In
this thread on Bigeminy or paced rhythm, EMTLife user
Milla3P shared:
Can you shed any light on the idea that LifePak 12's only recognize Physio Control pacemakers?
Thanks,
The LIFEPAK 12 and 15 are actually both good at detecting pacemaker stimuli if they are set up with internal pacemaker detection turned on. The user can change this in setup.
The 12 and the 15 both use lead V4 for pacemaker spike detection if available, otherwise they use lead II. Detected spikes are marked with a hollow arrow on the screen and printout.
To best see pacemaker spikes, print the ECG at diagnostic bandwidth, 0.05-150 Hz.
Additional information can be found in the
LIFEPAK 12 Operating Instructions (page 3-7). Excerpt follows.
Monitoring Patients with Internal Pacemakers
The LIFEPAK 12 defibrillator/monitor 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. This may result in an inaccurate heart rate display.
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, and/or connect the ECG cable, select an ECG lead and print the ECG in diagnostic frequency response.
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 when monitoring patients with internal pacemakers, place ECG electrodes so the line between the positive and negative electrodes is perpendicular to the line between the pacemaker generator and the heart.
The 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 pacer pulses. If V4 is not available because it is not attached or is too noisy, lead II is used, if available. If this feature is configured or selected ON, the LIFEPAK 12 defibrillator/monitor annotates a hollow arrow on the printed ECG if internal pacemaker pulses are detected. False annotations of this arrow may occur if ECG artifacts mimic internal pacer pulses. If false annotations occur, you may deactivate the detection feature using the OPTIONS / PACING / INTERNAL PACER menu (see Figure 2-5). Patient history and other ECG waveform data, such as wide QRS complexes, should be used to verify the presence of an internal pacemaker. For information about configuring the internal pacemaker detection, refer to the Pacing Setup menu in Table 9-4.
