Physio-Control LIFEPAK 15 - Manual (Page 55)

MONITORING
4
©2007-2013 Physio-Control, Inc. LIFEPAK 15 Monitor/Defibrillator Operating Instructions
4-11
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 3-23).
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.