Physio Control LIFEPAK 15, Operating Instructions Manual

Page: 55 / 284

Chapter 4 | Monitoring
©2007-2015 Physio-Control, Inc. LIFEPAK 15 Monitor/Defibrillator Operating Instructions
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Monitoring Patients Who Have Internal Pacemakers
The LIFEPAK 15 monitor/defibrillator internal pacemaker detection feature can be used to
help identify internal pacemaker pulses on the printed ECG. When enabled, this feature uses
lead V4 to detect internal pacemaker pulses. If V4 is not available because it is not attached
or is too noisy, Lead II or Paddles Lead is used.
When the internal pacemaker detection feature is ON, the LIFEPAK 15 monitor/defibrillator
annotates a hollow arrow
on the printed ECG if internal pacemaker pulses are detected.
Patient history and other ECG waveform data, such as wide QRS complexes, should be used
to verify the presence of an internal pacemaker. False annotations of this arrow may occur if
ECG artifacts mimic internal pacemaker pulses. If false annotations occur frequently,
deactivate the detection feature using the
OPTIONS / PACING / INTERNAL PACER
menu (see
Options (on page 41)).
The LIFEPAK 15 monitor/defibrillator typically does not use internal pacemaker pulses to
calculate the heart rate. However, when using therapy electrodes or standard paddles to
monitor in
PADDLES
lead, the monitor may detect internal pacemaker pulses as QRS
complexes, resulting in an inaccurate heart rate.
Large amplitude pacemaker pulses may overload the QRS complex detector circuitry so that
no paced QRS complexes are counted. To help minimize ECG pickup of large unipolar
pacemaker pulses, place ECG electrodes so the line between the positive and negative
electrodes is perpendicular to the line between the pacemaker generator and the heart.
Smaller amplitude internal pacemaker pulses may not be distinguished clearly in
PADDLES
lead. For improved detection and visibility of internal pacemaker pulses, turn on the internal
pacemaker detector function using the
OPTIONS / PACING / INTERNAL PACER
menu or
connect the ECG cable, select an ECG lead, and print the ECG in diagnostic frequency
response. For information about configuring internal pacemaker detection, see the Pacing
Setup menu in the
LIFEPAK 15 Monitor/Defibrillator Setup Options provided with your device.