or NUPREP ECG & EEG Abrasive Skin Prepping Gel If necessary, shave the location where you want to attach the electrodes. Dry the skin carefully Electrodes should be MRI-Safe like Conmed 2700 Cleartrace electrodes and not expired Check The Signal Check the signal via the display on the magnet bore To ensure reliable triggering, a minimum of three stars should be shown at least on the I channel o The other AVF channel should show a minimum of two stars • • Page 1 of 2 • If one of the leads does not provide a sufficient signal, change to a single ECG triggering mode in the Physiological Display dialog window o Electrodes may also need to be repositioned or replaced to obtain better signal • Learning Phase is a brief period of time before the table is moved into the bore, during which the patterns of the ECG signals are learned and saved o Learning Phase consists of 10 heartbeats that should be acquired at Home Table Position o After acquiring the Learning Phase with the patient laying perfectly still, drive the table at least 30 cm beyond the Home position in order to complete and save the Learning Phase 3. Physiologic ECG & Respiratory Unit (PERU) • Position the PERU in the appropriate support or add absorbent material between the ECG cables, PERU and skin • If the red LED Electrode fault on the PERU flashes, the ECG electrodes are not attached correctly o Check to ensure that the electrodes are well attached o Optional: To help ensure stable skin contact, place a short strip of medical tape over each electrode 4. Physiological Display • The Physiological Display dialog window is a window on the GSP • Each signal track displays one of the physiological signals as a continuous curve, i.e., the ECG I signal, ECG aVF signal, the pulse signal, the respiratory signal, and the external signal • The trigger information delivered by the PERU is shown as triangles above the signal curve o Large triangle: Channel is used for triggering o Small triangle: Channel is not used for triggering • If you can see good ECG waveforms but there are no trigger pulses: o Try using a different triggering algorithm or try using the RELEARN VCG function with the patient at isocenter and triggering mode set to VCG Advanced Page 2 of 2