GE Responder 2000, Operator'S Manual

Page: 71 / 142

2026116-001 Revision B Responder™ 2000 Page 71
DEMAND PACING
WARNING:
The pacer pulses are delivered via the adhesive defibrillation electrodes. Separate electrodes must be
applied for acquisition of the ECG signal. It is imperative to apply the ECG electrodes before turning the pacemaker on.
Then wait for a few minutes before pacing to allow the electrode gel to penetrate the skin and reduce the electrode skin
contact impedance. The pacemaker can be enabled only when adhesive electrodes are connected.
In demand mode, the pacemaker does not deliver pacing pulses as long as the patient's intrinsic heart rate exceeds the
set pacing rate. When the heart rate drops below the pacing rate, the pacemaker starts emitting stimulation pulses. This
can only be ensured by continued electronic monitoring of the ECG. The necessary synchronization pulses are
automatically sent to the pacemaker.
PRECAUTION:
Pacemaker malfunction due to poor ECG signal quality
As a general rule, check the ECG signal quality before turning the pacer on. In the presence of excessive electrode-skin
contact impedance, the signal quality may drop to a level which the Responder 2000 interprets as a lead fail condition. As
a result the device will display a dashed line and switch from demand pacing to the fixed-rate pacer mode or to pacer
PAUSE mode. If you wish to continue pacing in the fixed-rate mode, it is mandatory to verify the success of stimulation by
checking the patient's pulse. If you wish to resume demand pacing, you first have to improve the electrode skin contact
impedance. Then switch the pacer manually from PAUSE to ON. The other pacer parameters will be kept.
NOTE:
Even in unfavorable situations, the electrode gel will penetrate the patient's skin in 5 to 7 minutes,
reducing the electrode-skin contact impedance. If this is sufficient to improve the signal quality, pacing in the demand
mode will then become possible.
The demand mode is the recommended pacing mode when the patient is at risk of developing bradycardia or even
cardiac arrest as a result of a critical event. As the pacemaker function is controlled by the patient's ECG, the harmful
competition between intrinsic and external stimulation which could induce ventricular fibrillation is excluded.
1. Check that the ECG electrodes and the pace pads are correctly applied and connected to the device.
2.
Turn the Rotary Selector Knob to turn on the pacemaker.
3.
Check the ECG signal quality.
If the signal quality is not adequate, either wait until the electrode gel has reduced the electrode skin contact
impedance or select another lead, or reapply the electrodes exactly as described.