Monitoring Paced Patients
ECG and Arrhythmia Monitoring 6-11
Monitoring Paced Patients
An ECG optimized for monitoring a paced patient should look like this:
1. Normal Beats
2. Pace Pulses/Beats
Choose a lead as primary or secondary lead that has these characteristics:
the normal QRS complex should be either completely above or below
the baseline and it should not be biphasic. For paced patients, the QRS
complexes should be at least twice the height of pace pulses.
the QRS complex should be tall and narrow
the P-waves and the T-waves should be less than 0.2 mV.
Optimizing Lead Selection for Paced Patients
Some unipolar pacemakers display pace pulses with repolarization tails.
These tails may be counted as QRSs in the event of cardiac arrest or other
arrhythmias.
If you note a visible repolarization tail, choose a lead that decreases the size
of the repolarization tail.
1. Repolarization tail
(note width)
Avoid fusion and pseudofusion beats.
1. Fusion
2. Paced
3. Pseudofusion
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