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Pacer Detect

Serbian translation: opcija detekcije signala pejsmejkera

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GLOSSARY ENTRY (DERIVED FROM QUESTION BELOW)
English term or phrase:Pacer Detect
Serbian translation:opcija detekcije signala pejsmejkera
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01:00 Nov 15, 2008
English to Serbian translations [PRO]
Medical - Medical: Instruments
English term or phrase: Pacer Detect
Pacer Detect disabled

Postavka EKG aparata.
Marijana Tropin
United States
Local time: 11:07
opcija detekcije signala pejsmejkera
Explanation:
Posto je opcija disabled-znaci da je iskljucena.
Na sledecoj adresi na 4. strani je objasnjenje:

http://www.draeger.com/MT/internet/pdf/CareAreas/InfoMoni/mo...

--------------------------------------------------
Note added at 8 hrs (2008-11-15 09:25:59 GMT)
--------------------------------------------------

Detekcije ili otkrivanja signala.

--------------------------------------------------
Note added at 8 hrs (2008-11-15 09:36:57 GMT)
--------------------------------------------------

Introduction
Monitoring ECG in patients with
pacemakers presents a challenge to
manufacturers of patient monitors.
Misinterpreting a pacer pulse as a
QRS complex can have dire
consequences for the patient.
Conversely, unusual circumstances
or a pacer that is incorrectly set
can result in repeated false alarms –
which is annoying to both patients
and staff and can cause the clinician
to become desensitized to the monitor.
Background
The indications to pace a patient are
varied. Simply put, pacemakers are
used with patients who have trouble
with the natural pacemaker and/or
electrical conduction cells in their
heart. There are many different types
of pacemakers, and they have
different pulse characteristics, with
different rise times and recharge
characteristics. For pacemakers that
can be implanted in the body, there
are single-chamber pacemakers, dualchamber
pacemakers, rate-responsive
pacemakers, and demand pacemakers.
The variety of chambers paced,
chambers sensed, and pacemaker
sensing functions lead to different
pulse characteristics, with different
rise times and recharge characteristics.
In spite of the best technology,
all these factors can make it difficult
to consistently differentiate pacemaker
pulses from QRS complexes. Dräger
Medical’s pacer algorithm is exceptionally
well-tuned to accommodate
for the majority of pacemakers. As
with all ECG applications, good skin
preparation and correct electrode
and lead placement will help achieve
maximum results in monitoring
paced patients.
Emergency Care · OR/Anesthesia · Critical Care · Perinatal Care · Home Care Because you care
Pacer Detection
Published: July 2004 T
E
C
H
N
I
C
A
L
A
B
S
T
R
A
C
T
Abstract:
Dräger Medical has developed
a patented pacer detection
algorithm that balances a
cautious approach to avoid
false positive1 alarms with
techniques to minimize false
negative2 ECG alarms. This
paper discusses various
aspects of pacer detection
during ECG monitoring.
Introduction 1
Background 1
Understanding pacer pulse
characteristics 2

Pacer signal detection 4
Pacing during asystole 4
False low heart rate of
asystole calls 5
Minimizing false alarms 5
Conclusion 7
2
Understanding Pacer Pulse Characteristics
Pacer pulses versus QRS complexes
Differentiating pacer pulses from QRS complexes is done by selective filtering,
whereby each signal is classified according to its unique characteristics. The
frequency band in which the heart’s electrical signal typically falls is between
0.05 to 150 Hz. By contrast, the pacemaker signal frequency range is much
higher, due to a much narrower pulse width of 0.2 to 2ms. Also, the amplitude
of a unipolar pacer spike is usually much higher than a natural R-wave spike
generated by the heart.
Pacer pulse definition
In general the characteristics of a pacemaker pulse, which the monitor
recognizes, are defined as:
Amplitude (ap) ±2 to ±700 mV; Width (dp) 0.2 to 2.0 ms; Rise / Fall times
(min.) 0.1 dp, 100 ms; Overshoot 0.025 ap, apdp/to; and recharge time (to)
constant 4 to 100 ms.
This means the amplitude of the pulse that is measured on the body surface
through the electrodes must be at least 2 mV amplitude with 0.2 ms width.
However, a large number of factors play a role in the presentation of the
pacemaker stimulus on the body-surface ECG. The electrode configuration of
the pacing system (unipolar or bipolar), the charge generated by the
pacemaker pulse (amplitude and width), the location of the anodal and
cathodal electrode, pacer location, the recorded ECG lead, and lead
impedance all determine the ECG presentation of the pacemaker stimulus.
These factors result in a widely varied amplitude and width of the pacemaker
pulse that is picked up at the body surface. More recent developments in
pacemaker technology have resulted in greater use of lower pulse width
(0.03ms) and lower pulse amplitudes (0.25 mV),3 which fall outside the pacer
detection sensitivity range. If the algorithm sensitivity of the Dräger Medical
pacer detection were increased, greater artifact inaccuracies would result on
T E C H N I C A L A B S T R A C T
Figure 2
Pacemaker pulse parameters
1mV
Pacer spike
5-700mV
ap
ao
dp
to
Figure 1
Heart response to the
pacemaker stimulus
3
T E C H N I C A L A B S T R A C T
the ECG. Dräger Medical does not claim that ECG patient monitoring systems
can be a substitute for adequate pacemaker diagnostics.
Unipolar versus bipolar pacemakers
When monitoring patients with pacemakers, it is important to know whether
the pacemaker is unipolar or bipolar. In a unipolar pacemaker, the distal tip of
the pacing lead serves as the negative pole and the pulse generator casing is
the positive pole. As a result of this wide circuit, the unipolar pacemaker
signal varies between 2 to 100 mV and generates a large pacemaker artifact on
the ECG. In bipolar pacemakers, both poles are in the pacing lead – resulting
in a small circuit and low signal voltage. Thus, bipolar pacemakers are more
difficult for physiologic monitors to detect than are unipolar pacemakers
because of the lower voltage signal. The bipolar signal could be less than 2mV
or even 0.2mV in amplitude with a negligible overshoot for surface ECG
electrodes to sense and transmit to the monitor. Because the unipolar system
requires the pulse to travel back to the pulse generator, the voltage signal is
larger (varying between 2 to 100 mV) with a larger overshoot and tail. It is
therefore easier to detect using body-surface ECG electrodes.
1mV
Pacer spike
Pacer repolarization curve
Figure 3
Pacemaker signal
4
Pacer Signal Detection
When monitoring a patient with a pacemaker, the “Pacemaker Detection”
feature must be turned on to increase sensitivity of the algorithm’s pacemaker
pulse detector and to reduce recording electrical artifact. The presence of
pacer signals is detected by the ECG processing front-end, immediately after
power line filtering. Pacer signals are blanked and therefore not shown on the
monitor. However, a pacer mark is displayed on the monitor to signify when
the artificial pacemaker is delivering current where the front-end detects an
actual pacer spike. The pacer detection sensitivity is set to >1mV for a typical
1 ms pacer spike. This setting is carefully chosen to avoid false triggering from
erroneous or spurious signals induced by 50 or 60 Hz noise from such items
as heating blankets, infusion pumps, etc.


Opcija copiranja nece pa sam kopirala deo teksta jer vidim da ne prima ni Internet adresu!
Selected response from:

Natasa Djurovic
Serbia
Local time: 18:07
Grading comment
4 KudoZ points were awarded for this answer

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Summary of answers provided
4 +1opcija detekcije signala pejsmejkera
Natasa Djurovic
3detektovanje pejsmejkera
Katarina Delic


  

Answers


8 hrs   confidence: Answerer confidence 3/5Answerer confidence 3/5
pacer detect
detektovanje pejsmejkera


Explanation:
Ovo nije ništa sigurno. Ovaj prevod sam sama skovala na osnovu nekih stvari koje sam čitala na internetu.
Mislim da je "pejser" i "pejsmejker" jedno te isto.
Naravno, kod prevođenja ovakvih stvari poželjno je ostaviti i original, jer se softver ne lokalizuje u većini slučajeva.

When using Pacer Detect, the physician should be aware that
false positive and false negative pacer detects may occur.
False positives - may result from poor electrode hook-up or high
noise conditions.

Katarina Delic
Serbia
Local time: 18:07
Specializes in field
Native speaker of: Native in SerbianSerbian
PRO pts in category: 64
Notes to answerer
Asker: Hvala i vama, Katarina!

Login to enter a peer comment (or grade)

8 hrs   confidence: Answerer confidence 4/5Answerer confidence 4/5 peer agreement (net): +1
pacer detect
opcija detekcije signala pejsmejkera


Explanation:
Posto je opcija disabled-znaci da je iskljucena.
Na sledecoj adresi na 4. strani je objasnjenje:

http://www.draeger.com/MT/internet/pdf/CareAreas/InfoMoni/mo...

--------------------------------------------------
Note added at 8 hrs (2008-11-15 09:25:59 GMT)
--------------------------------------------------

Detekcije ili otkrivanja signala.

--------------------------------------------------
Note added at 8 hrs (2008-11-15 09:36:57 GMT)
--------------------------------------------------

Introduction
Monitoring ECG in patients with
pacemakers presents a challenge to
manufacturers of patient monitors.
Misinterpreting a pacer pulse as a
QRS complex can have dire
consequences for the patient.
Conversely, unusual circumstances
or a pacer that is incorrectly set
can result in repeated false alarms –
which is annoying to both patients
and staff and can cause the clinician
to become desensitized to the monitor.
Background
The indications to pace a patient are
varied. Simply put, pacemakers are
used with patients who have trouble
with the natural pacemaker and/or
electrical conduction cells in their
heart. There are many different types
of pacemakers, and they have
different pulse characteristics, with
different rise times and recharge
characteristics. For pacemakers that
can be implanted in the body, there
are single-chamber pacemakers, dualchamber
pacemakers, rate-responsive
pacemakers, and demand pacemakers.
The variety of chambers paced,
chambers sensed, and pacemaker
sensing functions lead to different
pulse characteristics, with different
rise times and recharge characteristics.
In spite of the best technology,
all these factors can make it difficult
to consistently differentiate pacemaker
pulses from QRS complexes. Dräger
Medical’s pacer algorithm is exceptionally
well-tuned to accommodate
for the majority of pacemakers. As
with all ECG applications, good skin
preparation and correct electrode
and lead placement will help achieve
maximum results in monitoring
paced patients.
Emergency Care · OR/Anesthesia · Critical Care · Perinatal Care · Home Care Because you care
Pacer Detection
Published: July 2004 T
E
C
H
N
I
C
A
L
A
B
S
T
R
A
C
T
Abstract:
Dräger Medical has developed
a patented pacer detection
algorithm that balances a
cautious approach to avoid
false positive1 alarms with
techniques to minimize false
negative2 ECG alarms. This
paper discusses various
aspects of pacer detection
during ECG monitoring.
Introduction 1
Background 1
Understanding pacer pulse
characteristics 2

Pacer signal detection 4
Pacing during asystole 4
False low heart rate of
asystole calls 5
Minimizing false alarms 5
Conclusion 7
2
Understanding Pacer Pulse Characteristics
Pacer pulses versus QRS complexes
Differentiating pacer pulses from QRS complexes is done by selective filtering,
whereby each signal is classified according to its unique characteristics. The
frequency band in which the heart’s electrical signal typically falls is between
0.05 to 150 Hz. By contrast, the pacemaker signal frequency range is much
higher, due to a much narrower pulse width of 0.2 to 2ms. Also, the amplitude
of a unipolar pacer spike is usually much higher than a natural R-wave spike
generated by the heart.
Pacer pulse definition
In general the characteristics of a pacemaker pulse, which the monitor
recognizes, are defined as:
Amplitude (ap) ±2 to ±700 mV; Width (dp) 0.2 to 2.0 ms; Rise / Fall times
(min.) 0.1 dp, 100 ms; Overshoot 0.025 ap, apdp/to; and recharge time (to)
constant 4 to 100 ms.
This means the amplitude of the pulse that is measured on the body surface
through the electrodes must be at least 2 mV amplitude with 0.2 ms width.
However, a large number of factors play a role in the presentation of the
pacemaker stimulus on the body-surface ECG. The electrode configuration of
the pacing system (unipolar or bipolar), the charge generated by the
pacemaker pulse (amplitude and width), the location of the anodal and
cathodal electrode, pacer location, the recorded ECG lead, and lead
impedance all determine the ECG presentation of the pacemaker stimulus.
These factors result in a widely varied amplitude and width of the pacemaker
pulse that is picked up at the body surface. More recent developments in
pacemaker technology have resulted in greater use of lower pulse width
(0.03ms) and lower pulse amplitudes (0.25 mV),3 which fall outside the pacer
detection sensitivity range. If the algorithm sensitivity of the Dräger Medical
pacer detection were increased, greater artifact inaccuracies would result on
T E C H N I C A L A B S T R A C T
Figure 2
Pacemaker pulse parameters
1mV
Pacer spike
5-700mV
ap
ao
dp
to
Figure 1
Heart response to the
pacemaker stimulus
3
T E C H N I C A L A B S T R A C T
the ECG. Dräger Medical does not claim that ECG patient monitoring systems
can be a substitute for adequate pacemaker diagnostics.
Unipolar versus bipolar pacemakers
When monitoring patients with pacemakers, it is important to know whether
the pacemaker is unipolar or bipolar. In a unipolar pacemaker, the distal tip of
the pacing lead serves as the negative pole and the pulse generator casing is
the positive pole. As a result of this wide circuit, the unipolar pacemaker
signal varies between 2 to 100 mV and generates a large pacemaker artifact on
the ECG. In bipolar pacemakers, both poles are in the pacing lead – resulting
in a small circuit and low signal voltage. Thus, bipolar pacemakers are more
difficult for physiologic monitors to detect than are unipolar pacemakers
because of the lower voltage signal. The bipolar signal could be less than 2mV
or even 0.2mV in amplitude with a negligible overshoot for surface ECG
electrodes to sense and transmit to the monitor. Because the unipolar system
requires the pulse to travel back to the pulse generator, the voltage signal is
larger (varying between 2 to 100 mV) with a larger overshoot and tail. It is
therefore easier to detect using body-surface ECG electrodes.
1mV
Pacer spike
Pacer repolarization curve
Figure 3
Pacemaker signal
4
Pacer Signal Detection
When monitoring a patient with a pacemaker, the “Pacemaker Detection”
feature must be turned on to increase sensitivity of the algorithm’s pacemaker
pulse detector and to reduce recording electrical artifact. The presence of
pacer signals is detected by the ECG processing front-end, immediately after
power line filtering. Pacer signals are blanked and therefore not shown on the
monitor. However, a pacer mark is displayed on the monitor to signify when
the artificial pacemaker is delivering current where the front-end detects an
actual pacer spike. The pacer detection sensitivity is set to >1mV for a typical
1 ms pacer spike. This setting is carefully chosen to avoid false triggering from
erroneous or spurious signals induced by 50 or 60 Hz noise from such items
as heating blankets, infusion pumps, etc.


Opcija copiranja nece pa sam kopirala deo teksta jer vidim da ne prima ni Internet adresu!

Natasa Djurovic
Serbia
Local time: 18:07
Native speaker of: Native in SerbianSerbian
PRO pts in category: 27

Peer comments on this answer (and responses from the answerer)
agree  Larisa Djuvelek-Ruggiero
14 hrs
  -> Hvala Lara!
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