6 ECG, Arrhythmia, ST and QT Monitoring
108
Monitoring Paced Patients
An ECG optimized for monitoring a paced patient should look like this:
You should 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 bi-phasic. 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.
For ease of identification on the screen, the pacer spikes can be configured to have a fixed size. They
are then shown in the background as dotted lines. The length of the dotted line is fixed to the wave
channel height and is independent of the actual pacer amplitude.
Setting the Paced Status
In the Setup ECG menu, select Paced Mode to switch between On, Off or Unconfirm.
You can also change the paced mode in the
Patient Demographics window.
1 Normal Beats
2 Pace Pulses/Pace Beats
When Paced Mode is set to On:
– Pace Pulse Rejection is switched on. This means that pacemaker
pulses are not counted as extra QRS complexes.
– pace pulse marks are shown on the ECG wave as a small dash (only
when the pacer spikes are not configured to have a fixed size).
– the paced symbol is displayed under the HR label.
When
Paced Mode is set to Off, pacer spikes are not shown in the ECG wave.
Be aware that switching pace pulse rejection off for paced patients may result
in pace pulses being counted as regular QRS complexes, which could prevent
an asystole event from being detected.
When the paced mode has not yet been set for a patient, the paced symbol
will have a question mark indicating the
Unconfirm mode. When the paced
mode is
Unconfirm, pace pulse rejection is switched on.
Paced Mode On
Paced Mode Off
Paced Mode
Unconfirmed
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