User Manual Part 7

Viewing real-time patient data
2001989-301A- draft 1 ApexPro™ 7-15
The Pace 1 mode allows successful detection of the largest variety of paced QRS
morphologies. As a direct consequence, this mode does have a higher risk of counting
pacemaker artifact as QRS complexes during ASYSTOLE. For this reason, it is
imperative that the user keep patients with pacemakers under close observation. It is
also recommended that the user set the low heart rate limit on the monitor close to the
minimum pacing rate, and that the BRADY arrhythmia alarm level be elevated to a
Warning or Crisis level.
The Pace 2 mode is much more conservative in recognizing paced QRS
morphologies and is recommended for use whenever possible. It is designed to
minimize the possibility of counting pacemaker artifact as QRS complexes during
ASYSTOLE. If the monitor does not adequately detect paced beats in the Pace 2
mode, then the user may wish to try the Pace 1 mode.
When either pace mode is enabled, the software places an artificial spike on the
waveform whenever the pacemaker triggers. When pacemaker detection is on, it is
indicated by a “P” in the patient’s ECG parameter window.
For successful monitoring of pacemaker patients follow these suggestions:
 Use recommended electrode placement.
 Brady, Pause, and Low Heart Rate are additional alarms available for use when
monitoring pacemaker patients.
 Problems you may experience are:
 heart rate double counting;
 inaccurate alarms for low heart rate or asystole;
 pacemaker spikes not recognized by the software.
 Possible solutions to above problems are:
 relearn arrhythmia;
 try an alternate electrode placement;
 try Single-Lead analysis;
 try switching to the other pace detection mode.
Multi-vector pace detection
The T14 transmitter uses multi-vector pace detection. Here are some additional
guidelines for successful monitoring pacemaker patients when using the T14
transmitter.
 When using the 5- or 6-leadwire set with all the electrodes attached, pace
detection occurs on two ECG leads simultaneously.
 The default leads used for detection are II and V. If these leads are not available,
multi-vector pace detection switches to available leads.
 Pace detection switches to Single-Lead when using a 3-leadwire set.
For more information, refer to “Pacemaker troubleshooting” on page D-3.
Pace help
Clicking on the Pace Help button opens a window that shows common problems and
solutions in regard to pacemaker detection. This window is shown below.
Draft