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Electrode contact fluid in electrocardiography
Letter
to the Editor
Electrode
Contact
Fluid in Electrocardiography
Dear Sir: Approximatelv ten years ago attempts were hegun to miniliize or overcome the disadvantages of electrocardiograph paste. This material \vas sticky, unpleasant and adhered alike to patient, clothing, equipment and technician. Since most of the difficulty was apparentl) due to the vehicle rather than its electrolyte content, \,arious liquid formulas were prepared and tested. E\.entuallp, an entirely suitable material was compounded of 2 per cent electrolyte in 50 per cent aqueous propenol with a small quantity of glycerine to inhibit evaporation. In use, the electrodes were moistened with the solution, applied in the normal fashion and retained with rubber straps. The tracings were recorded in the usual manner. At the conclusion of the test the electrodes were removed, drying took place promptly and the patient was able to resume his clothing without washin,? or dcla)-. Electrodes were cleaned b) a brief rinse in tap water. No significant difference was detected between the records obtained with the clcctrodc solution and those made I,)- conventional methods. After a six-month trial period the electrode solution \vas adopted for routine use and has s&sequently been employed for allout 90 per cent of all electrocardiograms. Recently, a commercial fluid electrode material became a\railable. * It is supplied in 4 ounce “squeeze bottles“ which permit con\,enient application and prevent evaporation. It appears quite similar to the solution described and is in use at this hospital. L2:e have tested it during a three-month period and compared it \vith the material presently employed and with conventional electrode paste. During this time some 700 standard 12-lead electrocardiograms were made of which approximately 10 per cent were performed with * E-Graph. Corporatio:1.
manufactured by the Hoyt Newton. Massachusetts.
Pharmaceutical
554
electrode jelly and the remainder wirh the new commercial electrode solution and with the original fluid. Random selection was employed and all tracings were recorded by a single skillful technician. The records were made on four different instruments, two photographic and two “direct writing.” All tracings were read by residents and reviewed by the cardiologist. When serial electrocardiograms were made on the same patient different recording technics were often employed. It was quickly apparent that no qualitati1.c difterences existed between the three materials employed in obtaining electrode-to-skin contact. None of the readers was ever aware of rile method used or of changes in technic. ThC records obtained t)y the various methods wcrc, apparently, identical in form and in magnitude. No difference was greater than what is customarily observed over a period of time with any- single method. It was concluded that liquid clcctrodc solutions of saline in aqueous alcohol pro\idc adequate electrode-to-skin contact for routine electrocardiograph\,. No significant diffcrcncc was dctccted Ijetween tracings recorded wittl the use of conventional jelly, a solution prepared in the hospital pharmacy and the recentl) availallle E-Graph. However, electrode liquids are more convenient to use, cleaner and less objectionable to patients and technicians. Clothing is not soiled and patients need not wash after the test. Electrodes, especially the self-retaining variety, and instruments remain clean and corrosion is minimized. It appears likely that presently availal)lr electrode solutions arc not only adequate replacements for salt-containing electrode paste Init arc superior to them in many respects. DAVID LITTMIANN,M.IJ. Veterans Administration Hospital West Koxl)ur)-, Massachusetts
to the Editor
Electrode
Contact
Fluid in Electrocardiography
Dear Sir: Approximatelv ten years ago attempts were hegun to miniliize or overcome the disadvantages of electrocardiograph paste. This material \vas sticky, unpleasant and adhered alike to patient, clothing, equipment and technician. Since most of the difficulty was apparentl) due to the vehicle rather than its electrolyte content, \,arious liquid formulas were prepared and tested. E\.entuallp, an entirely suitable material was compounded of 2 per cent electrolyte in 50 per cent aqueous propenol with a small quantity of glycerine to inhibit evaporation. In use, the electrodes were moistened with the solution, applied in the normal fashion and retained with rubber straps. The tracings were recorded in the usual manner. At the conclusion of the test the electrodes were removed, drying took place promptly and the patient was able to resume his clothing without washin,? or dcla)-. Electrodes were cleaned b) a brief rinse in tap water. No significant difference was detected between the records obtained with the clcctrodc solution and those made I,)- conventional methods. After a six-month trial period the electrode solution \vas adopted for routine use and has s&sequently been employed for allout 90 per cent of all electrocardiograms. Recently, a commercial fluid electrode material became a\railable. * It is supplied in 4 ounce “squeeze bottles“ which permit con\,enient application and prevent evaporation. It appears quite similar to the solution described and is in use at this hospital. L2:e have tested it during a three-month period and compared it \vith the material presently employed and with conventional electrode paste. During this time some 700 standard 12-lead electrocardiograms were made of which approximately 10 per cent were performed with * E-Graph. Corporatio:1.
manufactured by the Hoyt Newton. Massachusetts.
Pharmaceutical
554
electrode jelly and the remainder wirh the new commercial electrode solution and with the original fluid. Random selection was employed and all tracings were recorded by a single skillful technician. The records were made on four different instruments, two photographic and two “direct writing.” All tracings were read by residents and reviewed by the cardiologist. When serial electrocardiograms were made on the same patient different recording technics were often employed. It was quickly apparent that no qualitati1.c difterences existed between the three materials employed in obtaining electrode-to-skin contact. None of the readers was ever aware of rile method used or of changes in technic. ThC records obtained t)y the various methods wcrc, apparently, identical in form and in magnitude. No difference was greater than what is customarily observed over a period of time with any- single method. It was concluded that liquid clcctrodc solutions of saline in aqueous alcohol pro\idc adequate electrode-to-skin contact for routine electrocardiograph\,. No significant diffcrcncc was dctccted Ijetween tracings recorded wittl the use of conventional jelly, a solution prepared in the hospital pharmacy and the recentl) availallle E-Graph. However, electrode liquids are more convenient to use, cleaner and less objectionable to patients and technicians. Clothing is not soiled and patients need not wash after the test. Electrodes, especially the self-retaining variety, and instruments remain clean and corrosion is minimized. It appears likely that presently availal)lr electrode solutions arc not only adequate replacements for salt-containing electrode paste Init arc superior to them in many respects. DAVID LITTMIANN,M.IJ. Veterans Administration Hospital West Koxl)ur)-, Massachusetts