Philips IntelliVue TRx, Instructions For Use Manual

Page: 32 / 274

Draft - 1 Aug 08
ST/AR Arrhythmia
2-10 Product Safety
For Paced
Patients
Warning Warning
Some pace pulses can be difficult to reject. When this happens, the pulses
are counted as a QRS complex, and could result in an incorrect HR and
failure to detect cardiac arrest or some arrhythmias. Keep pacemaker
patients under close observation.
Warning Warning
During complete heart block or pacemaker failure (to pace or capture), tall
P-waves (greater than 1/5 of the average R-wave height) can be erroneously
counted by the arrhythmia algorithm, resulting in missed detection of
cardiac arrest.
Warning Warning
For paced patients who exhibit only intrinsic rhythm, the monitor can
erroneously count pace pulses as QRS complexes when the algorithm first
encounters them, resulting in missed detection of cardiac arrest. The risk of
missing cardiac arrest can be reduced by monitoring these patients with the
low heart rate limit at or slightly above the basic/demand pacemaker rate.
A low heart rate alarm alarms you when the patient begins pacing. Proper
detection and classification of the paced rhythm can then be determined.
Warning Warning
When an external pacemaker is being used on a patient, arrhythmia
monitoring is severely compromised due to the high energy level in the
pacer pulse. This can result in the arrhythmia algorithm’s failure to detect
pacemaker non-capture or asystole.