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ECG/RESP
Propaq Encore Reference Guide 47 Welch Allyn
Using the Propaq Encore With Pacemaker Patients
Pacemaker Signals
If the patient being monitored has a pacemaker, the Propaq Encore detects and can indicate
the occurrence of pacemaker signals. With the Propaq, pacemaker signals are not counted as
heart beats as long as the pacemaker signal meets the pulse amplitude, pulse width, and
overshoot/undershoot specifications listed in Appendix B.
Pacer Display
On the Propaq Encore display, vertical dashed lines indicate each time a pacemaker signal is
detected when the Propaq Encore PACER function is turned on. The waveform “spike”
produced by the pacemaker will also be displayed if it contains sufficient energy. Whether
the pacer is atrial, ventricular, or both, the indicator and the spike appear. If the PACER
function is turned off, only the pacemaker spike is displayed:
Turn On and Off the Pacemaker Indicator
The status of the pacer display is shown in the ECG status window. Turn PACER DISPLAY
on or off using the
NEXT and CHANGE buttons.
The Propaq Encore counts as “breaths” respiratory efforts that are larger than
two times background Cardiovascular Artifact (CVA).
Since RESP is derived from the same leads as the ECG channel, the Propaq
Encore determines which signals are cardiovascular artifact and which signals
are a result of respiratory effort. If the breath rate is within five percent of the
heart rate or a multiple or sub-multiple of the heart rate, the monitor may
ignore breaths and trigger an apnea alarm.
Warning Pacemaker signals can differ from one pacemaker to the next. The
Association for Advancement of Medical Instrumentation (AAMI) cautions that
“in some devices, rate meters may continue to count the pacemaker rate
during occurrences of cardiac arrest or some arrhythmias. Do not rely entirely
upon rate meter alarms. All pacemaker patients should be kept under close or
constant observation.”
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