Pacer Detection - GE Dash 2500 Operator's Manual

Pacer detection

2042480-001 C
ECG: ECG Menu
The Pacer detection option enable/disables the pacemaker detection algorithm.
It must be used whenever the monitored patient has a pacemaker. Pace
detection choices are PACE 1, PACE 2, and OFF.
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 algorithm defaults to off so if you have a patient with a
pacemaker, you will have to turn the algorithm 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 user may wish to try the PACE 1 mode.
The PACE 1 mode allows 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.
When either pace mode is enabled, the software places an artificial spike on the
waveform whenever the pacemaker triggers. When pacemaker detection is
enabled, it is indicated by either PACE 1 or PACE 2 being displayed adjacent to
the lead selection display.
In most cases, PACE 2 mode will effectively monitor a pacemaker patient.
However, if you are experiencing problems, select the PACE 1 mode as an
option, and observe all cautions as described for PACE 1 mode.
NOTES
Use standard lead placement for pacer detection. Pacer detection is done in
the primary or selected lead. Go to the Lead selection option and choose
the best lead for accurate HR detection. If you have a monitor with 5-
electrode configuration, go to the Primary Lead option and choose the best
lead for accurate HR detection.
Large surface potentials such as those encountered with external
(transcutaneous) pacing may result in an inability to display ECG
waveforms. Reducing the ECG size to X/2 may allow these waveforms to be
displayed.
Monitoring ECG with an external ECG monitoring device may be necessary
when using non-invasive transcutaneous pacemakers.
Dash 2500 Patient Monitor 9-11