• ✓ If 12-lead ECG is available, continuous ST-segment monitoring should be performed using all 12 leads.

  • ✓ If 12-lead ECG is unavailable, use the most appropriate leads for ST-segment monitoring based on the patient’s needs and risk for ischemia and/or arrhythmias.

    • For patients with ACS and a known “ST fingerprint,” obtained during STEMI or PCI, use the lead(s) that best displays the patient’s “ST fingerprint” when monitoring.

    • If the “ST fingerprint” is not known in ACS use leads III and V3.

    • For patients without definitive ACS, but are suspected of having or being ruled out for ACS, leads III and V5 should be monitored.

    • In noncardiac patients undergoing surgical procedures or admitted to the ICU, lead V5 is valuable for identifying demand-related ischemia, which appears to be more common in this group of patients.

  • ✓...

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