Mindray DS USA Inc. WT0707-00000 Manual De Usuario
Panorama™ Operating Instructions
0070-10-0690-01
4 - 11
Arrhythmia and ST Analysis
Arrhythmia Algorithm
Some of the causes of ECG noise include poor skin preparation, improperly attached
electrodes, dried electrode gel, defective lead wires, and patient movement. The algorithm
uses several techniques to differentiate a patient’s QRS complexes from noise sources.
electrodes, dried electrode gel, defective lead wires, and patient movement. The algorithm
uses several techniques to differentiate a patient’s QRS complexes from noise sources.
If noise levels are too high, the following will occur until the signal quality is re-established:
• Beat detection is suspended
• All rhythm calls are suspended
• An ECG Noise message is displayed in the Patient Status line at the Panorama
Central Station when the noise continues beyond the configured noise delay
Heart Rate Meter
Heart Rate is computed using the 16 most recent R-R intervals for heart rates above 48 beats
per minute while 4 R-R intervals are used at rates equal to or less than 48 beats per minute.
All detected beats are used to compute the heart rate. A separate ventricular rate is used in
the algorithm to determine rhythms like ventricular tachycardia and ventricular run.
per minute while 4 R-R intervals are used at rates equal to or less than 48 beats per minute.
All detected beats are used to compute the heart rate. A separate ventricular rate is used in
the algorithm to determine rhythms like ventricular tachycardia and ventricular run.
Filtering Pacer Signals
In order to prevent pacer pulses from being mistaken for QRS complexes, they are removed
from the ECG data sent to the arrhythmia algorithm for analysis. Pacer pulses are shown on
the Panorama Central Station and bedside monitors as exaggerated vertical lines.
from the ECG data sent to the arrhythmia algorithm for analysis. Pacer pulses are shown on
the Panorama Central Station and bedside monitors as exaggerated vertical lines.
ECG Amplitude
The QRS detection threshold algorithm setting is fixed between 0.15 and 0.45 mV to avoid
detecting noise spikes or P-waves as valid beats. Changing the display gain (or wave gain)
on the monitor does not affect the signal that is used by the algorithm for beat detection. For
optimal performance, the leads selected for monitoring should have an amplitude of 0.5 to 1
mV or more.
detecting noise spikes or P-waves as valid beats. Changing the display gain (or wave gain)
on the monitor does not affect the signal that is used by the algorithm for beat detection. For
optimal performance, the leads selected for monitoring should have an amplitude of 0.5 to 1
mV or more.
Learning
The process of learning is used to establish a normal beat template for a patient. The learn
period is dependent on heart rate and dominant pattern. Learning should not be initiated
during a primarily ventricular rhythm because an ectopic beat may be established as normal.
period is dependent on heart rate and dominant pattern. Learning should not be initiated
during a primarily ventricular rhythm because an ectopic beat may be established as normal.
A learn should be initiated when beats are not being properly detected, or when they are
being erroneously classified. However, if a signal is not strong enough, or lead data is
extremely noisy, better signal quality must be established before a learn can be effective.
being erroneously classified. However, if a signal is not strong enough, or lead data is
extremely noisy, better signal quality must be established before a learn can be effective.