GE Healthcare 12RL ECG Quick Guide

Additionally, reports state “leads V2, V3, V4 and V6 are
interpolated” to clarify that these leads are not directly
acquired. 12RL reports do not contain interpretations
of rhythm, morphology or classifi cation.

A view of a 12RL report on the monitor screen

As with all patient monitoring, 12RL ECG needs to
be used in conjunction with the patient’s clinical
history, symptoms and other diagnostic tests for
clinical judgement. 12RL ECG is intended for use in
the general adult patient population in a monitoring
environment.

© 2010 General Electric Company – All rights reserved.
GE, GE Monogram, 12RL and 12SL are trademarks of
General Electric Company

General Electric Company reserves the right to make changes
in specifications and features shown herein, or discontinue the
product described at any time without notice or obligation.
Contact your GE representative for the most current information.

GE Healthcare Finland Oy, doing business as GE Healthcare.

CAUTION: U.S. Federal law restricts this device to sale by or on the
order of a licensed medical practitioner.

Consult the monitor User’s Guide for detailed instructions.

About GE Healthcare

GE Healthcare provides transformational medical technologies
and services that are shaping a new age of patient care. Our
broad expertise in medical imaging and information technolo­gies, medical diagnostics, patient monitoring systems, drug
discovery, biopharmaceutical manufacturing technologies,
performance improvement and performance solutions services
help our customers to deliver better care to more people around
the world at a lower cost. In addition, we partner with healthcare
leaders, striving to leverage the global policy change neces­sary to implement a successful shift to sustainable healthcare
systems.

Our “healthymagination” vision for the future invites the world to
join us on our journey as we continuously develop innovations
focused on reducing costs, increasing access and improving
quality and effi ciency around the world.

GE Healthcare

P.O. Box 900, FIN-00031 GE, Finland
Tel. [phone]
Fax [phone]

GE Healthcare

Quick Guide

12RL ECG

Reconstructed 12-lead
ECG Monitoring

What is 12RL technology?

Continuous ECG monitoring requires a balance of
patient comfort, monitoring information and clinician
workload. More electrodes on the patient result in
more information being available to the clinician.
However, this may result in patient comfort and
clinician workload being compromised. The value of
12-lead ECG monitoring, requiring 10 electrodes,
is in its ability to detect arrhythmias and acute
myocardial ischemia.

Placing 10 electrodes on a patient often requires
too much work when compared with the benefi t
and extra maintenance required. Sometimes it can
even be impossible due to treatment the patient has
already received or is due to receive.

™

The 12RL

technology provides 12-lead view,
12-lead ST monitoring and global QT/QTc interval
measurement using a reduced leadset. It means only
six electrodes in standard placement (RA, RL, LA, LL,
V1 and V5) are required.

1

1) Drew, B. J. Celebrating the 100th birthday of the
electrocardiogram: Lessons learned from research in
cardiac monitor. American Journal of Critical Care 11, No. 4
(July 2002)

2) Drew, B. J., et. al. Comparison of a new reduced lead
set ECG with the standard ECG for diagnosing cardiac
arrhythmias and myocardial ischemia. Journal of
Electrocardiology 35, (Supplement 2002)

www.gehealthcare.com

EMEA M1205735/0410

Global version DOC0506506 Rev2

RA

LA

R

V

1

V

RL

LL

C

1

5

N

L

C

F

6 Lead Confi guration AHA 6 Lead Confi guration IEC

Precordial electrodes V2, V3, V4, and V6 are not
needed. Instead, these waveforms are reconstructed
using data derived from the other, directly recorded,
ECG leads. The calculated waveforms are displayed as
dV2, dV3, dV4, and dV6.

When to use 12RL

Using 12RL technology is a lot like using a standard
12-lead ECG. 12RL enables 12-lead ECG monitoring
on patients when a conventional 12-lead ECG is not
practical since some precordial leads may block the
echocardiographic transducer location or be in the
way for defi brillator pads. 12RL provides 12-lead ECG

5

monitoring for a larger patient population.

Since 12RL technology uses the standard electrode
positions, switching from 12RL ECG to conventional
12-lead ECG just requires adding four electrodes.

Where the current standard of care monitoring may
be utilizing fi ve electrodes, adding one more chest

All 12 waveforms on the monitor screen. Leads dV2,
dV3, dV4 and dV6 are not directly measured but

electrode would mean that clinicians could obtain the
benefi ts of 12RL technolology.

reconstructed from the information recorded from the
other ECG leads.

What you need

Accuracy in clinical practice

It has been shown that observations were identical
between 12RL and standard 12-lead ECGs for the
following: tachycardia, bundle branch and fascicular
blocks, left atrial enlargement and the distinction
of ventricular tachycardia from supraventricular
tachycardia with aberrant conduction
study also found 99% agreement for prior anterior MI
and 95-99% agreement for diagnosis of acute MI.

2

. The same

12RL technology requires a six leadwire set and a
corresponding trunk cable in order to obtain the
ECG signal.

Va and Vb must be identifi ed as V1 and V5 in the
monitor and properly placed in V1 and V5 electrode
locations to enable the 12RL functionality. If this is not
the case, the monitor will just show eight leads and
not calculate or show V2, V3, V4 and V6 waveforms.

Why 12RL uses V1 and V5

Lead V1 is one of the best leads for identifi cation of
P-waves, is important for accurate rhythm analysis
and provides critical information in distinguishing:

• ventricular tachycardia (VT) from supraventricular

tachycardia (SVT)

• SVT with aberrancy

1, 2

1, 2

Lead V5 is valuable in detecting MI2 and helps to
provide coverage of the anterior and lateral walls of
the heart.

On the other hand, there are reasons for not using
other precordial leads for 12RL:

• The location for lead V2 conflicts with the preferred

location for an echocardiography transducer

2

• Leads V3 and V4 may obstruct the placement of

defibrillator pads

2

Calculating the other four precordial leads from V1
and V5 can be done with very little error.

2

ECG reports

The clinician can generate a standard 12-Lead ECG
report with measurements calculated by the
GE 12SL

• Ventricular rate

™

ECG analysis program, including:

• PR interval

These results compare favorably with expected
accuracy of standard 12-lead ECG, which means 12RL
is appropriate for detecting cardiac abnormalities in
hospitalized patients.

• QRS duration

• QT/QTc intervals

• Axis