GE CARESCAPE, User Manual

Page: 181 / 548

ECG
The EK-Pro arrhythmia detection algorithm is used. EK-Pro simultaneously analyzes
leads I, II, III, and V. Once learning is complete, the dominant QRS complex becomes
the template. When a PDM with an ongoing ECG measurement is connected, the
system shall provide the EK-Pro V11 arrhythmia detection from the PDM until the
monitor’s EK-Pro v13 algorithm has learned the ECG rhythm and starts to provide
the arrhythmia detection.
The algorithm uses continuous correlation, incremental template updating and
contextual analysis. Continuous correlation attempts to find the best match between
each incoming complex and the set of stored (learned) templates. If no match is
found with the existing template, a new template is stored for the identified new
QRS shape. Incremental template updating allows information from each beat, that
correlates over time, to be reflected in the associated template. Contextual analysis
uses information from neighboring QRS complexes along with existing template
measurements to make the best possible decision regarding the beat’s origin (e.g.,
early, wide).
Arrhythmia troubleshooting
Problem Solution
Why is the monitor alarming for asystole, bradycardia,
pause, or inaccurate heart rate when a visible QRS
waveform is present? The monitor may not be detecting sufficient QRS
amplitude in all analyzed leads. Multiple leads are
used for arrhythmia processing.
1. Assess the patient.
2. Check the ECG signal acquired from the patient.
3. View all ECG leads to assess the amplitude of the
QRS complexes. To ensure correct HR readings,
a 0.5 mV QRS amplitude is recommended for a
normal ECG signal. If the QRS amplitude drops
below 0.5 mV or an abnormal QRS width occurs
(more than 120 ms), QRS detection may be
reduced, leading to false
Asystole alarms.
4. Relearn arrhythmia. It is important to relearn
the patient’s ECG pattern any time the electrode
configuration is adjusted.
5. The ECG size settings affect the arrhythmia
detection and heart rate calculation. Increase the
ECG size by selecting a value from the
ECG Size list.
If the problem continues, switch to the ECG lead
with the greatest amplitude, display that lead, then
switch to single lead analysis so all arrhythmia
interpretations are based on this single ECG lead.
How does the IntelliRate algorithm impact an
Asystole alarm with a QRS waveform?
Intellirate will report Asystole when the following
conditions are met:
●
The ECG HR has been valid and has changed by
1/min or less during the previous 30 seconds .
●
The invasive pressure pulse rate has been valid for
the previous 60 seconds, and it has been 0/min
during the previous 30 seconds.
●
The mean arterial blood pressure of the invasive
pressure pulse rate source is below the user-
selected limit.
2062971-001 CARESCAPE Modular Monitors 181