Performance challenges in ECG pacemaker pulse detection systems

The paced patient population has significantly increased recently making it a priority for modern patient monitoring systems to provide accurate results for paced patients. This task has become more complicated with modern pacemaker technology and changes in the paced patient population. Certain pace pulse morphologies and paced heart rhythms demand a significant increase in the complexity of pace pulse detection algorithms. A system wide approach that focuses on both improved pace pulse detection as well as improved artifact rejection is important. In this paper, we present an approach to address common performance challenges in pace pulse detection to improve the overall monitoring of paced patients in commercial patient monitoring systems. Intensive testing of this approach using proprietary ECG databases resulted in improvements in performance benchmarks.