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Internal Trigger Mode: If the patient has no myocardial activity at all (e.g., during
bypass surgery), inflation and deflation can be generated using the INTERNAL trigger
mode. You can select any constant rate from 40 BPM to 120 BPM in 5 beat increments,
using the multi-function keys when INTERNAL is selected.
Recommended IABP Triggers (Operator Mode)
Rhythm
Pattern
R-Wave
Criteria:
25-135msec.
NSR
*
S Brady
*
S Tachy
*
Cautery
Interference
NSR with
*
Premature Beats
(atrial)
2
NSR with
*
Pauses
PAT/SVT
*
Atrial Flutter
*
Atrial
*
3
Fibrillation
Atrial Pacing
*
demand
Ventricular
Pacing
A-V Pacing
RBBB, LBBB
Ventricular
tachycardia
CPR
Bypass-Pulsatile
flow testing
1Note: No capture beat needed for trigger. 2 Depends on type and number of premature beats. 3 For significant irregularity use Peak. 4 If Real Time Timing is desired 5
May be preferred for HR > 140 bpm
Triggering Assessment
Once triggering has been established you should assess the accuracy of triggering and
timing. Triggering may be assessed in several ways:
Heart Rate: The HR displayed on the AutoCat 2 IABP should match the patient HR. If
the displayed HR is higher or lower than the patient HR, triggering is not correct.
White Highlight on ECG waveform: A white band is shown on each assisted ECG
waveform. Check the Assist ratio setting. For example, if the Assist Ratio is 1:2 then
there should be white highlights on every other ECG waveform. There should be ONE
white highlight per trigger on the ECG waveform. In addition the white highlight
indicates the relative timing positions of inflate and deflate on the ECG.
Trigger mode: The trigger mode is displayed below the HR value. Make sure the display
matches the trigger mode selected.
4 . P r i n c i p l e s o f T i m i n g a n d T r i g g e r i n g
4 . 3 . 2 : T r i g g e r s e l e c t i o n i n O p e r a t o r M o d e
Peak
AFIB
V-Pace
Wide Complex
Varying R-R
100% Paced
QRS
Automatic
R-Wave deflation
*
*
4
*
*
4
*
5
*
4
*
*
(vent)
*
*
if severe
*
*
*
if irregular
*
*
*
demand
*
demand
100% paced
*
demand
100% paced
*
*
A-Pace
AP
100% Paced
(Consistent
BP)
*
*
*
*
*
*
*
*
100% paced
*
*
*
*
*
*
*
first choice
Trigger selection in Operator Mode
INT
Rate 80
automatic
Range 40-120
*
*
4-7
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Troubleshooting
