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Monitoring Paced Patients; Optimizing Lead Selection For Paced Patients - Philips IntelliVue MX40 Instructions For Use Manual

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Monitoring Paced Patients

An ECG optimized for monitoring a paced patient should look like this:
Choose a lead as primary or secondary lead that has these characteristics:
the normal QRS complex should be either completely above or below
the baseline and it should not be biphasic. For paced patients, the QRS
complexes should be at least twice the height of pace pulses.
the QRS complex should be tall and narrow
the P-waves and the T-waves should be less than 0.2 mV.

Optimizing Lead Selection for Paced Patients

Some unipolar pacemakers display pace pulses with repolarization tails.
These tails may be counted as QRSs in the event of cardiac arrest or other
arrhythmias.
If you note a visible repolarization tail, choose a lead that decreases the size
of the repolarization tail.
Avoid fusion and pseudofusion beats.
Monitoring Paced Patients
1. Normal Beats
2. Pace Pulses/Beats
1. Repolarization tail
(note width)
1. Fusion
2. Paced
3. Pseudofusion
ECG and Arrhythmia Monitoring
6-11

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