Welch-allyn Arrhythmia Monitoring Chart - Quick Reference Guid User Manual download pdf

P-R

Interval

QRS Duration

Q-T

Interval

NORMAL SINUS RHYTHM

QRS NORMAL SINUS RHYTHM EXAMPLE

The Relearn Function

The Relearn function enables the clinician to tell Acuity to relearn a patient’s rhythm based

on the patient’s dominant beat morphology.

During the learning period, Acuity indicates only the VFib and Asystole arrhythmia conditions.

Other vital signs are unaffected.

Acuity automatically relearns the patient’s normal reference beats whenever the alert

presents itself under the following conditions:

 • Afterpatientconnectionorsystemrestart

 • Aftersomeleadchangesorleadfailures

 • AfterST/Arr Relearn or Analyze Pacers or Single ECG is clicked in the Arrhythmia

Alarms Setup window

WARNING Inappropriate use of Relearn can lead to mislabeling of beats and possibly a

failure to alarm. Carefully evaluate the patient’s current rhythm to make sure that you want

the Acuity System to establish it as the patient’s normal sinus rhythm.

1. VFib is detected if the waveform fulﬁlls the following conditions for at least 5 seconds:

• Absence of fast slew-rate activity (QRS-like activity). • Average peak-to-peak wave amplitude higher than 200 µV.

• Wave rate higher than 130 bpm. • Wave period variance higher than a speciﬁc threshold.

2. The American Heart Association describes sustained and nonsustained ventricular tachycardia as follows:

Ventricular tachycardia can be referred to as sustained or nonsustained. Sustained refers to an episode that lasts at least 30

seconds and generally requires termination by antiarrhythmia drugs, antitachycardia pacing techniques or electrical cardioversion.

Nonsustained ventricular tachycardia suggests that the episodes are short (three beats or longer) and terminate spontaneously.

The average heart rate is calculated on the basis of the mean R-to-R interval of the last 16 beats. If the heart rate calculated

using the last four beats is less than or equal to 48, then this rate is used.

ARRHYTHMIA EVENT DEFINITIONS

Arrhythmia Monitoring

on the Welch Allyn Acuity

Central Station

Using Mortara Instrument’s VERITAS

™

ECG analysis algorithms

VFib

(Ventricular

Fibrillation)

Lethal Arrhythmia

ARRHYTHMIA EVENT

WAVEFORM EXAMPLES DEFINITION

Chaotic quivering of the ventricles

accompanied by rapid irregular

waves but no formed QRS

complexes.

Asystole

Lethal Arrhythmia

Absence of any detected beat for

4 or more seconds.

VTach

(Ventricular

Tachycardia)

Lethal Arrhythmia

Characterized by a run of premature

ventricular beats that exceeds the

PVC run alarm limit setting and

that meets or exceeds the patient’s

VTach alarm limit.

PVC Run

(Ventricular Run)

Characterized by a run of three

to six consecutive, premature

ventricular beats that meets or

exceeds the patient’s VTach

alarm limit.

Couplet Characterized by two consecutive

ventricular beats that are preceded

and followed by a normal beat.

PVC/min

(Ventricular

Beats per

Minute)

Premature ventricular contractions

(PVCs, either unifocal or multifocal)

that are greater or equal to the

patient’s PVC/min alarm limit setting.

Bigeminy

Characterized by three or more

successive cycles consisting of a

normal beat followed by a premature

ventricular beat. Bigeminy is

independent of the average heart rate.

Trigeminy

Characterized by three or more

successive cycles of two normal beats

followed by a premature ventricular

beat. Trigeminy is independent of the

average heart rate.

Tachycardia

Characterized by a HR greater than or

equal to the patient’s tachycardia alarm

limit value. (If the tachycardia limit is

decreased past the HR high limit, then

the HR high limit will decrease to a value

equal to the tachycardia limit.)

Bradycardia

Characterized by a HR less than or

equal to the patient’s bradycardia alarm

limit value. (If the bradycardia limit is

increased past the HR low limit, then

the HR low limit will increase to a value

equal to the bradycardia limit.)

Pause

An R-to-R interval that is greater

than or equal to two times the

average R-to-R.

Arrhythmia Alarms Setup Window

Other company names mentioned herein are for identiﬁcation purposes only and may be the trademarks or registered trademarks of their respective companies.

Printed in USA SM2567 Rev C

Irregular

(Irregular

Rhythm)

An irregularity in the R-to-R

interval over a series of at least

16 nonventricular beats.

Noncapture

(Pacemaker

Noncapture)

For pacemaker patients with the

Analyze Pacers option enabled,

a beat does not directly follow

a pacer.

VRhythm

(Ventricular

Rhythm)

Characterized by a run of successive

ventricular beats that is less than the

VTach alarm limit setting, and the

number of successive ventricular

beats is greater than or equal to three.

Irregular Limit:

Preferences vary regarding Acuity System alarming sensitivity for irregular rhythm arrhythmia

types. There is now a way to adjust the minimum time that an irregular rhythm occurs before your

Acuity System alarms, on a patient-by-patient basis.

Single ECG:

The system uses up to three ECG leads to detect normal beats, ventricular beats and to analyze

arrhythmias. If false arrhythmia alarms are occurring due to a patient’s unique beat morphology,

you can direct the Acuity System to analyze arrhythmias using one reliable lead.

WARNING If you turn on Single ECG in response to false lethal arrhythmia alarming (for example,

due to bundle branch block or irregular rate), arrhythmia analysis is limited to one lead. Typically,

3-lead analysis (via a 5-lead cable) is optimal.

Analyze Pacers:

Always turn on Analyze Pacers for paced patients, and always turn off Analyze Pacers for non-

paced patients. The Acuity System analyzes arrhythmias based on whether the Analyze Pacers

setting is on or off. The Analyze Pacers setting is Off by default.

If monitoring with Propaq

LTR or Micropaq

, Acuity will use ECG leads II, V and III for

arrhythmia analysis.

If monitoring with Propaq

CS and/or Propaq Encore

, Acuity uses the leads that the user selects

for ECG1 and/or ECG2. To optimize arrhythmia analysis performance: verify that the ECG lead(s) have

signiﬁcant amplitude. Otherwise, an incorrect heart rate or arrhythmia alarm condition could occur.

If the QRS complex is less than twice the amplitude (height) of the P and T waves, a different monitoring

lead should be selected. Tall P and T waves may be incorrectly classiﬁed as a QRS complex or PVC and

potentially generate a high heart rate or other alarm condition.

ECG Lead Selection

and Placement

Arrhythmia Monitoring 1

Summary of Contents

Page 1 - Arrhythmia Monitoring

P-RIntervalQRS DurationPSTRQQ-TIntervalNORMAL SINUS RHYTHMQRS NORMAL SINUS RHYTHM EXAMPLEThe Relearn FunctionThe Relearn function enables the clinicia

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