GE CARESCAPE - Arrhythmia troubleshooting

ECG
TheEK-Proarrhythmiadetectionalgorithmisused.EK-Prosimultaneouslyanalyzes
leadsI,II,III,andV.Oncelearningiscomplete,thedominantQRScomplexbecomes
thetemplate.WhenaPDMwithanongoingECGmeasurementisconnected,the
systemshallprovidetheEK-ProV11arrhythmiadetectionfromthePDMuntilthe
monitor’sEK-Prov13algorithmhaslearnedtheECGrhythmandstartstoprovide
thearrhythmiadetection.
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.Relearnarrhythmia.Itisimportanttorelearn
thepatient’sECGpatternanytimetheelectrode
congurationisadjusted.
5.TheECGsizesettingsaffectthearrhythmia
detectionandheartratecalculation.Increasethe
ECGsizebyselectingavaluefromtheECGSizelist.
Iftheproblemcontinues,switchtotheECGlead
withthegreatestamplitude,displaythatlead,then
switchtosingleleadanalysissoallarrhythmia
interpretationsarebasedonthissingleECGlead.
HowdoestheIntelliRatealgorithmimpactan
AsystolealarmwithaQRSwaveform?
IntelliratewillreportAsystolewhenthefollowing
conditionsaremet:
●TheECGHRhasbeenvalidandhaschangedby
1/minorlessduringtheprevious30seconds.
●Theinvasivepressurepulseratehasbeenvalidfor
theprevious60seconds,andithasbeen0/min
duringtheprevious30seconds.
●Themeanarterialbloodpressureoftheinvasive
pressurepulseratesourceisbelowtheuser-
selectedlimit.
2062971-001CARESCAPEModularMonitors181