Pacemaker Precautions - Dräger Infinity Acute Care System M540 Instructions For Use Manual

When pacer detection is deactivated, the message
,
Pacer off appears in the top ECG channel.
To optimize pacer monitoring, follow the guidelines
on page 147.

Pacemaker precautions

The M540 has been tested for pacemaker pulse de-
tection. However, it is impossible to anticipate every
clinically possible waveform characteristic. For
paced patient, the M540 could therefore miscount
heart rates and misinterpret rate-dependent ar-
rhythmias. False low-rate alarms can result under
the following conditions:
– Fused beats and asynchronous pacemakers,
when coupling intervals are in the range of
+10 s to –90 ms
– 700 mV pacemaker pulses followed by QRS
complexes smaller than 0.5 mV
– Asynchronous pacemaker pulses with over-
shoot
WARNING
Make sure pacer detection is deactivated for
patients without pacemakers. Make sure it is
activated for patients with pacemakers. Deac-
tivating pacemaker detection for paced pa-
tients may result in pacemaker pulses being
counted as regular QRS complexes, which
could prevent an asystole alarm from being
detected. Always verify that the pacer detec-
tion status is correct for the patient. Be aware
that setting the ECG filter option to ESU deac-
tivates pacemaker detection automatically.
Instructions for use Infinity Acute Care System – Infinity M540 SW VG4.n
ECG, arrhythmia, and ST segment
To turn pacer detection on/off
1 Touch the heart rate parameter box to select the
ECG dialog window directly.
2 Touch the Settings tab > ECG 2 tab.
3 Touch Pacer detection until it toggles to On or
Fusion (see page 242).
4 Touch X to close the dialog window.
WARNING
Interference from a monitor may cause some
rate-adaptive implantable pacemakers to pace
at unnecessarily high rates. Be extra vigilant
with patients when using these types of pace-
makers.
WARNING
Always keep pacemaker patients under close
surveillance and monitor their vital signs care-
fully.
– Do not assess the patient's condition ex-
clusively from the heart and respiratory
rate values the monitor displays and the
rate alarms that are generated. Heart rate
meters may continue to count the pace-
maker rate during cardiac arrest or some
arrhythmias.
– Some pacemakers (especially external
pacemakers with body surface electrodes)
emit pulses with amplitudes far exceeding
the 700 mV maximum amplitude specified
for the M540. The M540 may incorrectly de-
tect these large pacemaker pulses as valid
QRS complexes and may fail to detect car-
diac arrest.
145