Operator's Manual Part 2

Revision D ApexPro Telemetry System 11-19
2001989-134
ECG Monitoring: ECG Tab Sheet
Monitoring Pacemaker Patients
The Detect Pace option enables/disables the pacemaker detection
program. It must be used whenever the monitored patient has a
pacemaker. Pace detection choices are Pace 1 and Pace 2. You can also
choose to turn pace detection Off. Use the mouse to click on a Detect Pace
selection.
NOTE
The Off option turns pacemaker detection off. It does NOT perform
pacemaker detection. Either the Pace 2 or Pace 1 option MUST be
used with patients who have pacemakers.
There are two pacemaker processing modes, Pace 1 and Pace 2. The Pace
1 and Pace 2 modes use different algorithms for pacemaker artifact
rejection. The clinician must be the judge as to which mode is better for
each patient. The pacemaker detection program defaults off so if you
have a patient with a pacemaker, you will have to turn the program on.
The Pace 2 mode is much more conservative in recognizing paced QRS
morphologies and is recommended for use whenever possible. It is
designed to minimize the possibility of counting pacemaker artifact as
QRS complexes during ASYSTOLE. If the monitor does not adequately
detect paced beats in the Pace 2 mode, then the user may wish to try the
Pace 1 mode.
NOTE
Please observe all cautions as described when choosing the Pace 1
mode of operation.
The Pace 1 mode allows successful detection of the largest variety of
paced QRS morphologies. As a direct consequence, this mode does have a
higher risk of counting pacemaker artifact as QRS complexes during
ASYSTOLE. For this reason, it is imperative that the user keep patients
with pacemakers under close observation. It is also recommended that
the user set the low heart rate limit on the monitor close to the minimum
pacing rate, and that the BRADY arrhythmia alarm level be elevated to a
WARNING or CRISIS level.
When either pace mode is enabled, the software places an artificial spike
on the waveform whenever the pacemaker triggers. When pacemaker
detection is on, it is indicated by a “P” in the patient’s ECG parameter
window.