GE CARESCAPE ONE - About the Arrhythmia Detection; Arrhythmia Troubleshooting

ECG
AlarmmessageArrhythmiaanalysisAlarmprioritydefaultArrhythmiadetection
criteria
exceedsselectedHRfor
VTach/minvalue.
Aboutthearrhythmiadetection
WhenanECGsignalisdetectedatthestartofmonitoring,thearrhythmiadetection
algorithmbeginsacquiringandanalyzingQRScomplexesintheleadsusedfor
arrhythmiadetection.Thisphaseisknownaslearning.Oncelearningiscomplete,
thedominantQRScomplexisstoredasareferencetemplate.Thereferencetemplate
isusedasanormalmorphologyofthatpatientanditiscomparedwithincoming
beatstoidentifypossiblearrhythmias.
TheEK-Proarrhythmiadetectionalgorithmisused.EK-Prosimultaneouslyanalyzes
leadsI,II,III,andVorVa.Oncelearningiscomplete,thedominantQRScomplex
becomesthetemplate.
Thealgorithmusescontinuouscorrelation,incrementaltemplateupdatingand
contextualanalysis.Continuouscorrelationattemptstondthebestmatchbetween
eachincomingcomplexandthesetofstored(learned)templates.Ifnomatchis
foundwiththeexistingtemplate,anewtemplateisstoredfortheidentiednew
QRSshape.Incrementaltemplateupdatingallowsinformationfromeachbeat,that
correlatesovertime,tobereectedintheassociatedtemplate.Contextualanalysis
usesinformationfromneighboringQRScomplexesalongwithexistingtemplate
measurementstomakethebestpossibledecisionregardingthebeat’sorigin(e.g.,
early,wide).
Arrhythmiatroubleshooting
ProblemSolution
Whyisthemonitoralarmingforasystole,bradycardia,
pause,orinaccurateheartratewhenavisibleQRS
waveformispresent?
ThemonitormaynotbedetectingsufcientQRS
amplitudeinallanalyzedleads.Multipleleadsare
usedforarrhythmiaprocessing.
1.Assessthepatient.
2.ChecktheECGsignalacquiredfromthepatient.
3.ViewallECGleadstoassesstheamplitudeofthe
QRScomplexes.ToensurecorrectHRreadings,
a0.5mVQRSamplitudeisrecommendedfora
normalECGsignal.IftheQRSamplitudedrops
below0.5mVoranabnormalQRSwidthoccurs
(morethan120ms),QRSdetectionmaybe
reduced,leadingtofalseAsystolealarms.
4.RelearntheECGrhythm.Itisimportanttorelearn
thepatient’sECGpatternanytimetheelectrode
congurationisadjusted.
5.TheECGsizesettingsaffectthearrhythmia
detectionandheartratecalculation.Increasethe
ECGsizebyselectingavaluefromtheSizelist.
Iftheproblemcontinues,switchtotheECGlead
withthegreatestamplitude,displaythatlead,then
120CARESCAPEONE2094480-001
CARESCAPE ONE User Manual DRAFT 26 October 2017