Home

here

1. cccccceeeeeeeeeeeeeeeeeeeeeeeeeeeeteneeeeeeeees 53 6 Tarifi PRAM tiscssvesscesaccueciucseteteucceucsstannsevndesedusndisaduvsdivedavaddsidunndanedavnddstinendavaiaenidtiias 56 6 1 Section appointment c cece cece cere eeeeeeaeeeeeeeeeeeeeeeeneneeeeeeees 56 6 2 Management of the tariff plan 00 erecta 56 Te IN TRAIN ia Sasa assess cetaceans eased aiaa a iaaa iaeia aiaa a ddiaa iiaia 58 7 1 Section appointment eeeeeeeeeeeeeeeeerrrreeeererrrnnnrrnnserrrrrnnnnnnenererne nenne 58 7 2 Management of family memberts 0 ccccccccceeeeeeeeeeeeeeeeeeeeeeneaees 58 MUNIN eater ce otter dem cect e ee a Eaa E eee 59 8 1 Section appointment cccccccec eee cceeeeee eee tere eeeeeeaaeeeeeeeeeeeeeeeeeaaeees 59 MKS KS040001 64 Rev 1 0 Page 3 8 2 Management of patients cccccccccceeeeceee cette eeeeeeeeeeeneeeeeeeeeeeeeeee 59 9 Reporting sivasseacaiiaussnnnnacraanuatiacnpiradasaanwaamsidnmensaouuaesiaeiiicueaenesdubaaumennkeusnencaguencasla 61 9 1 Section appointment 2 cece cece eeeeeneee eee treet eeeeeaaeeeeeeeeeeeteeea 61 9 2 View history examinations 00 0 ccccccccccecee cece etree eeeeeeteeeeeeeeeeeeeeeee 61 10 Deposit FUNdS siscessncnscsiencsinssenctaccsssusiseadsnscdsndsisansiadeaanaadaevesseisanadanddnciwessaiad 62 10 1 Section appointment ccc cece cece eee eeeeeeeeeeeeeeeeeeeeeeseeeeeeeeeeees 62 10 2 Deposit by
2. Dispersion index Norm Deviation Evident deviation Main integral indexes 1 Myocardium lt 15 15 20 2 Rhythm lt 50 51 79 3 T alternation mkV lt 12 12 20 4 Index of electrical instability uBeT nHgekca OTOOparkaeTca B BEPXHen 1 2 or 4 yacTu noptTpeta cepAua Detailization code 0 norm S small deviation L norm border deviation greater then 0 evident deviation Small values greater than 0 may be a variant of the norm for indexes of detalization 1 and 2 G1 Depolarization of right atrium 0 S L 1 5 6 11 G2 Depolarization of left atrium 0 S L 1 3 4 6 G3 Depolarization of right ventricle 0 S L 1 6 G4 Depolarization of left ventricle 0 S L 1 6 G5 Repolarization of right venticle 0 S L 1 G6 Repolarization of left venticle 0 S L 1 6 G7 Electrical symmetry of ventricles 0 S L 1 3 G8 Intraventricular blocking 0 S L G9 Compensatory reaction of 0 S L 1 3 4 6 ventricules In direct comparison with each examination the current values of indexes and boundary values of Table 1 is not necessary The main indexes have a color that matches following table and text evaluation values of detalization code which is optional optional for the user is given in the additional text messages see below Emphasize once more that the client is required to view only the major indexes Myocardium and Rhythm Other indexes the user can view when gain expe
3. Rev 1 0 Page 61 10 Deposit Funds 10 1 Section appointment You can fund your account in ecg4me com various methods The section Make deposit is designed to recharge your account ecg4me com 10 2 Deposit by credit card Visa MasterCard To recharge your account in the system ecg4me com with a credit card to perform the following tasks 1 Open section Make deposit 2 Enter the amount of deposit in the field Pay 3 Choose a payment type Payment system Visa MasterCard and others Add money to your account Pay 1000 Payment terminals Bank receipt Prepaid card Payment system Visa Mastercard Webmoney and others Payment type Create bill Fig 43 Deposit by the payment system 4 Press the Create bill After clicking this button you will be redirected to the payment system with a secure interface to make a payment 5 Select a payment method bank card and enter your e mail and click Continue Page 62 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Payment from credit card You should pay 1000 00 rubles alinnik mks ru NEXT Fig 44 Selecting payment method 6 Enter the card number card expiry date cardholder s name in Latin letters the code CVV2 CVC2 and click Pay Enter credit card data VISA amp gt Card number 4276345645235 103 Date of expire 01 7 2014 Owner Alexey Linnik CVV2 CVC2 111 PAY CANCEL Puc 45 Enter your c
4. Tariff plan plan You do not have this section if you are registered as Cabinet diagnosis Site section which is an adjustment you have a list of family My family members who use the Internet service You do not have this section if you are registered as Cabinet diagnosis Site section where you can replenish your account in Make deposit different ways In this section you can replenish your account by credit card instantly Cardiovisor Service function estimation of the heart functional state This section is only available for Cabinet diagnosis This Patients section is intended for patient management of Cabinet diagnosis This section is only available for Cabinet diagnosis This Reporting section is intended to view a report about examinations that were conducted at your Cabinet diagnosis Site functions Cardiovisor Page 30 MKS KS040001 64 Rev 1 0 User Manual Cartiovisor Gallery of portraits View of dispersion portraits from of the active page table examinations If you wish to view more short lists change the number of records per page In addition viewed lists can be filtered by date via the function lt Select Examination gt which is available in the Table examinations Dynamics View the chart changes over time the four most important dispersion indexes List view identical with the list of portrait gallery View graphs is the simplest and most effective procedure for
5. Deviations in the ventricular function In the presence of deviations assessed the adequacy of myocardial oxygen supply the probability of myocardial hypoxia primarily Red color of this heading messages are indicating about probable problem situation 5 COMPENSATORY REACTION of myocardium Deviations in the electrical excitation synchronicity of the left and right ventricles These deviations are associated with transient temporary or persistent causes of overloading one of the ventricles usually the left always This overload is due to the increase in the activity one of the ventricles for compensating insufficiency of blood supply If the messages in this heading have stable red color this is evidence of pathological changes 6 OTHER CHANGES Signs of exhaustion asthenia the regulatory reserves of the organism as a whole May be associated with high levels of stress even in the absence of significant deviations in myocardium Prolonged stay in a state of regulatory asthenia is associated with high risk but not necessarily cardiac Page 44 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor 4 4 Control of dynamics and gallery of portraits The most basic and important information for the client contains in graphics to control of dynamics of dispersion indexes on time and also in the gallery of portraits is synchronized with graphics This information is formed on the correspondin
6. 1 2 5 3 View GENERAL CONCLUSION at children In text messages of the general conclusion in children s population there are reports about the presence of borderline deviations reports about truncated P Q or extended Q T more often Such reports reflect personal age singularities and it is not associated with clinically significant changes in most cases The most effective method of objective specification of such reports it is periodic control of dynamics for example once a week 1 2 5 4 Singularities of detailing G3 G9 indexes at children while watching the dynamic Children tend to have significantly higher variability of G9 index Normal background value of G9 index is 0 3 often O at adult patients in the absence of ventricular hypertrophy By contrast natural children s background can up to 5 8 or even 10 Thus Myocardium remains the principal objective indicator of a state If value of Myocardium index does not exceed 15 16 and on the G9 graph appear red indicator it is personal age singularities instead of a significant deviation more often In such cases watch closely dynamics However if the G9 index has steadily high value and decreases as they grow up it requires consultation with a doctor Increasing the value of any of the indexes G3 G4 or G7 separately or in combination with G9 index are reliable sign of significant changes in the dispersion characteristics as in adults Page 28 MKS KS040
7. 30 consult a doctor advisor is advisable 4 In serial examinations If the oscillations of the main index Myocardium in examinations which are fulfilled successively have saltuses value 15 20 and more this is evidence that technical possibilities of the device Cardiovisor are exceeded This situation is relatively rare and may occur at the expressed position of the heart features in the chest for example with a significant deviation apex back By repeating such a situation in examinations e first it is expedient to receive consultation of the doctor since it anyway a situation of deviations and is necessary to estimate their clinical significance e second you can try to eliminate this factor by clicking on the ECG input in the prone position and you need an assistant In rare instances if you do not manage to eliminate this problem you can refuse the given service or to use it only for monitoring of slow tendencies which described saltuses influence slightly Page 70 MKS KS040001 64 Rev 1 0 User Manual Cartiovisor Problem description Recommendations In serial examinations which are fulfilled successively the larger oscillations of the index G9 The second graph on top in lt Dynamic gt section For example e 1 e examination G9 3 e 2 e examination G9 14 e 3 e examination G9 16 e 4 e examination G9 0 If oscillations of index G9 are
8. 7 My family 7 1 Section appointment Section My Family is available if you are registered as individual person In the cabinet diagnosis this section is not available You can examined except yourseves other members of your family or friends in your private site area For each examinee the separate history of surveys is conducted and dynamics is formed In this section you can add change or delete the attributes of your relatives which you will examined 7 2 Management of family members Section My Family looks like this Add member of family Search by lastname Enter lastname or first letters of lastname Find My family 2 First name Age Pages 1 Black Ann V 46 View details Delete Black John V 27 View details Delete Pages 1 P Fig 40 Settings of family members Attention t is impossible under one login account under one name to examine different people as the history and dynamics of examinations will be distorted If you want to examine other people you have to define them as family members and then you can examine these people By clicking the Add member of family you can add a new family member To see the new family member you must click View Turning to the view mode you can change the family member attributes By clicking the Delete button you can remove a family member If a family member have been examinated already then the system will prevent removal P
9. In other cases such 15 oscillations can accompany processes of negative dynamics of a myocardium for example at slow rise of average value of main index Myocardium Presence of such enlarged oscillations always is the additional factor of presence of deviations If in the peak of oscillations absolute numbers main index higher than 24 useful to consult a doctor advisor Page 68 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Problem description Recommendations The server returns the report Error at conclusion formation In the Examinations table there is a new record that does not include conclusions i e the positions Myocardium Rhythm and Pulse empty The possible reasons e Contact has worsened or was completely disturbed on one of electrodes in the course of input This situation can be detected through viewing the ECG by buttons lt I gt and lt lll gt Others ECG lead can not view An example of disconnecting the electrode during removal is shown in the following figure e isoline experience significant oscillations for example as shown in Figure e During ECG input there was an electromagnetic noise in the form of impulse of the big amplitude for example at performance near to repair work with electric welding usage In all these cases the reason can be identified by viewing of lead lt I gt or lt lll gt in an appropriate row of the exam
10. basic rules f there is a significant increase of indexes G7 and G3 G4 it is a sign of changes which have pathological character with high probability W f oscillations of index G9 that on magnification on reduction it is evidence of transient Such a process may not necessarily be caused by progressive pathology Often it is transient and is caused by overloads physical and psychological factors transient hormonal changes defective rest meals etc If index G9 steadily increased also matters 7 and more to consult the cardiologist is expediently already available hypertrophy of one of ventricles In many cases it can be a forerunner of developing or Similarly if the symmetry indices of ventricular G7 and G3 G4 steadily increased are a sign of possible pathological changes Indexes G1 G2 G5 G6 and G8 which are not commented upon in this manual are intended only for the doctor Client who wants to see these indexes and detail of the code needs to know only the following general information Indexes G1 G2 Page 46 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor characterize atrial myocardium Increased attention to these indexes may be appropriate in the presence of arrhythmias or pronounced changes in the index of electrical instability Indexes G5 G6 concern ventricles and can show complex dynamics of changes that are dependent on many factors which can handle only a doctor These indexes increa
11. changes it is age related features instead of deviations Portrait features at children are characteristic for two areas the area of auricles and area of ventricular repolarization SO Se 1 2 Fig 34 Portrait features at children 1 Auricles 2 Ventricular repolarization Some sample variants of portraits with such features are resulted in a following drawing Fig 35 Heart portraits at children 1 10net Myocardium 14 2 10net Myocardium 13 3 15 net Myocardium 15 changes in the right auricle 4 13net Myocardium 14 5 17 net Myocardium 14 MKS KS040001 64 Rev 1 0 Page 51 4 5 4 Features of the indicator of electric instability at children The indicator of electrical instability in children s population also is characterised by the enlarged variability directly associated with increased variability of a rhythm at children The most common expression of this feature this is the frequent appearance of yellow color on this indicator In age group till 15 years existence of the yellow indicator is often associated with functional instead of pathological states which reflect natural stages of a children s organism growth However persistent signs of instability in the form of red indicator requires the attention of a doctor to determine the probable cause of the identified arrhythmia Page 52 MKS KS040001 64 Rev 1 0 User Manual Cari 5 Personal data 5 1
12. comments Fig 17 Cardiovisor comment Examination is finished You can add comment to examination You can enter the comment or select comment from list and press button Add comment You can see the examination conclusion immediately without comment entering if you press button Don t add commenti If you want save your blood pressure data you should measure it Select from list or enter SAD pressure DAD pressure Add comment Fig 17 Window enter comments If you have any precise information about your current state the feeling sick drugs taken etc type in the field and click lt Add comment gt Attention Added comment has no effect on automatic conclusion of examination and provides only to inform the doctor You can go the conclusion without entering comments by clicking lt Do not add the a comment gt If you wish to measure pressure by tonometer and to specify also the pressure you can make it on this page Conclusion of examination to wait 1 60 seconds it depends on the characteristics of the line connection and computer performance MKS KS040001 64 Rev 1 0 Page 23 If you have not received the conclusion or error information during this time record the re examination If after registration re examination you have not received conclusion please contact technical support 1 2 4 Result evaluation Conclusion Window contains the following information located top to bo
13. connected to USB port Check whether the device Verify whether the device is connected check whether the USB port and whether the device driver is correctly installed If everything is all right over the button there will be a message Cardiovisor detected and ready for use If over the button there is a message Subsystem of operation with CardioVisor available Make sure that necessary software installed it means that the software either is not installed absolutely or installed incorrectly If you have not installed the software the software is on a disk or it can be downloaded from section of the site Price Install it Page 22 MKS KS040001 64 Rev 1 0 User Manual Cari If the software is installed and up until that time all worked try to quit from personal site area restart your browser and come again to personal site area If it does not work try to reinstall CardioVisor software If also it has not helped please contact technical support 1 2 3 Perform examination After button click lt Start examination gt the page of Examination will open and cardiogram registration will begin Adjustment of service within the first 5 seconds is led in this time you should a comfortable position relax and stop moving and then within 30 seconds will be ECG registration Buumanne Save a state of a relaxation and rest during all time of ECG registration After 30 seconds the screen will be displayed window enter
14. correctly If the given branch is not present or the given device is not present means the hardware driver cardioamplifier system Cardiovisor is not installed If the hardware driver cardioamplifier systems Cardiovisor is not installed or the device works incorrectly install reinstall the driver manually Cardioamplifier driver when installing Internet service software installed in default folder C Program Files MCS KardiRu Drv For driver installation manually to connect cardioamplifier to USB port it is necessary There will be standard Windows dialog that the new device is founded In this dialog you specify that you will choose the driver path independently and set the path location of the driver C Program Files MCS KardiRu Drv If you can t install the device yourself contact technical support Technical support contacts and hotline phone listed on the site http Awww ecg4me com in section Contacts MKS KS040001 64 Rev 1 0 Page 19 Cardiovisor er Manual 1 2 Conducting Examination Examinations of the functional state of the heart produced produced in some stages by means of Internet service 1 Authorisation on site http www ecg4me com 2 Preparing for examination 3 Perform examination 4 Result evaluation 1 2 1 Authorization To log on to the main page should click Private site area and specify on the authorization page your E Mail and password that you entered during registration and contr
15. doctor usually who examines his patients Individual person It is a method of registering the client in system which allows to receive the short simple conclusion after examination The client this is a person without medical education and examines himself and his family members independently MKS KS040001 64 Rev 1 0 Page 73
16. first survey you get a steady increase in the value of the dispersion index it is only evidence ofthe need toconsulta doctor and not a cause for false self severe pathology A Internet service ecg4me com DOES NOT REPLACE other methods of research on clinical examination of the heart and CAN be used only when compared with other clinical data Self use appropriate for screening and monitoring Internet service ecg4me com does not make the DIAGNOSIS Internet service appointment identifying early dispersive deflections in the group of borderlines of heart and the prevention of presence of the expressed pathology Medications can influence by sight a portrait of heart and character of the conclusion of the screening assessment In the case of Internet service in the course of treatment with drug exposure required current matching portraits of the heart and portraits received prior to beginning or at the beginning of drug therapy MKS KS040001 64 Rev 1 0 Page 5 Basic principles of using Internet service ecg4me com Z Internet service ecg4me com provides independent measurement ECG microalternations dispersive indexes characteristics and forms on the basis of their conclusion the measurement for the client containing one of four major recommendations It is not revealed deviations NORM There are borderline deviations you should control the dynamics of dispersive indexes At revealing of slow negative dynamics of dispers
17. fluctuates in a range of 20 60 as a rule increases in the evening When the Rhythm is consistently over 50 at any time of day is evidence of probable presence in the organism a constant source of increased tension of regulatory systems nervous tension dysfunction of internal organs inflammation etc In this case in the conclusion of text heading RHYTHM below the portrait of the heart there is a warning about high levels of stress or probable arrhythmia 4 2 Heart portrait All cameras on a heart portrait have green color in a state of physiological norm as is shown in a figure 27 Page 40 MKS KS040001 64 Rev 1 0 User Manual ari Indicator of electrical instability Right atrium Left atrium Right ventricle Left ventricle Fig 27 Heart portrait Color of the appropriate areas of a myocardium changes towards red color at appearance of deviations and rich red color is a sign of the maximum expression of pathological deviations The slightest change of the dispersion characteristics of the electric excitation are visible on the portrait The color pattern of color changes has characteristic individual signs in the presence of deviations so the portrait of the heart keeps such individual features for a long time like an individual face featured a portrait of the individual These individual variations are quite significant but all of them submit to a uniform principle The more expression of re
18. is detected for the first time control of dynamics and mandatory examinations is necessary More than 27 pathology or the expressed pathology If this deviation is detected for the first time steadily repeated and has no tendency to increase in successive examinations should be examined at the first opportunity If in this same situation has steadily rapid growth of the deviations of time measured by minutes or other minute intervals the emergency consultation of the doctor is necessary Similarly the index of Rhythm is a marker of the adaptive capacity of the organism or arrhythmia less than 15 no significant deviations 15 50 slight deviations may be a variant of the norm in the natural daily oscillations 51 80 it is borderline state More than 80 expressed deviation from the norm This is a sign of exhaustion of compensatory allowance asthenia in the regulatory system of the heart rhythm Medical examination is necessary If there are signs of arrhythmia in an additional section of text messages Rhythm Table 2 is formed by a message on the probable arrhythmia Indicator Rhythm is enough dynamical value If you are healthy and rhythm control system optimally balanced the indicator Rhythm steadily in the range 0 20 At high stress or expressed arrhythmia indicator will be in the range of gt 70 A MKS KS040001 64 Rev 1 0 Page 39 healthy urban dweller this index
19. service Attention Before you begin make sure that you have completed the installation of required software see section 1 of this guide and that cardioamplifier connected to the USB port of your computer After logged into lt Private site area gt click lt Cardiovisor gt In the opened window push the button lt Examine your heart gt Dynamic Gallery of portraits Examine your heart Fig 21 Button lt Examine your heart gt A window with the instruction which determines the order of the input ECG This procedure reduces to the following sequence of actions STEP 1 Place the electrodes on the standard template limb leads as shown in Figure pre moistened point overlap with a contact spray in the absence of a contact spray is acceptable wetting contact of the electrode surface with clean water red electrode R on the right hand the yellow electrode L on the left hand green electrode F on left lower leg black electrode N on right lower leg Make sure that the electrodes are imposed without an error at the specified color match Pay special attention to the quality of contact between the electrode N which determines the quality of the ECG in the other channels R L F If the electrodes N and F are imposed on nylon stocking fabric to ensure good contact points should be plentiful moisture superposition Page 32 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Fig 22 Scheme applicatio
20. the client user To simplify the analysis tendencies excess boundaries of normal is indicated on the graphs by yellow and red color Print You can make a paper copy of the main examination results This copy called the examination form can be used for archiving conclusions and as the preliminary information at medical survey Examination table Database examinations of personal section This section is the main service Cardiovisor window as from this window begins examination and from this window you can view any record that is stored in the database examinations View of ECG signal for all six limb leads at the same time With the help of scroll you can view the 30 sec recording step Allwaves by step This review is only for a doctor in case of necessity ECG analysis because requires special knowledge View the ECG signal on a selected lead This view can be useful if the server returned the error message instead of the l II Il aVR aVL conclusion One of the main reasons is the poor quality of the aVF ECG signal in this situation see more in section 5 Problem situations in the conclusion analysis which can detect when viewed leads and Ill To send This function allows to send your examination to the doctor discharged Your doctor will look a survey and will give their examination to recommendations the doctor MKS KS040001 64 Rev 1 0 Page 31 3 Operations with Internet
21. ventricular hypertrophy normal background value of index G9 is 0 3 more often 0 at adult patients By contrast natural background at children can reach 5 8 and even 10 In this case the smaller child have the higher background value of this MKS KS040001 64 Rev 1 0 Page 49 Cardiovisor er Mana indicator This feature is caused by natural prevalence at children s age of the right departments of heart For this reason children may have increased the value of a single index G9 at simultaneously low value of the main index a myocardium within 14 15 l e it is not a sign of significant deviations unless the age exceeds it 16 years However if index G9 has steadily high value and does not decrease as they grow older it requires special attention of the doctor Much higher variability of indexes G5 G6 is observed at children Detailing code 13 6 3 575 5711 S S G5 G6 Fig 33 Variability of G5 G6 at children These indexes also are not specific signs of pathological changes at adults since can be caused transient metabolic changes The increased value of G5 G6 are is more often caused by natural age metabolic fluctuations instead of the pathological reasons at children Some variants of cardiomyopathies can represent an exception therefore anyway great values of these indexes demand attention of the doctor In case of simultaneous joint augmentation other indexes G3 G4 G7 G9 too the increased value of
22. 001 64 Rev 1 0 User Manual Cardiovisor 1 3 Shutdown To complete the work with Internet service click lt Exit gt at the top of the menu page Disconnect cardioamplifier from the computer remove remaining gel spray from the electrodes by cotton cloth collect and add all the accessories of the Cardiovisor system in custom packaging MKS KS040001 64 Rev 1 0 Page 29 Cardiovisor User Manual 2 Interface description brief Name Button Menu Item Function Description Main menu Home Main page a brief project description and news feed About Cardiovisor Information section about Cardiovisor It describes the purpose of the device and short information about work technology Section of the site which describes the service Cardiovisor Prices and other services tariff plans and other legal information about using the service The project has the ability to work under the supervision of a Doctors doctor This page lists the doctors who are working with the project already For partners The affiliate program is specified in this section outlines Contacts Site section contains information about technical support distributor and manufacturer of Cardiovisor Site functions PRIVATE SITE AREA Personal data Section of the site which contained your personal data during registration Site section where you see the rates and change the tariff
23. Approved MKS KS040001 61 LU The computer system for heart screening Cardiovisor User manual Internet service ECG4ME COM MKS KS040001 61 Familiarize before the operation beginning We are glad to welcome you as the user of Internet service ecg4me com the computer system for heart screening CardioVisor hereinafter Internet service the newest evaluation system of the heart functional state which differs convenience simplicity and efficiency of application The given manual is intended for users of Internet service ecg4me com on the Internet portal http www ecg4me com Attention Before operation with Internet service attentively familiarize with the given manual Manual provides detailed information and instructions for proper use of the Internet service Changes which are not worsening characteristics of Internet service can be not reflected in this document If you encounter any errors or failures when using Internet service please inform us about it Contact Information OOO Medical Computer Systems POST ADDRESS Moscow 124460 Russia P O Box 58 REGISTERED ADDRESS passage 4922 4 2 Zelenograd Moscow 124460 Russia PHONE 7 495 913 31 94 FAX 7 495 913 31 95 E MAIL mks mks ru SITE www mks ru The computer system for heart screening Cardio Visor TY 9442 013 17635079 2007 Registration certificate Ne CP 2007 00155 Document Status Document MKC KC040001 64 Car
24. G5 G6 substantiating clinically significant deviations W Reliable sign of significant changes in the dispersion characteristics are increasing the value of any indexes G3 G4 G7 separately or in combination with other indexes as well as at adults Ss In text reports of Conclusion in children s population more frequent occurrence of reports about truncated P Q or extended Q T is probably Automatic classifier device Cardiovisor takes into account the age norms for the given intervals therefore appearance of such reports can be an indication of the individual characteristics of the myocardium or the presence of deviations In any case the most effective way of objective specification is a control of dynamics 4 5 3 Features of a dispersive heart portrait at children Dispersion portraits of the heart in children population as well as detalization indexes are more sensitive in comparison with portraits of heart at adults Therefore the basic features of children s portraits are shown mainly in the field of norm or small deviations Often at low or borderline values of the main index Myocardium within 12 15 on heart portraits are observed local yellow or orange changes These changes have individual character and reflect the increased variability of microalternations at children Therefore if the main index Page 50 MKS KS040001 64 Rev 1 0 User Manual Caio Myocardium is less than 15 and on a portrait there are
25. Section appointment The section Personal data is designed to view and change personal data provided during registration In this section you can also change the password to enter the private site area 5 2 Change of the personal data In order to open the section Personal data should click on Personal data in your account Kardi Ru Personal data Add photo Last name Black First name Alex Middle name V E mail alexblack mks ru Login for forum alexblack Date of birth 14 12 1967 Male male Weight kg 70 Height sm 170 Region New York Contact mobile phone Example 9031234567 9981234567 Account number 4550 Money 870 0 Modify person data Change password Fig 36 Personal data To change the personal data press the button Modify personal data it is necessary The system passes into edit mode after button pressing MKS KS040001 64 Rev 1 0 Page 53 Cardiovisor er Mana Personal data Add photo Last name Black First name Alex Middle name V E mail alexblack mks ru Login for forum alexblack Date of birth 14 12 1967 Male male Weight kg 70 Height sm 170 Region New York Contact mobile phone Example 9031234567 9981234567 Account number 4550 Money 870 0 Modify person data Change password Fig 37 Kind of the conclusion for children The symbol marked fields are required After data input for the changes to take effect you must click Save You must cli
26. age 58 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor 8 Patients 8 1 Section appointment Section Patients is available if you are registered as cabinet diagnosis In the individual person this section is not available This section is intended to introduce or making their patients here The separate history of examinations is conducted and formed dynamics for each examinee In this section you can add delete or modify the attributes of your patients that you will examine This page appears at the entrance to the private site area in the cabinet diagnosis 8 2 Management of patients Section Patients looks as follows z v Add patient Search by lastname Enter lastname or first letters of lastname Find Patients 2 First name Age Pages 1 Black Ann V 46 View details Cardiovisor Black John V 27 View details Cardiovisor Pages 1 Fig 41 Settings of patients Attention You cant examine different people under one account under the same name as the history and dynamics of the examinations will be distorted If you want to examine other people you should define everyone inspected as separate patient and already then to conduct examination of these people By clicking the Add Patient you can add a new patient To see the new family member you must click View If you go to view mode you can change the attributes of the patient If many patients the patients are displayed on s
27. al support for the online service ecg4me com Gallery of portraits it is the sequence of the dispersion portraits in time presented in one window for monitoring of rate and expression of changes Dispersion indexes these are total numerical estimations of ECG microalternations which are formed in a window of results for the user Dynamics it is the graphs of the variation 4 main dispersion indexes in time to observe the rate of growth abnormalities Dispersion heart portrait Computer model of dispersing characteristics of the heart showing expression and locating of deviations of these characteristics from of norm on 2nd auricles and 2nd ventricles of man s heart Color of appropriate areas of a portrait also correspond to a traditional scale traffic light green NORM yellow and its shades the DEVIATION red the EXPRESSED DEVIATION Conclusion it is the text information which contains results of measuring the amplitude of ECG _ microalternations This information contains recommendations for the client service and some general information about the electrophysiological nature of deviations in addition to numeric values of the dispersion index CardioVisor it is device for fast measurement of ECG microalternations amplitude so the button for a call of the given service in section lt Private site area gt is called The device consists from cardioamplifier and the specialized software am
28. aminations of another family member or patient In other words from one to five examinations performed consistently for over an hour by one family member will be charged as one examination Your tarif plan defines the Kardi ru services price You can change tarif plan on this page Your tarif plan Simple Last date of tarif plan modifying 01 01 2009 Service CARDIOVISOR Monthly payment N 0 rub Cost of one examination 65 rub Restriction of tarif plan modifying no restriction Change tarif plan Select tarif Unlimited v Service CARDIOVISOR Monthly payment 4500 rub Cost of one examination 0 rub Restriction of tarif plan modifying 30 days Change Fig 39 Tariff plan Attributes of the following tariff plan Monthly payment this is the amount that each month will be charged to your account Cost of one examination this Page 56 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor is the amount to be debited each time from the account after the examination immediately Restriction of tariff plan modifying the amount of days during which will be forbidden to variate the tariff plan after passage to it Your plan and your rates are indicated at the top of the page Tariff plans for which you can go in the bottom of the page In order to change the tariff plan you need to choose a new tariff plan at the bottom of the page and click Change MKS KS040001 64 Rev 1 0 Page 57 Cardiovisor ser Mana
29. anges in the dispersion indicators follow these basic rule f there was a sharp magnification of numerical indicators and intensity of red color on a heart portrait these changes steadily repeat in several successively the fulfilled examinations and the system recommends immediate examination without postponing you should contact a doctor If this indicator and electrical instability sharply changed color from green to red a sure sign of a high probability of acute myocardial ischemia infarct is possible further evaluation should be performed by a doctor 4 5 Features of dispersive indexes at children 4 5 1 Features of the analysis children s results W As noted above the natural processes of organism growth at children produce characteristic electrophysiological background reflecting the complex processes of metabolic oscillations in the growing myocardium In many cases these background MKS KS040001 64 Rev 1 0 Page 47 Cardiovisor ser Mana fluctuations occur in the range of index values Myocardium at least 15 However there are enough cases when such background not expressed deviations of deviation of the dispersion characteristics from of norm increase the index Myocardium to values of 15 16 and in the conclusion reports are formed about boundary changes of auricles and ventricles This conclusion has the following standard form GENERAL CONCLUSION 15 If these deviations are repeated on sequential he
30. art porterts you should control the dynamics of examinations Negative dynamic is eventual Moderate nonspecific myocardium CHANGES of ventricles Indications of hypoxia CHANGES in ventricular myocardium are similar to ISCHEMIC changes RYTHM NORM sinoatrial rate ELECTRICAL AXIS NORMAL position of heart electrical axis ATRIUMS VENTRICLES COMPENSATORY REACTION of myocardium Puc 30 Bug zaknioyenna gna peten In these cases in the conclusion the recommendation about control of dynamics is formed during certain time If the index Myocardium in long term dynamics within days or weeks does not increase or decreases it is evidence of background character of these boundary changes If in dynamics of the main index Myocardium and on portraits is observed a negative trend for gradual increase consultation of the doctor is necessary The value of main index Myocardium and related indexes of detail G1 G9 may experience transient episodes in children with a temporary increase followed by a return to original values Page 48 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Detailing code Detailing code 13 613 S 11 S S Saia aaia BESS G1 G2 G5 G6 G3 G4 G7 G8 G9 Fig 31 G1 G9 at children Such episodes may be associated with the residual process in the myocardium after previous inflammatory or infectious diseases A The values of main index myocardium in the range 18 20 demand extremely attent
31. ations between improvement and deterioration it is advisable resort to the help of doctor consultant of this service gt This service can be used for periodic monitoring of heart disease at children since 6 years Thus it is necessary to remember that variability of ECG _ microalternations at childrenis much higher than at adults since reflects natural adapting reactions of the growing heart MKS KS040001 64 Rev 1 0 Page 7 Hardware and communication system requirements For the stable operation of Internet service your hardware and communication system should be satisfy the following minimum requirements Minimum configuration PC Pentium III 500 RAM 512 Mb HDD 20 Gb Operating system requirements for desktop computer Windows 2000 XP Vista 7 32 x 6uTHaa nnn 64 x 6uTHaA OC Browser Requirements Internet Explorer 6 and higher Mozilla Firefox 3 andhigher Google Chrome 13 0 andhigher The browser shouldbe a 32 bit With 64 bit browser for example Internet Explorer browser that comes with a64 bit operating system the registration of examination is not working amp Requirements for the communication channel the speed of data transmission over the network to the subscriber per subscriber must be at least 256 kbit sec Page 8 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor 1 Quick Start 1 1 Getting Started Preparing to work with Internet service in several steps 1 Registration on a site htt
32. ava now C Change destination folder Install gt Fig 8 Initial screen of the JAVA RUNTIME ENVIRONMENT package If you click Cancel you abort the installation of JAVA RUNTIME ENVIRONMENT package If you click nstall the following window will open Fig 9 MKS KS040001 64 Rev 1 0 Page 17 Cardiovisor er Manual ie Java Setup Progress E Installing Java e r amp Sun This may take a few minutes Java Status LLLELLELELLLL CLL LLL LLL LLL LL LLL LELELLELLELLELLLLLLLLLLL Now you can have a full featured office suite that s compatible with Microsoft Office for free Powerful integrated set of word processing spreadsheet presentation drawing and database applications Reads edits and saves Microsoft Office files Supports over 70 languages and Solaris Windows Linux and Mac operating systems Uses industrystandard open file format OpenDocument as its default file format rit Builtin one click PDF export lt f 8 El f OpenOffice org mpress Sase Mat Fig 9 Window of the installation JAVA RUNTIME ENVIRONMENT package This window shows that the installation JAVA RUNTIME ENVIRONMEN package is running Progress barin the window indicates that necessary files for work are recorded Once the necessary files will be written the following window will open Fig 10 i Java Setup Complete x amp Sun Java You have successfully installed Java Java updates wil
33. bility The constant presence of red indicator of electric instability has a poor prognosis If such sign has arisen for the first time and is steadily saved faster consultation of the cardiologist is necessary If this sign is present already at the first examination by service KARDi ru you should definitely consult a cardiologist and avoid physical or mental overloads 4 3 The text conclusion with recommendations In a window results of section lt Cardiovisor gt under a heart portrait the text information containing results of the analysis of measuring the amplitude of ECG microalternations This information contains recommendations for the customer service and some general information about electrophysiological nature of identified Page 42 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor deviations in addition to numeric values of dispersion indexes The text of conclusion grouped by 6 headings presented in Table 2 The client should read the first heading GENERAL CONCLUSION is necessary The remaining headings are optional gray or black text message and provide additional details aggregative deviations which can be useful when consulting a doctor The client is not required to read these additional messages but can use the latest if you want more profoundly to observe the dynamics deviations from the norm Messages excreted with red color read in all headings expediently since it is reports on significant deviations Some
34. cal stages of pathological processes Therefore if the index Myocardium in this range of values does not return to the values 14 16 for a long time to consult a doctor is advisable MKS KS040001 64 Rev 1 0 Page 27 1 2 5 2 View heart portrait at children W Dispersion heart portraits in children s population as well as detailed indexes are more sensitive in comparison with the heart portraits at adults Often at small or boundary values of main index Myocardium within 12 15 local yellow or orange changes observed on heart portraits These changes have individual character and reflect the increased variability of microalternations at children Therefore if the main index of infarction is less than 15 and there is a change on the portrait it is age related features not deviations For more detailed information about the features children s portraits are given in paragraph 4 5 Indicator of electrical instability on the heart portrait at children s population much more frequently than at adults has a yellow color In the age group under 15 years existence of the yellow indicator is often associated with functional not pathological conditions that reflect the natural stages of child s organism growth In most cases yellow indicator is reflectance of natural age variations instead of the enlarged probability of a possible arrhythmia Only frequent repeat of the red indicator demands the same attention as at adults
35. ck Change password to change your password login into your personal account At password change to enter the old password it is necessary then enter your new password twice After password input to press the button Change it is necessary Modify password Old password eecccece New password eeeccecce New password re enter eevccecee Change Back Fig 38 Change password Page 54 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor After password change at a following entrance in private site area you will need to specify the new password If to press the button Add photo you can download the photo on the server In the same section are displayed account number and the sum on the personal account You should supervise the sum on the personal account that possibility to carry examinations has not been blocked MKS KS040001 64 Rev 1 0 Page 55 Cardiovisor ser Mana 6 Tariff Plan 6 1 Section appointment Examinations in the project CardioVisor ecg4me com are paid Each examination is charged according to your tariff plan After the examination a fixed amount is deducted from your account in the system ecg4me com 6 2 Management of the tariff plan Section Tariff Plan is designed for review of tariff plan and choose another tariff plan Attention Under the same examination refers to one to five examinations made during the hours of one family member or patient which are not interrupted ex
36. credit card Visa MasterCard cc ceesseeeeeeeeeeeeees 62 10 3 Deposit by prepaid card iscsi ectcesstcansniensamsinns Cond vens Cvbdaed cca deen SeaeeensCasames 64 10 4 Deposit by Sberbank of Russia receipt ceeeeeeeeeeeeeeeees 64 10 5 Deposit by a payment terminals ccc eeeeeeeeeeeeeeeeeeeeeteanees 65 11 Typical problem situations when using the service eeeeeeees 66 11 7 EGG WN etna ern saaisersntehed dali dace ieni ndaid aeiaai ia ndide iai 66 11 2 Conclusion AMA YSIS esis siessiceutnersvevtenrcnnptnerldtentved neeebumdbueubeeuevayiueumemubueunnes 68 Annex 1 Basic concepts and terminology used sssssseeeeeeeeeeeeeeeeeeeeeeeeeeeeees 72 Page 4 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Restrictions Z This service does not change the doctor and it is not the instrument for self diagnostics even if the user hasany knowledge inthe field of cardiology It is a service independent periodic assessment of the functional state of the heart measuring the average amplitude of the ECG microalternations and subsequent observation of dynamics of this amplitude in time A Significant amplitude of the ECG microalternations may be transient in nature and may be caused not changes inthe myocardium but other causes in certain cases for example periodic changes in hormonal levels Only a doctor canestablish the true cause of these changes Therefore if the
37. d color and the more area on which there was a change of green color towards red there is more deviation The most significant pathological changes include the left ventricle or both of the ventricle as well as area 15 in the left angle of the heart portrait see Fig 28 Particular attention should be paid to bright red band in the area of 15 even if all the other areas of the portrait are green standards In the case of a stable frequency of this sign should consult a cardiologist MKS KS040001 64 Rev 1 0 Page 41 The high degree of richness of red color in different areas of the portrait is not always clearly associated with poor prognosis For example in some slowly varying states of postinfarction cardiosclerosis red is more pronounced than for certain types of acute ischemia infarction although probability of relapse in case of deterioration cardiosclerosis usually less than in myocardial infarction Therefore after portrait review you should be required familiarize with text conclusions and recommendations allocated under a portrait Need Fig 28 Display of pathological changes to a heart portrait In the upper left part of a portrait field there is an indicator of electrical instability of a myocardium in the form of a square field with changed colour see fig 28 Expressed signs of electrical instability corresponds to the color red normal green The yellow color corresponds to the border of electrical insta
38. diovisor User manual ecg4me com Revision 1 0 Publication date 17 09 2011 Medical Computer Systems Page 2 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Content Restrictions Sam eee eee ee ee eee eerie ee eer ee ee ee eee ee ee ee 5 Basic principles of using Internet service CCO4ME COM 11111seeseeeeeeeeeeeees 6 Hardware and communication system requirements 220eeeeeeeeeeeeeeeeeeettteeees 8 1 Q ick Starton a AA aiaa aAa aaa aaa ian 9 1 1 Getting Started iia cssd etek cis andre nenprdedcenendvarinpcdccvenendsadanendeevenpedcebang tac 9 1 1 1 How to register on the Site ccccccccceeeeeeeeeeeeeeeeeeeeeeeeeentneeeeeeeees 9 1 1 2 How to download software cccccccceeeeeeeeeeeeeneeeeeeeeeeeeeeeeneeees 11 1 1 3 How to install software 0 0c cece eee eeeeeeeeeeeeeeeeeeeeesenaaees 11 1 2 Conducting Examination cccccccceceeccceeeeee cece rete eeeeeceeeeeeeeeeeeeeeee 20 1 2 1 Authorization soc Seaetcaie eestor se epeaienenge die aadeewientan euduieatantpceuieniactcaniontonse 20 1 2 2 Preparing for examination ccccceceeee cece eeeeeeeeeeeeeeeeeeeeeeenaeees 20 1 2 3 Perform examination sien en aaiatnaRatheneataes 23 1 2 4 Result evaluation ccccccccccc ccc ceeeceeeeeeeeeeeeeeceeeeeeeeeeeeeeeeeeeeaaees 24 1 2 5 Specific analysis of children s results cccccceeeeetteeeeeeees 27 1 3 TNO iasreietertetiet
39. e of the thermometer also identifies three basic gradations of deviations 1 the insignificant 2 the border when the help of the doctor is recommended 3 expressed when the help of the doctor is necessary Z The important factor of the analysis of dynamics are the first examination which receive right after how you became the client of this service Dispersive indexes and portraits of the first examination are standards reading level for control of subsequent dynamics If you have established heart disease the indices of the first examinationto belarge and theportraits will be with red zone in the area of change But this level despite its considerable size will Sampling in subsequent examinations Even at the expressed pathological changes of the myocardium but correctly selected medication the Page 6 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor dispersion index and the portraits remain stable over time This fact provides the ability to effectively use this service to control the disease and influence on this flow of various factors of an everyday life A To improve the quality control procedures forthe slow dynamics over long periods months or years it is advisable to carry out examinations in the most similar conditions i e at the same time of day at the same time before or after meals etc Z When you are facedwith an incomprehensible to you the dynamics of dispersion parameters for example periodic oscill
40. e of any significant deviations from the dispersion model of the ideal heart Similarly the rate of Rhythm 100 corresponds to the most expressed changes in the regulation of heart rhythm peculiar to expressed arrhythmias or strong stress details of these deviations contained in the text comments of section Rhythm in conclusion The Detalization code includes 9 additional indexes The number of each additional index detail code begins with the letter G G1 G2 G9 Indexes of detail G1 G9 are the rank the higher value the is more deviation from the norm Medical titles of the dispersion indexes are not important for the user These titles are saved only for uniform terminology as in sections of the site ecg4me com for the user and it is in fuller sections for the doctor In text reports meaning major indexes have a color in accordance with Table 1 green yellow red Indexes of code detail G1 G9 are always displayed only in black Average pulse rate is always displayed in addition to the dispersion indices Pulse is not a dispersion index but it is necessary for the doctor decision making as an important system parameter The value of each dispersion index belongs to one of the three bands standard deviation expressed deviation in the following table Table 1 Quantitative limits of the dispersion index for the separation of state standard deviation MKS KS040001 64 Rev 1 0 Page 37 Cartliovisor User Manual
41. ecourse to a doctor or to plan visit to a doctor or To achieve consultation of the doctor without delay However if the dispersion indexes are significant variations and you doubt the validity of self assessment do not delay reversal to the doctor 1 2 5 Specific analysis of children s results 1 2 5 1 View of value of an MYOCARDIUM index at children Natural processes of growth of the organism at children create the characteristic electrophysiological background reflecting complex personal processes of metabolic oscillations in the growing myocardium In many cases these background oscillations increase the MYOCARDIUM index to values of 15 16 and at the end formed message about border changes of auricles and ventricles although there is no pathological changes Therefore in spite of the fact that these boundary value concern an interval of small deviations dynamics control is the principal indicator in such states at children If the Myocardium index is in a range of 15 16 within days or weeks does not increases or decreases within days or weeks it is certificate of background character of these boundary changes i e this state of individual norm W Values of main myocardium index in the range 18 20 demand attentive relation to dynamics control at children In this range the increase of the dispersion characteristics may be caused by transient metabolic causes unrelated to heart disease and early preclini
42. electrophysiological detailing Main INDEX This index is the sum integral of all the other dispersion deviations indexes This is an index with very slow dynamics as it is MYOCARDIUM influenced by all the indexes G9 Index of Index G9 the most dynamical of all It reflects the myocardial processes in myocardium associated with the fast compensatory compensatory reactions of the myocardium If average reaction in the value G9 steadily exceeds value 6 is a sign of the early functional changes in a myocardium when transient depolarization compensator response was fixed and became a constant It is observed at the left ventricle hypertrophy less often right though this sign can accompany and other pathologies of heart more often G7 Index of ventricular symmetry in the middle of depolarization Index G7 is less dynamical than G9 It reflects processes in peak of electrical excitation of a myocardium and is very sensitive to a myocardium hypoxia oxygen insufficiency The increased value of this index are associated with credible pathological changes in most cases G3 G4 Index of ventricular symmetry in the end of depolarization Index G3 G4 slow also Reflects the processes at the end of the electrical excitation of the myocardium If this index has significant deviation it is almost faultless indicator of pathological changes in ventricular myocardium It is advisable to remember two
43. everal pages The patient can be found by surname or by the first letters of surname if to use search To do this enter the first letters of the name and click Search By clicking Cardiovisor may switch to the selected patient examination MKS KS040001 64 Rev 1 0 Page 59 Cartliovisor User Manual Black Ann V Select Black Ann V X Dynamic Gallery of portraits Examine your heart Examination filter Faia To Record count on 25 Fa dd mm yyyy a dd mm yyyy page Change Examinations 0 Examination Myocardium Rhythm Pulse date tick min Pressure Comment Fig 42 Examination of selected patient If you make examination of the patient be convinced that in the top of the page that person whom you examine is specified Page 60 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor 9 Reporting 9 1 Section appointment Section Reporting is designed to view the history of examinations in your cabinet of diagnostics Section Reporting is is available if you are registered as cabinet diagnosis In the individual person this section is not available 9 2 View history examinations To view the history of examinations in the cabinet diagnosis to select a date range for which you request the history of the examinations After you click Generate reports you will see a report on examinations that have been produced in your cabinet of diagnostics for specified time period MKS KS040001 64
44. g button lt Dynamic gt and lt Gallery of portrait gt at the top Graphs of the function lt Dynamic gt formed from the time when made 2 examinations at least If deviations are not present the graph of tendencies looks like a line allocated in the field of admissible value of indexes If there are deviations in the field of the value exceeding admissible value there is a filling of yellow or red color yellow excess of boundary of norm red the expressed deviation from norm The main sign of adversity is a tendency of gradual increase of indicators If such tendency is not present even at the increased indicators it is a sign of the functional stability of myocardium In such cases fulfill examination with increased frequency appropriate timely to see the start of the negative dynamics Four graphs are supervised MYOCARDIUM J G9 J G7 G3 G4 Graphic structure of the field output is shown in Figure Main INDEX of deviations MYOCARDIUM Puc 29 Graph structure lt Dynamic gt If graphics exceed norm boundary there is an indicator filling by yellow colour If the boundary of the expressed deviations is exceeded filling by red colour is formed General information about electrophysiological detail of these graphs are presented in Table 3 Ta6nuua 3 MKS KS040001 64 Rev 1 0 Page 45 Cardiovisor User Manual Description of lt Dynamic gt graphs The graph name The graph description
45. ge necessarily expect from a user clicking a button After entering the comment or withdrawal service to send data entered to the server for processing After 1 minute depending on PC performance speed and load on the server the process will be completed by output to the display screen lt Results window gt which includes heart portrait and conclusion with recommendations If you have any transient noise in the process of input ECG which caused abrupt changes in contour ECG examination appropriate to repeat substandard examination in this case must be removed from the Examinations table Attention f at the first portrait detect deviations from the norm to prevent accidental influence of artifacts on examination get another one or two portraits without removing the electrodes it is expedient MKS KS040001 64 Rev 1 0 Page 35 Cardiovisor er Mant 4 Analysis of conclusions Results Window section lt Cardiovisor gt looks like Gallery of portraits Dynamic Print Examinations table ViewECG Allwaves n m avr avi avf Myocardium Rhythm Pulse Detailing code 15 40 98 tick min 3 L S 1 1 S 5 DIFFICULT variant of low amplitude alternations The CONCLUSION may have decreased reliability GENERAL CONCLUSION 15 If these deviations are repeated on sequential heart porterts you should control the dynamics of examinations Negative dynamic is eventual Moderate CHANGES of ventricles myocard
46. ie csscesctscetacscaseuscelaeicteopacnleateniedl argeianientensge taseulasten taten anne aseulastenteseeaanemnesesianics 29 2 Interface description brief sisicicssicsccsnsicasisesdsnsasnansesadesssncddsnasnscsndssucavnedsncadnansades 30 Operations with Internet Service ssesssssunnnnneeennnnnunnnnnnnnnnnnnnnnnnnnn nnmnnn 32 4 Analysis of conclusions sccniciciaustatcianeinitinnsiansaediialsimiaddinkadaliiaduiataiaiauilaanlabaton 36 4 1 Numerical values of dispersive indexes of a myocardium status 37 4 2 Heart portrait cztcsoscsi tite d tetcch tngh de tbeeclebetOrcensbee eos eeetiertudbae mi debaberieniieesiaa eee 40 4 3 The text conclusion with recommendations ee 42 4 4 Control of dynamics and gallery of portraits 0 ees 45 4 5 Features of dispersive indexes at children cccccccceeeeeeeeeees 47 4 5 1 Features of the analysis children s results cceeeees 47 4 5 2 Features of indexes of detailed elaboration G1 G9 at children 49 4 5 3 Features of a dispersive heart portrait at children 000 50 4 5 4 Features of the indicator of electric instability at children 52 5 Personal Cat cata tcsstauntaastmetantanetnnedannhita ca untannaeadanibaantsehanunlaraianlaunbeuntantonnalneaben 53 5 1 Section appointment c cece cccecee eee e ee eeeeeeeeaeaaeeeeeeeseesecneeeeeeeees 53 5 2 Change of the personal data
47. ill go to next stage of software installation The next stage will be installed JAVA RUNTIME ENVIRONMENT necessary packages The installation program in English The following window should open Fig 8 This software can be installed on yourcomputer before You open another window in this case Fig 7 i amp Java Setup A This software has already been installed on your computer Would you like to reinstall it Fig 7 Confirm cancel window to reinstall JAVA RUNTIME ENVIRONMENT package In this case you must click No so that JAVA RUNTIME ENVIRONMENT package does not produce again If JAVA RUNTIME ENVIRONMENT package was not installed earlier then the following window will be opened Fig 8 Before the opening of the window can be Page 16 MKS KS040001 64 Rev 1 0 User Manual Cari opened additional windows which show that the installation program collects information These tool windows do not require any participation from the user ie Java Setup Welcome x amp Sun Welcome to Java Java provides safe and secure access to the world of amazing Java content From business solutions to helpful utilities and entertainment Java makes your internet experience come to life No personal information is gathered as part of our install process For more information on what we do collect see http java com data View License Agreement Click Install to accept the license agreement and install J
48. inations table If explicit defects of ECG it is not identified and the server returns an error message you should contact support service MKS KS040001 64 Rev 1 0 Page 69 Cardiovisor User Manual which are fulfilled successively the larger oscillations of the main index MYOCARDIUM are occasionally observed In addition more than 15 for example e 1 e examination 43 e 2 e examination 16 e 3 e examination 19 e 4 e examination 17 In the first survey the saltus over a stable background 16 19 is explicitly observed Ne Problem description Recommendations 3 Inthe beginning of the This report is the standard information that in the text inference before a__ course of microalternations registration device heading GENERAL Cardiovisor worked to limit the technical possibilities CONCLUSION of low In this situation the error of measurement of amplitude alternations microalternations amplitude is increased and or difficult situation of accordingly and therefore decreases the reliability of electrical axis of heart is conclusions formed The user is At appearance of this report it is necessary to informed that the remember that value of main index a myocardium can conclusion may have be uprated on 7 10 In the case of the stable reduced reliability repetition of this situation and the high values of main index Myocardium more than 25
49. ith Edit fields that are not marked with an asterisk are filled according to your desire PIN code is entered from a card which is included in the kit which is transmitted by the acquisition unit If you are a private person and plan to work independently at home examining yourself and members of the family that you set a mode Individual person when registering If you have amedical degree and you are going to serve your patients CardioVisor examination then you set amode Cabinet diagnosis when registering By operation in a mode Cabinet diagnosis is formed more complex conclusion after examination which may not Page 10 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor be obvious person without a medical education Please contact technical support for the project can change the mode of operation already in operation in the future After registration on yours E mail which you specify in the field E mail the message with a link to confirm your registration should come You must open this link in a letter and this action will confirm the registration When you specify a PIN code from a prepaid card at registration the system can automatically confirm your registration and not to request a registration confirmation via email 1 1 2 How to download software To download the installer software internet service you needto open the section Prices on the site www ecg4me com and click Last version of Cardiovisor software he
50. ium Fig 25 Appearance of the section lt Cardiovisor gt It is located on the left keypad section of the main functions of personal section lt My Account gt the description of buttons in section 2 of this guide It is the main options for viewing reports in the upper part The main field of the window is the current block of the examination results Block of the examination consists of three sections numerical values of the dispersion indexes of state heart portrait textual conclusion with recommendations Page 36 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor 4 1 Numerical values of dispersive indexes of a myocardium status At the top of the block contains the results of four main status indicators the index Myocardium index Rhythm the average pulse rate and index Detalization code Myocardium Rhythm Pulse Detailing code 15 40 98 tick min 3 L S S 1 1 S 5 Fig 26 Presentation of main dispersion indexes Dispersion indexes Myocardium and Rhythm are relative characteristics that characterize the total value of the deviations dispersion from the norm and changed in the range 0 100 The more value of index the is more deviation from the norm Physically the meaning of infarction 100 corresponds to the pathological complex that is associated with significant deviations from the norm practically in all chambers of the heart Value Myocardium 0 corresponds to complete absenc
51. ive indexes examination is expedient There are deviations in excess of normal ranges inspection is expedient At revealing of negative dynamics of dispersive indexes in time examination is necessary There are expressed deviations examination is necessary At the expressed deviations and simultaneous detection of fast negative dynamics the emergency reference to the doctor is necessary A Periodically performing examination and monitoring the dynamics of dispersion indexes B pasgenax in sections lt Dynamic gt and lt Gallery of portraits gt you are capable to solve effectively two main problems concern in due time to see the fast and latent increase of the deviations capable to cause heart attack and it is reliable to supervise dynamics of the slow deviations associated with established heart disease A At work with the given service you can be guided by the simple analogy that is familiar to everyone since childhood This household measurement of body temperature by means of the thermometer This procedure cannot provide statement of the medical diagnosis butit allows you to record the fact that deviations from the norm the severity of these abnormalities and the feasibility or the need to call the doctor Z The main dispersive index Myocardium is analogue of temperature the above value of this index it is more deviations the less functional reserves of amyocardium Scale of this index it is similar to the scal
52. ive relation to dynamics control at children In this range the increase of the dispersion characteristics can be caused by transient metabolic reasons unrelated to heart disease and early preclinical stages of pathological processes Therefore if the index Myocardium in the range of values does not return to the values 14 16 for a long time consultation of the doctor is expedient 4 5 2 Features of indexes of detailed elaboration G1 G9 at children Higher variability of indexes G1 and G2 is observed at children especially in the age group of 6 12 years Detailing code 13 6 3 s s s 11 s s a G1 G2 Fig 32 Variability of G1 G2 at children The index values in these groups in size 5 7 indicate the presence of deviations from the physiological norm at adults but such increased values reflect only natural individual processes of age adaptation of the growing heart at children in most cases Therefore the index values less than 7 10 and text reports about boundary changes in auricles are generally among the natural physiological background and it is not significant change Conclusion specification is possible only at repeated examination i e at dynamics control Only in the presence of a tendency to increase of these indexes in process of a growing it is expedient to address to the doctor to determine the cause of such negative dynamics Much higher variability of index G9 is observed at children In the absence of
53. l automatically be downloaded to provide you with the latest features and security improvements To change this see htta java com autoupdate Close l Fig 10 JAVA RUNTIME ENVIRONMENT package installed Page 18 MKS KS040001 64 Rev 1 0 User Manual Cari This window displays that the installation completed successfully Click Close to exit the installation program In this installation is complete it is desirable to check whether correctly installed hardware driver cardioamplifier system Cardiovisor after installation For this purpose connect cardioamplifier to USB port and open Windows Device Manager on your computer Fig 11 m Computer Management Local i System Tools B Acronis Devices E E Event Viewer i Batteries E Shared Folders ig Computer E 2 Local Users and Groups Disk drives i a Performance Logs and Alert 2 Display adapters a Device Manager 4 DYD CD ROM drives Sg Storage E Human Interface Devices a g Removable Storage E IDE ATA ATAPI controllers Disk Defragmenter Disk Management oe Services and Applications 7 w Modems Monitors gt Fig 11 Windows Device Manager Should be a branch MCS USB Medical Devices in Device Manager In this branch should be a device such as KARDi2 4 N gt Attention Exclamation points should not be on the device The exclamation point shows that the device does not work
54. ly saved faster consultation of the cardiologist is necessary If this sign is present already at the first examination already you should consult a cardiologist and to avoid physical or mental overloads 1 2 4 3 View the recommendations of the general conclusion Read the general conclusion The analysis is completed if there is no recommendation about expediency or necessity of consultation at the doctor Please note other information of the general conclusion Estimate dynamics of changes if there are recommendations about medical consultation 1 2 4 4 Dynamics review MKS KS040001 64 Rev 1 0 Page 25 Cardiovisor er Mana At the top of page push the button lt Dynamic gt In opened window check the top graph of thedispersion index MYOCARDIUM Attention Dynamics review is possible since the moment when you have made at least 2 examinations Fig 20 Graphics of dynamics of the dispersion index Define is or not tendencies of steady rise of value of the given index Especially attentively should perform this evaluation if the graph of the index MYOCARDIUM indicated by red color In the case of the growth tendency this index look at the other graphs in the window dynamics G9 G7 G3 G4 If the observed G9 index advance it is a signof the transition process associated with the compensatory reactions ofthe myocardium In this case in subsequent examinations to find out is that transient process or
55. m description Recommendations 1 By button pressing lt Examine your heart gt at the top of the input window there is a report that Cardiovisor is not connected to USB port The possible reasons e Cardioamplifier is not connected to the USB port e USB connection is made but the connection done the wrong jack which carried out the first initialization the cardioamplifier on this computer On some computer models it is possible that the operating system can not automatically apply to the driver of cardioamplifier with this USB port You have not paid attention to a systemic window with a sentence to install the driver probably In this situation or return to the original USB port or once again pulling out and inserting the USB connector initialize the cardioamplifier for the new USB port following the request of the Hardware Wizard If the defect does not disappear you can contact support by reference phone presented on the home page 2 Input does not start by Must again button pressing e check the correctness electrode application on lt Examine your heart gt the finiteness and at the top of the e make sure that all 4 leads from cardioamplifier input window there is a connected with the right electrode and all the report stating that the terminals on connectors of the electrodes are electrodes are not twisted all the way connected or not wetted e moisten the contact surfaces of all elec
56. n of ECG electrodes Attention Entanglement of the electrodes during the setting is unacceptable because this will lead to completely misleading conclusions The most important factor to guarantee accuracy of the portrait is a state of rest when you type ECG If the examination is performed in a sitting position take a comfortable relaxed position the most exclusive muscle tremors is necessary hands on knees body slightly tilted forward lean back in his chair is not recommended as in this case the tremor increases usually Breathing during input ECG should be normal preferably without the deep breaths and exhalations If you are in a state of nervous excitement you can close your eyes During ECG input talk or head turns are inadmissible STEP 2 Click the left mouse button lt Examine your heart gt There will be a window of ECG input on the screen Attention f you have a problem situation see section 5 Typical problem situations when using the service ECG input The first 5 seconds the supporting procedures performed optimal adaptation of cardioamplifier to input signal It is also assigned to take a comfortable position and relax However as noted above the recommended position of the hands with fixed electrodes on his knees At this time on the indicator of exposure time is the countdown 5 4 0 ECG display begins with counting 0 MKS KS040001 64 Rev 1 0 Page 33 Cardi
57. nation automatically Fig 14 gt Start examination ef AER N Fig 14 Page preparation for the new examination Before being displayed this page will open a confirmation window of run the application Internet service ecg4me com Fig 15 MKS KS040001 64 Rev 1 0 Page 21 Warning Security The application s digital signature cannot be verified Do you want to run the application Name mkssite applet kardi Publisher MKS From http kardi ru Run Cancel The digital signature cannot be verified by a trusted source Only run if you trust the origin of the application More Information Fig 15 Confirmation window to run the application You must set the flag Always trust content from this publisher and click Run When you enter the private site area this window may not be displayed Follow the instructions on the page Place electrodes on limbs and take a comfortable position When you re ready click lt Start examination gt Cardiovisor as standard equipment includes four electrodes clothespins If you have extended completion CardioVisor with chest leads you can choose to switch Fig 16 workin standard mode 6 leads orin advanced mode with chest electrodes 12 leads O 6 standard leads 12 standard leads N gt Start examination Fig 16 Confirmation window start the service If the above button the message Cardiovisor is not
58. not is necessary l e need to find out there was transition process recently or it is observed long enough If G9 index will start to be returned after a while to reference values it there was a transient episode of deterioration If the G9 index does not decrease it s a powerful argument for mandatory consultation with a doctor Dynamics example in a picture illustrates the described singularity On the last examinations are visible index fluctuations G9 which ultimately led toless pronounced fluctuations of the main index MYOCARDIUM 1 2 4 5 Final decision Accept the final decision about the functional state of heart by comparing the recommendations of general conclusion and dynamics assessment according to the following logic Page 26 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor W If there is an increase of deviations in the dynamics must exactly follow the recommendations of GENERAL CONCLUSION This is a sign of the negative dynamics that can be associated with the approaching relapse of the disease If there is no sustainable growth abnormalities you can increase the frequency of examinations and continue specification of dynamics of changes on short intervals of time hours or days Especially attentively to carry out this clarification if you take drugs during this period is necessary Dynamic is a critical indicator in the final choice of alternatives for further action detailed dynamics without r
59. observed it is a sign of particular transient processes in a myocardium caused by compensatory responses First of all you need to pay attention to the value of the index G3 G4 In case of presence of deviations in these groups oscillations of index G9 is a sign of possible early stages of pathological changes This case demands mandatory consultation from the cardiologist In case there are no deviations in G3 G4 G7 or they are insignificant it is appropriate follow the dynamics of the oscillations provided the main index Myocardium is not in the red zone above 23 If the amplitude oscillations of G9 on the graph lt Dynamic gt decreases in due course it s evidence of transient changes It is possible to try to analyze what events of last time could lead to such compensatory response of a myocardium If the tendency on decrease of oscillations G9 is not present especially if these oscillations are accompanied by slow augmentation of main index Myocardium it is necessary to consult a cardiologist It is necessary to consider that in the absence of significant deviations in groups G3 G4 G7 oscillations G9 can trace changes in hormonal background In such situation the doctor advisor can make the decision on necessity of examination at the endocrinologist MKS KS040001 64 Rev 1 0 Page 71 Annex 1 Basic concepts and terminology used Doctor it is registered expert cardiologist performing medic
60. of deposit in the field Pay 3 Choose a payment type Bank receipt 4 Click Create bill Page 64 MKS KS040001 64 Rev 1 0 User Manual Cari Add money to your account Pay 1000 Payment terminals Bank receipt Payment type Prepaid card Paymeht system Visa Mastercard Webmoney and others Create bill Fig 47 Deposit by bank receipt 5 You will be redirected to the next page Bill information Bill is successfully created N Account Number 194 Create date 04 10 2011 Pay rub 1000 Method of payment KBMTaHuMA C ep aHKka Download receipt If you don t pay the bill during 15 days the bill will be annuled Click the link download receipt Receipt opens Print receipt on a printer You should enter your address in the receipt and deliver the signature O o ND Cash receipt at the nearest branch of Sberbank of Russia 10 5 Deposit by a payment terminals To replenish the account in system ecg4me com it is possible through terminals of payment system QIWI Several thousands of terminals located throughout Russia To replenish your account through the terminals you must first set ourselves an account in the ecg4me com then find the nearest terminal and entering your phone number which is specified in your account to make ecg4me com deposit MKS KS040001 64 Rev 1 0 Page 65 Cardiovisor User Manual 11 Typical problem situations when using the service 11 1 ECG input No Proble
61. ol numbers Puc 12 Authorization Registration Email alexblack mks ru Password eccccece Remember me Enter digit from picture OS 6023 show other Enter Forget password lf you are not registered and you want to see the private site area with examinations and conclusions you can see demo cabinet Puc 12 Authorization window You will be automatically logged into private site area after authorization 1 2 2 Preparing for examination Examinations done in the Cardiovisor personal account This page opens automatically when you enter private site area if you are registered as Individual person If you are registeredas Cabinet diagnosis you shouldgo to the section Cardiovisor In the Cardiovisor there is a button lt Examine your heart gt Page 20 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Examine your heart Fig 13 Button lt Examine your heart gt From the graph Select at the top of page from the drop down list select a family member if you are registered as Individual person or patient if you are registered as Cabinet diagnosis examination which will now be carried out The owner of individual person is selected by default Attention Examination that you conduct will be correlated only with the family member whom you have chosen before Connect cardioamplifier to USB port on your computer and click lt Examine your heart gt Next will be open a page for a new exami
62. ovisor er Mana Stop examination 6 Fig 23 ECG input box Lead signals and II are displayed in the input box for visual inspection of the input process These signals can be quite different in different people It is important that periodically appear narrow pulses R teeth with a frequency of heart beats R wave can take the form of stretched pulses in the presence of pathology but in any case it is waves of the electrocardiogram with the highest rate of increase R wave can be directed both upwards and downwards If the noise exceeds the path of 4 mm in mm substrate or contour undergoes sharp variations across the field of graph paper you need to press the mouse button lt Stop examination gt Possible reasons for this situation see Section 5 Typical problem situations when using the service ECG input Page 34 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor R wave Isoline Noise path Fig 24 Typical appearance of the ECG signal Enter resumed by pressing the button lt Start examination gt Inout ECG data is completed within 35 seconds from the time pressing the button lt Start examination gt 5 sec Preset 30 sec exposure At the end of input ECG window for adding a comment with instructions how to write a comment will appear automatically at the top of the window Attention Until you enter a comment or refuse it processing will not continue l e service at this sta
63. p www ecg4me com 2 Download the installer from the site the installer is also on the disc which comes in the sales package with cardio amplifier 3 Install supporting software MKS company 4 Driver installation of cardioamplifier 5 Install the software JAVA RUNTIME ENVIRONMENT 3 5 stages are automated and run the installer 1 1 1 How to register on the site To install the client software of internet service www ecg4me com you must register on the site To get on the registration page to click on Private site area on the home page and thenthe link Registration or by opening link http www kardi ru ru register ntmlRegister The registration page is presented in Figure Fig 1 MKS KS040001 64 Rev 1 0 Page 9 Cardiovisor User Manual Registration Obligatory fields are marked Individual person Cabinet diagnosis Lastname Alex Firstname John Middle name V E mail alexblack mks ru Login for forum alexblack Password 8 32 characters in length This password is necessary for using private site area eeeeeooee and forum Password re enter eoccccce N Date of birth aaa Male male bd Weight kg 70 Height sm 170 Country RUSSIA X Town Moscow bal Contact mobile phone Example 9031234567 1897891233 PIN code agree with conditions of contract Fig 1 Registration window on the site http www ecg4me com On this page you need to complete all elements of editing marked w
64. p Cardioamplifier USB prefix for the personal computer Is it the hardware system CardioVisor and is designed for digital ECG input into the computer Client the registered user who has concluded the contract for provision of given service ECG microalternations microscopic oscillations of the ECG electrocardiogram signal Simplistically it is possible to present these microoscillations as jitter of line of ECG records To see it by eyes and especially visually to analyze line jitter it is impossible because of very small amplitude of microoscillations To do _ this applies special processing of weak signals Personal site area personal section of general information about the site ecg4me com client This section also includes the start button for all basic functions of service Examination Procedure of ECG input for measurement of microalternations which includes applying of 4 electrodes and the subsequent ECG input during 30 sec Page 72 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Heart portrait same as Dispersion heart portrait Ta6nnua o6cnegosannn the main window of section lt Cardiovisor gt which contains ECG input and the automatic conclusion of all completed examinations Cabinet diagnosis It is a method of registering the client in system which allows to receive the complete medical conclusion by results of examination The client this is the
65. quent examination of the client also should be performed only in this position because ECG may be dependent on body position This mark about the specified singularity it is expedient to import in the field Comment in data processing MKS KS040001 64 Rev 1 0 Page 67 Cardiovisor 11 2 Conclusion analysis User Manual Ne Problem description Recommendations 1 In the serial surveys This is a sign of increased instability in the executable electrophysiological parameters of myocardium successively the The main index Myocardium in a state of increased oscillations of physiological norm may naturally oscillate in the main index range of 1 3 Similarly the main index may MYOCARDIUM are have a large value in the presence of pathology watched additional but to be stable under these boundaries 1 3 in increase in the index properly selected drug therapy more than 4 but less If the oscillations of the main index increased than 15 for example namely the increase in the index make additional 5 e 1 e examination 14 this indicates the presence of causes 15 leading to the heterogeneity of the myocardium e 2 e examination electrical excitation process in successive cycles 20 These oscillations may not have clinical e 3 e examination significance for example may be transient or may 17 be due to abnormalities of the skin at points e 4 e examination electrode application
66. re After opening the link browser is automatically saving the installer software on the computer If download does not start automatically click Last version of Cardiovisor_ software here right click and choose from the drop down menu Save as or use the download manager Do not forget to remember the location where the installer is saved On the site you can download the latest version of the distribution Distributive software is also available on disk which is included in the package The disc can be not the latest version of the distribution so installation is better to download the package from the server Distributive located in the archive Before installation you need to extract it from the archive 1 1 3 How to install software Attention You need administrative access to PC for software installation Attention No matter connected cardioamplifier to PC USB port or not when installing software Necessary to unpack the installer from archive and run the file start bat for software installation Internet service After the start you must open the installation wizard Fig 2 Attention The sequence of actions and appearance of windows may vary slightly for different versions of the Windows operating system MKS KS040001 64 Rev 1 0 Page 11 Cardiovisor seer Manual J KardiRu Welcome to the KardiRu Setup Wizard The installer will guide you through the steps requi
67. red to install KardiRu on your computer WARNING This computer program is protected by copyright law and intemational treaties Unauthorized duplication or distribution of this program or any portion of it may result in severe civil or criminal penalties and will be prosecuted to the maximum extent possible under the law Fig 2 Setup Wizard Internet Service ecg4me com In this window you need to press Next to continue the installation If you click Cancel you abort the installation After clicking the Next opens the following window Fig 3 Page 12 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor J KardiRu Select Installation Folder The installer will install KardiRu to the following folder To install in this folder click Next To install to a different folder enter it below or click Browse Folder fC Program Files x86 MCS KardiRus Browse l Install KardiRu for yourself or for anyone who uses this computer Everyone Just me Te Cancel lt Back Next gt Fig 3 Choice of setup folder In this window you must specify the file location where the installation will be done The installation program will offera folder to install automatically You can enter the location manually in the edit window Folder or by clicking Browse to select the folder from the list of existing folders If you click disk space you can estimate the disk space require
68. redit card information 7 The payment system will process the transfer of money and you will be redirected to his private site area of ecg4me com after a while MKS KS040001 64 Rev 1 0 Page 63 Cardiovisor er Mana 10 3 Deposit by prepaid card The card for primary activation of the account is in a sale set ecg4me com Card data for subsequent deposit can be acquired at partners of distributors of cards and at office of sales ecg4me com To recharge your account in the system ecg4me com by prepaid card to perform the following tasks 1 Open section Make deposit 2 Choose a payment type Prepaid card 3 Your PIN code card which is located at your blanket The protective layer should erase it to see the PIN code Add money to your account PIN code 12234 35544 23492 12662 Payment terminals Bank receipt Prepaid card Payment system Visa Mastercard Webmoney and others Payment type Activate card Fig 46 Deposit by prepaid card 4 Click Activate card 5 Money from a card will be will be automatically transferred to your account in system ecg4me com 10 4 Deposit by Sberbank of Russia receipt This scheme allows us to write ourselves receipt and to pay this receipt in the bank Bank paymentusually occurs during the one to five days To recharge your account in the system ecg4me com by bank receipt to perform the following tasks 1 Open section Make deposit 2 Enter the amount
69. rience of working with this service Page 38 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor The index Myocardium is the main marker of the myocardium state less than 15 no significant deviations This indicates that at the moment myocardial function is normal If this conclusion is obtained by the intake of drugs it is advisable to consult a doctor because more detailed information the doctor can be obtained only after examination by a medical device CardioVisor with a load 15 19 it is borderline state control of dynamics is expedient At negative dynamics i e at slow rise of value of the indicator mandatory consultation of the doctor is necessary The borderline state can result from weariness because of a physical or mental overload an irrational delivery alcohol influence and also the metabolic changes caused by a pathology of other organs Therefore the sustainable preservation of this state requires consult a doctor If the borderline state due to transitory factors the indicator should decrease gradually reflecting the functional normalization myocardium 20 22 pathology is probable If this deviation is detected for the first time need to control the dynamics increased frequency of surveys and medical examination is expedient If the indicator steady rise in this range a medical examination is necessary 23 27 pathology is probable If this deviation
70. s at least 20 MB If you click Cancel you abort the installation If you click Back you return to the previous window If you click Next the following window will open Fig 4 MKS KS040001 64 Rev 1 0 Page 13 Cardiovisor ser Manual J KardiRu Confirm Installation The installer is ready to install KardiRu on your computer Click Next to start the installation Fig 4 Confirm Installation This window warns you that everything is ready for installation and asks you to confirm installation continuation If you click Cancel you abort the installation If you click Back you return to the previous window If you click Next to begin installation of the software and the following window will open Fig 5 Page 14 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor K KardiRu Installing KardiRu KardiRu is being installed Please wait Fig 5 Window installation process Progress bar displaysin the window write the necessary files on your computer If you click Cancel you abort the installation Then you go to the next window Fig 6 MKS KS040001 64 Rev 1 0 Page 15 Cardiovisor er Mana J KardiRu pm Lol Se Installation Complete L KardiRu has been successfully installed Click Close to exit Fig 6 Installation Complete This window shows that this stage the installation completed successfully If you click Close you w
71. se with significant pathological changes practically always However there may be transient changes caused by for example dehydration high salt intake in the diet etc factors Therefore in itself indexes G5 G6 without indexes G3 G4 G7 G9 have no for the client of any independent significance This is a level of medical expertise as noted Index G8 gives a rough estimate of average excitation rate of the ventricles and also is intended for the doctor Additional overview information about the structure and intensity changes can be obtained by clicking lt Gallery of Portrait gt The gallery shows dynamics of changes for all map of dispersing changes of a myocardium taking into account localisation of changes on four heart cameras It is also advisable to focus on the empirical rule On localisation most significantly intensive reddening of ventricles lf it is visible the tendency to deterioration of the ventricles in the gallery consulting cardiologist is required Do not forget the continued availability of red indicator electrical instability in the gallery of portraits in the form of colored squares on the top left on each portrait has a poor prognosis If you use this internet service all the time you will always have time to make the right decisions since electric ECG microalternations are the earliest markers of approaching functional failures of a myocardium In this case the rare but possible cases of abrupt ch
72. times before the main text of the conclusions may be reports of lower reliability of conclusions such as Advanced variant of low amplitude alternations Conclusion may have reduced reliability This means that the existence deviations in the examination is reliable but the absolute values of dispersion indexes have increased uncertainty This increase of error in measuring the dispersion indexes a relatively rare event It is associated with features of ECG microalternations that occur at the boundary of technical capabilities of the device Cardiovisor MKS KS040001 64 Rev 1 0 Page 43 User Manual Cardiovisor Table 2 Characteristics of text s conclusion headings by section lt Cardiovisor gt The heading name The heading content Main heading reading for client is mandatory 1 GENERAL This message displayed value of the index Myocardium CONCLUSION in again and makes recommendations regarding the medical examination The most significant of the identified deviations are listed Additional headings optional to the client 2 RHYTHM Deviations in the regulation of heart rate Information about the high level of stress or probable arrhythmia 3 AURICLES Deviations in the function of the auricles The dispersion characteristics of the auricles are characterized by high sensitivity therefore to focus attention only on red or orange by color messages it is necessary 4 VENTRICLES
73. trodes by the spray gel for ECG or by water If the defect does not disappear you can contact support by reference phone presented on the home page Page 66 MKS KS040001 64 Rev 1 0 User Manual Cartiovisor Problem description Recommendations The noise track in the input field is more than 4 mm in millimetric substrate or isoline has sharp oscillation on all field of a squared paper oe Sct mere A was wae VisonuHna tee Aopoxka The main reason for these phenomena may be e Poor contact of one or more electrodes e Network electrical interference caused by a wire passing near 220 V or uninterruptible power supply computer close allocated to the cardioamplifier or a body of the client or the proximity of any other household device a source of electromagnetic interference e Unsuccessful pose or nervous tension at input of ECG which causes a reflex tremor of muscles The first reason is eliminated moistening the electrodes and twisting until it stops the contact terminals of the electrodes To eliminate the second reason take all measures for the location of the cardioamplifier from potential interference sources on distance not less than 1 5 m If it is impossible to eliminate large oscillation of isolines by pose changing pose try to input ECG from a prone position and there must be an assistant who clicks start button procedure n the latter case remember that any subse
74. ttom Numerical values of main dispersion indexes Myocardium and Rhythm Heart portrait General conclusion 1 2 4 1 View main values of the dispersion indexes Numerical values of main dispersion indexes are specified directly over heart portraits at the top window of conclusion Myocardium Rhythm Pulse Detailing code 15 3 73 tick min 0 S S 0 0 S S 7 Fig 18 Presentation of main values of the dispersion indexes Estimate in which zone main values of the dispersion indexes come Myocardium and Rhythm according to the table Dispersion index Norm Deviation Evident deviation Myocardium lt 15 15 20 gt 20 Rhythm lt 50 51 79 gt 79 Pulse and Detalization code indexes are optional and can be correctly analyzed only by a doctor see part 4 1 2 4 2 Heart portrait In the upper left part of a portrait field there is an indicator of myocardium electrical instability in the form of a square field with changing color green yellow red Fig 19 Page 24 MKS KS040001 64 Rev 1 0 User Manual Cardiovisor Indicator of electrical instability Right atrium Left atrium Right ventricle Left ventricle Fig 19 Heart portrait Attention Constant presence of red indicator on the portrait of electrical instability on a heart portrait has a worse prognosis If such sign appeared in the first time and is steadi

here

Contents

Download Pdf Manuals

Related Search

Related Contents