User Manual

Arrhythmia Algorithm Arrhythmia and ST Analysis
4 - 10 0070-10-0690-01 Panorama™ Operating Instructions
WARNING: PACEMAKER PATIENTS - Indication of the heart-rate may be
adversely affected by cardiac pacemaker pulses or by
cardiac arrhythmias. Keep pacemaker patients under close
surveillance. Refer to ‘‘ECG Performance Requirements’’ on
page 16-2 for disclosure of the pacer rejection capability.
CAUTION: Some pacemakers may contain a respiratory sensor that
may produce artifact on an ECG waveform.
4.2 Arrhythmia Algorithm
The Panorama Central Station uses an arrhythmia algorithm to monitor ECG waveform data.
The arrhythmia analysis feature is intended to detect ventricular rhythms only. However, due
to physiologic differences in patient populations, the arrhythmia algorithm may occasionally
result in a false alarm or may not recognize certain arrhythmia patterns.
The algorithm creates ECG waveform templates based on a patient’s normal ECG data and
uses them to analyze newly received data. The algorithm verifies that data is free from noise
and artifact, and that it does not deviate from the patient’s normal ECG rhythms.
A normal ECG waveform typically includes consistent spacing between R waves, a sharp
and well defined QRS complex, and an ECG baseline that is free of noise and artifact. The
computerized arrhythmia algorithm works best when the patient’s R wave is significantly
larger than the P wave and the T wave. If the R wave is not significantly larger than other
lower voltage waves on the ECG tracing, the computer may have some difficulty in
identifying the appropriate waves. On some patients, electrode patch placement and/or the
viewed ECG lead may need to be adjusted in order to obtain a significant R wave.
FIGURE 4-17 Sample Waveform
Noise and Artifact
The presence of noise or artifact in an ECG waveform makes the accurate detection and
classification of heart beats difficult. To best optimize performance, all leads should be free
of noise. If artifact is present on any ECG lead/waveform, then the arrhythmia processing,
alarm processing, and quality of the monitoring function may be adversely affected.
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ST deviation
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40 to 80 msec
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