4: ECG Monitoring Arrhythmia Monitoring
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Arrhythmia learning/relearning automatically occurs when:
• The Therapy knob is turned to Monitor, Pacer, AED or a Manual Defibrillation setting.
• Any time there is a change in the lead selection for Wave Sector 1.
• After the correction of a leads or pads off condition that has been active longer than 60
seconds.
Initiate manual relearning if the beat detection is not occurring or if beat classification is incorrect
and results in a false alarm. Remember if the same signal condition which caused the algorithm to
perform poorly still exists, relearning does not correct the problem. The problem can only be
corrected by improving the signal quality (e.g., selecting a different lead).
To initiate relearning manually:
1 Press the Smart Select knob.
2 Turn the Smart Select knob to highlight
and press the Smart Select knob.
3 Select
and press the Smart Select knob.
4 Select
and press the Smart Select knob.
and messages appear in the bottom portion of Wave Sector 1.
WARNINGS: If arrhythmia relearning takes place during a ventricular rhythm or during a period of poor ECG
signal quality, ectopic beats may be incorrectly learned as the normal QRS complex. This may result
in missed detection of subsequent events of V-tach and high PVC rates. For this reason you should:
• Take care to initiate arrhythmia relearning only when the ECG signal is noise-free.
• Be aware that arrhythmia relearning can happen automatically.
• Respond to any messages (e.g., if you are prompted to reconnect electrodes).
• Display an annotated wave to ensure the beat labels are correct.
Pacemaker Pulse Rejection: When arrhythmia monitoring paced patients who exhibit only intrinsic
rhythm, the monitor may erroneously count paced pulses as QRS complexes when the algorithm
first encounters them, resulting in missed detection of cardiac arrest. Be sure that the paced status is
set correctly on the device.
Some pace pulses can be difficult to reject. When this happens, the pulses are counted as a QRS
complex, and could result in incorrect HR and failure to detect cardiac arrest or some arrhythmias.
Keep pacemaker patients under close observation. See Specifications Chapter 19 “Specifications” on
page 199 for details on Pacemaker Pulse Rejection Capability.
NOTE: It is important to set the patient’s correct paced status in order to optimize ECG analysis.
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