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False Asystole Alarms Post-Temporary Pacemaker Placement Due to Pseudo-fusion
Alyssa M Vermeulen1, Frank Zimmerman1, Hoang H Nguyen2,3
1Department of Pediatrics, Rush University Medical Center, Chicago, IL, 60612, USA.
Temporary pacing wires in infants can cause false alarms due to pacemaker malfunction. Adjusting pacemaker and monitor settings resolved these issues, improving infant care in the intensive care unit.
Area of Science:
- Pediatrics
- Cardiology
- Biomedical Engineering
Background:
- Congenital heart block and bradycardia necessitate interventions like temporary pacing wires in infants.
- Hemodynamically significant bradycardia poses critical risks to infant well-being.
Observation:
- Post-operative telemetry monitoring revealed frequent "asystole" alarms in an infant with temporary pacing wires.
- These alarms caused significant distress to the infant's family and healthcare providers.
Findings:
- Pacemaker malfunction was identified as the cause of the monitor's pseudo-malfunction, triggering false asystole alarms.
- Optimizing pacemaker and telemetry monitor parameters effectively resolved the alarm issues.
Implications:
- This case underscores the complexities of pacemaker management and monitoring in critically ill neonates.
- Increased awareness of potential pacemaker-monitor interactions is crucial for troubleshooting in neonatal intensive care settings.
- Mindful parameter adjustment can prevent unnecessary alarm fatigue and improve patient care.
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