Which ECG lead should be monitored for reocclusion of the RCA after stent placement?

Monitoring for reocclusion of the right coronary artery (RCA) following stent placement is best accomplished using Lead III. This lead is particularly sensitive to changes in the inferior wall of the heart, which is typically supplied by the RCA.

When the RCA becomes occluded or experiences issues after stenting, there may be characteristic changes in the ST segment or T waves seen specifically in Lead III due to its anatomical positioning. Abnormalities in this lead may indicate ischemia or infarction of the inferior portion of the myocardium, which is directly related to RCA perfusion.

In addition, while other leads provide valuable information about the heart's electrical activity, Leads II and V1 have different focal points of electrical activity and may not specifically highlight reocclusion or issues related to the RCA as effectively as Lead III. Monitoring Lead II can give insight into the overall rhythm and any potential atrial issues, but it is not as directly involved in detecting RCA complications. V6 and V1 primarily assess areas of the lateral and anterior walls, respectively, which are not as directly affected by RCA reocclusion. Thus, Lead III is the most suitable choice for these situations.