An Electrode Montage for Electrocardiographic Monitoring

An electrocardiographic electrode montage is described using electrodes mounted on the manubrium sterni (RA), xiphisternum (LA) and V5 position (LL). The lead II setting on the monitor, equivalent to CM5, offers optimal ischaemia detection, while lead I, now a vertical lead, manubrium to xiphisternum, results in maximal P wave amplitude. The montage has been evaluated in sixty-two intensive care patients with electrocardiographic abnormalities and has been used extensively in intensive care, the operating theatres and in shock wave lithotripsy. The ‘Prince Henry’ montage offers advantages over the standard bipolar leads in P wave amplitude, arrhythmia diagnosis and artefact rejection.