Home

User`s Manual

1. Preferences ETE Categories Leads ECG device Unipolar Speed ECG precordial 1 3 25 mm sec 5 Print precordial 4 6 Batch rest ECG DII LEES 2x6 leads Batch ergometry X Cabr amp Precord Amplitude View of monitor and dialogs 2x6 Cabr amp Precord 1l 5 mm mV Ergometry Free selected 3 g 10 mm mV Ergometer program Free selected 6 20 mm mV Treadmill program 3x4 leads Blood pressure User At given seconds eg 300 600 Options iv Online comment list amp Advanced 7 ECG With 12 Leads ECG M Median M Vector M Diagnosis M HRV iv Extra beat Parameters M Single lead fi 50 mm s 2 0 mm mV 7 Ok Cancel Apply Lead combinations multiple selection possible soeed and amplitude of the recording can be selected Specifying given seconds results one page of ECG curve printout at each given time points With the special marking three dots periodicity can be defined e g 100 means every 100 second ltems from the interpretation can also be selected Median Diagnosis The Extra beat prints the recording s extra events in a table form along all 12 leads The list of online comments associated with given moments of the record can be printed with time information and optionally with the 12 Leads printout of the events The Single lead box gives additional printout of the whole record with the Revision 4 0 25 03 2015 23 Imed Ltd Cardiax PC ECG corresponding speed a
2. Revision 4 0 25 03 2015 56 Imed Ltd Cardiax PC ECG Synchronization also starts d l by selecting the target new items gt database lf there is currently no Cardiax database then a new one will be created The synchronization process is a two steps operation first the local database will be searched for newer recordings and patients and after confirmation will be copied into the other database Next the other database will be searched for new items what are not present in the local database Those will be copied into the local database The other database will remain open as second database this case as well None of the above operations delete any data In both cases the selections can be ended using the key and the second database can be closed from the menu Transfer Close 2nd database 8 3 Copying and inserting ECG recordings Menu Record ECG copy Record ECG insert It is easy to copy individual ECG recordings as follows e Select the recordings to be copied on the Findings screen F3 e Use the Record ECG copy function to copy the selected recordings The program will store which recordings have been selected e Select the patient s card file where the selected ECG recordings are to be copied then use the Record ECG insert function to insert them in the list Examples of using this function e Ifa patients ECG is mistakenly recorded twice it is possible to unite the two recordings i
3. Histogram of NN intervals The triangular index HRV index is the integral of the density distribution divided by the maximum of the density distribution The index reflects total heart rate variability measured over the recording and is more influenced by the lower than by the higher frequencies Revision 4 0 25 03 2015 94 Imed Ltd 2 Frequency Domain Methods Methods for calculation of power spectral density may be classified as parametric and non parametric in most instances both methods provide comparable results The important characteristics of the spectrum are the power of the spectrum and the powers of its separate zones Four main spectral components are distinguished Non parametric method Fast Fourier Transformation FFT Parametric method Autoregressive model Analysis of the short term recordings interval 5 min Total Power ms ms Variance of all NN intervals VLF ms ms power in the very low frequency range 0 01 0 04 LF ms ms power in the low frequency 0 04 0 15 Hz LF norm n u LF power in normalized units LF Total Power VLF 100 HF ms ms power in the high frequency range 0 15 0 4 Hz HF norm n u HF power in normalized units HF Total Power VLF 100 LF HF ratio LF ms ms HF ms ms Revision 4 0 25 03 2015 95 Cardiax PC ECG Imed Ltd Cardiax PC ECG 13 4 Appendix D WiFi ECG device usage guide Cardiax version 4 20 0 and ECG device firmware
4. First recovery phase W 25 Recovery load W 25 Load interval s 60 First recovery phase s 60 Recovery interval s 60 X BP measuring interval s 40 Ok Cancel BP measuring interval applies to blood pressure measurement frequency if no extra BP is given This duration cannot be shorter than 60 Sec Continuous increasing of load by selecting this option the load will increase linearly during the given interval not abruptly at the end of each one Conconi test special load type frequent in Switzerland By setting any of the stop conditions Max heartrate Max workload Max systole diastole Min SpO2 the program alerts when a specific value is reached Revision 4 0 25 03 2015 65 Imed Ltd Cardiax PC ECG When using a treadmill first a protocol must be selected or a new one can be created The tables contain the time speed and grade parameters for the phases of the program The stress and recovery programs have individual tables The maximum number of phases can be 12 The following common protocols are predefined 0 BRUCE 1 BRUCE MOD 6 ACIP 2 NAUGHTON 3 CORNELL 7 ELLESTAD I 4 BALKE 5 BALKE MOD 8 ELLESTAD II The following stop conditions can be set Max heartrate Max systole diastole Min SpO2 The program alerts when a specific value is reached Revision 4 0 25 03 2015 66 Imed Ltd Cardiax PC ECG 10 Stress test Menu Re
5. Cancel The Leads monitoring Speed and the Amplitude parameters can also be changed during the recording With every new recording the same default values set here will be used until they are changed by the user Diagnosis when switched on the automatic diagnosis function can be accessed otherwise it is disabled The categories can be enabled selectively Filters 35Hz muscle noise filter 50Hz 100Hz 200Hz or 60Hz and 120Hz mains filter it is advisable to have these turned on 0 1Hz baseline fluctuation reduction filter QTc the method used to calculate the corrected QT interval can be selected Bazett Friderica Framingham Hodges Nomogram Bazett Friderica Revision 4 0 25 03 2015 20 Imed Ltd Cardiax PC ECG e Sound state of QRS complex detection signaling e Speaker use the system speaker for QRS signaling e Recording length the default length of the stored ECG snapshot 8 16 or 32 sec e J 60 80 the method of calculating the end of the ST segment for more information see the Stress test chapter e Electrode placement the actual placement of electrodes Important for storing and evaluating ECG recordings e Leads the lead combination by which the ECG curves will be represented e Rhythm You can select any of the 12 leads to be the rhythm strip on the median screen e Free selected It is possible to monitor any 3 or 6
6. Egy konkr t extr ra kattintva teljes ablakban vizsg lhat az adott t s Additionally the time consecutive of extras in time can be displayed in 3D for comparison d Menu Mode 3D median compare called from the extra beats table Ef Cardiax 12 Demo Compare 25 03 2015 15 26 Demo e meen The spatial view can be zoomed using the slide on this window The cross hair provides a way for rotating the diagram Time labelling can be used for better identification In the listbox the displayed lead can be selected The 35Hz tremor filter can be applied to the displayed signal ial i Filter 35Hz on off I lead M Show labels M Auto zoom Iv Print Return Revision 4 0 25 03 2015 41 Imed Ltd Cardiax PC ECG Also from the ECG ruler where the ECG curve is displayed it is possible to analyze the ST segment of the signal like in the ergometric tests Menu Mode ST Trend The characteristic point STJ STM STE SLP can be selected in the toolbar its data will be displayed When the ST Trend tab is active the individual lead buttons in the toolbar open up the corresponding graph in greater detail The ST List tab shows the exact values of the selected point 12 Demo Compare 25 03 2015 15 26 8 Ex 12Demo Compare 25 03 2015 15 26 e SS BBA smse u MaMa V4 vs ve 3 SS BBB nms 1 M MaRa vi v2 V3 V4 VS v6
7. In this case a search must be initiated in order to assign the pulse oximeter device to Cardiax The pulse oximeter device must be turned on with the probe plugged in Pushing the Search button starts the process If the pulse oximeter device is found the Bluetooth name if automatically filled into the Assigned device field This means the Cardiax registered the device parameters for future connections If the search was invalid try once more If still nothing was found check the operation of the pulse oximeter device for sending real time data with the help of its manual If more devices are available at the same time one must be chosen in a selection dialog In case the pulse oximetry operation is not needed temporarily simply choose None under the Pulse oximeter device Later simply restoring the ChoiceMMed selection will revert to the registered device settings that can be immediately used without searching again e If the operating system uses other non Microsoft Bluetooth implementation mainly in older Windows XP versions like the Widcomm or the BlueSoleil stacks then the connection to the device needs user assistance The pulse oximeter device must be connected with the help of the used Bluetooth stack and a COM port will be assigned to it if a PIN code is required then supply 0000 as the answer The number of this port created must be supplied for Cardiax into the user connected field Revision 4 0 25 03 2
8. if different from the standard ones If Internet access is only available through a corporate proxy the relating parameters can also be set manually here for the mail sending receiving Preferences Exa iat bidhe Address of remote mailbox device ecg expert heart org iv Send to mobile device amp Print Name of SMTP server smtp myinstitute org ES SMTP port 25 SSL rgometry n View of monitor and di SMTP user id a Ergometry SMTP password Ergometer program Treadmill program Address of local mailbox Mail check Blood pressure my name free org 0 Min User Options Name of POP server pop free org 3 Advanced POP port 995 V SSL Md POP user id my name m POP password T Auto backup Auto export v Use proxy server squid myinstitute org NetCenter Proxy port 3128 Security groups Proxy user sqiduser P Proxy password pee ln Ok Cancel Apply Revision 4 0 25 03 2015 60 Imed Ltd Cardiax PC ECG The Send to mobile device option ensures that the sent mail can be imported by the Android version of Cardiax running on a mobile device According to the characteristics of the Cardiax Mobile software only 8 16 and 32 seconds long recordings snapshots are sent in this case This option can also be changed at the time of mailing as shown on the next figure However if other type of recording is tried to be mailed in mobile format only the patient data will be includ
9. AP mode The fast double blinking blue LED pattern informs the user about using the WLAN profiles At least one WLAN parameters are required to be already set up in the device The blue LED blinks regular fast if connection mode is reset to direct AP AP mode EHNEN Turned off Infrastructure mode All WiFi g devices can be firmware upgraded for this mode switching function to be available I mii Revision 4 0 25 03 2015 107 Imed Ltd Cardiax PC ECG Specific settings for first generation Ad Hoc mode devices These devices differ in the realization of the direct connection from the currently produced ones due to their WiFi module with older technology Those modules can only connect to available WiFi networks and are incapable of creating one for others to connect to The indirect connection mode infrastructure and the related settings are the same as previously described Direct connection to these devices is realized in ad hoc mode in which the computer with WiFi interface and the ECG device forms an Ad hoc WLAN network using the predefined name SSID Mobile ECG Creating the network is the task of the computer the ECG device in range can then connect to it Toolbar WiFi items The toolbar WiFi button and the status icon practically provide the same functionality and visual feedback as in the case of current devices the button initiates or breaks direct connection while established connection i
10. Cardiax PC ECG 6 Stored ECG recordings 6 1 ECG ruler manual measuring The curves are displayed with baseline correction If the baseline correction could not be performed for example because the recording was too noisy incomplete or possibly because the patient had a pacemaker and an error message will appear Baseline correction failed You can perform measurements on the curve displayed in the ECG rulers with the help of markers black The top right hand side of the window displays the average heart rate HR and parameters regarding the whole record On the bottom the distance of the markers are displayed in msec with possible oximetry data above If the markers are moved the amplitude values and their difference will be displayed on the right as read by the markers intersecting the ECG curves Below the distance of the markers a heart rate will appear calculated from that distance as an RH Using Frank placement 2D and 3D vector graphs are also available ES Cardiax 12 Demo Compare 25 03 2015 12 53 ele File Mode Leads Lead Set Macros Help jc SOM ser QWs Dd We FTT T i 7 mE LI 7 HR P 00 00 00 D anm 25 mms 10 mmm 12000 ms m gt 0 04 alcoholic smell imm mE Two other marker types can appear on the window e online comments attached to the record orange marker
11. ISERVER 20150320 14120150320 143832 945 1CFDFBC5 CBX7B6 7UC RZ 20150320 143839 424 REC Ok 14 Demo Frank 000 000 014 down ASERVER20150320 141220150320 143836 164 B42FDCB5 4NKFS2LG CRZ 20150320 143842 694 REC Ok 12 Demo Compare 000 000 012 down ISERVER20150320 14120150320 143838 530 BCCA9210 LHRY8150 CRZ 20150320 143845 059 REC C Ok 13 Demo Ergometria 000 000 013 down ASSERVER20150320 141220150320 144552 250 5BF2B4C5 T4KJKOKB CRZ 20150320 144601 036 REC Ok hello isn iu Terminating the main program by the Exit button also terminates the server agent Revision 4 0 25 03 2015 83 Imed Ltd Cardiax PC ECG The agent window can also be activated by clicking on its tray icon and the technical details of the received request are listed V Cr Server Agent listening RUMCAJSZ 192 168 1 7 3920 e Jte Je x IB 9 user request read write status 0 unathorized 941 user request read write status drCarter 20150320 143341 152 19F47CA2 104 273 39 273 Ok drCarter 20150320 143643 183 6B54472A 104 409 39 371 Ok drCarter 20150320_143710_098_FCE40624 109 32950 39 371 Ok drCarter 20150320 143748 851 OEEASE73 104 401 39 371 Ok profloe 20150320 143822 914 4E6283F2 104 273 39 273 Ok profJoe 20150320 143825 914 37FFE20D 104 425 39 371 Ok profloe 20150320_143828 914 D96292D1 104 409 39 371 Ok profloe 20150320_143832_945 1CFDFBC 104 409 39
12. Max HR X Max systolic BP In the last column choose the symbol or press F5 to toggle between the STE STM and STJ amplitudes and the slope of the ST segment and press the and keys to toggle between the lead systems The STE STM and STJ values are replaced with J80 J60 J40 J30 ST J values if the program used the option for J 80 60 msec to determine the end of the ST segment menu Setup ECG J 60 80 ON Select the ECG menu item to replay measure evaluate compare and delete a recording in the same way as for resting ECG recording Press F3 to select recordings for comparison The evaluation of ECG intervals and segments of the stress test ECG is performed in an identical manner as the evaluation of resting ECG recordings However the automatic interpretation function in the stress test ECG differs in a few ways e the parameters of the P wave do not occur in the parameter tables e ifaleadis noisy or cannot be evaluated the program does not calculate the median of this lead but the other medians and their parameter tables are calculated e the program does not propose a diagnosis but you can ask for the reports of the evaluation Revision 4 0 25 03 2015 71 Imed Ltd Cardiax PC ECG 11 1 Calculation of maximum exercise performance Maximal HR predicted HR 220 minus age maximal BP and the maximal workload achieved are displayed just below the recording list For an ergometer bicycle st
13. e places extra beats cyan marker Moving the mouse pointer over these kinds of markers the status bar will show the information regarding that marker Right mouse clicking on the screen enables to place new ones or to edit delete existing ones Also the Revision 4 0 25 03 2015 39 Imed Ltd Cardiax PC ECG displayed curve position can be moved to the next previous markers easily Bra QUI Premature complexes C Ventricular C Sinus C Atrial C Junctional Escape Inserting or editing extras the ee following qualifications are Sinus available C Atrial C Junctional Aberrantly C Aberrantly conducted Other form C Other form Cancel All extra beats can be displayed in a table form side by side Menu Mode Extras La E Cardiax 12 Demo Compare 25 03 2015 15 26 Demo Mode Leads Set Help OS 2 xe SAR 00 43 00 50 00 51 01 27 01 35 02 11 ESP Sinus EXT Sinus EXT Sinus ESP Sinus EXT Sinus ESP Sinus J m Ji Mii uud i Lina i j A c gt c j i 4 cee Bena gum EE EEG Revision 4 0 25 03 2015 40 Imed Ltd Cardiax PC ECG The each individual extra beat has a column both automatically recognized and manually inserted ones with time and type If all extras can not fit the window at a time the blue horizontal arrows can be used for scrolling Clicking on an extra opens a detailed view of it
14. 4 0 25 03 2015 72 Imed Ltd Cardiax PC ECG Treadmill The first two diagrams show the same measurements as in the case of the ergometer bicycle The third figure is the diagram of the calculated oxygen consumption as a function of time The right hand side of the screen displays the calculated oxygen consumption and the Double product values Beneath that there is diagram displaying the trend of the Double product 1000 as a function of oxygen consumption 11 3 ST evaluation ST Trend The screen displays the ST diagrams of the 12 standard leads as a function of time Press F5 to toggle the STJ STM STE or SLP values With Up and Down keys can you change the amplitude gain By pushing a lead button on the toolbar or double clicking a small graph the corresponding curve opens in a separate window for scalable display ST List The ST list is a comprehensive table of heart rates and ST values of the standard 12 leads Press F5 to toggle the STJ STM STE or SLP values The STE STM and STJ values are replaced with J80 J60 J40 J30 STJ values if the program used the J 80 60 msec to determine the end of the ST segment menu Setup ECG J60 80 ON This is reflected in the header of the first column of the list Revision 4 0 25 03 2015 13 Imed Ltd Cardiax PC ECG 12 Network operation multi user features 12 1 Local network operation Shared install database LAN User stations In ca
15. 61000 4 5 Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 Power frequency 50 60 Hz magnetic field IEC 61000 4 8 IEC 60601 1993 test level t4 kV contact 4 kV contact 8 kV air 8 kV air 2 kV for power supply lines 1 kV for input output lines Not Applicable 1 kV differential mode 2 kV common mode Not Applicable lt 5 UT gt 95 dip in UT for 0 5 cycle 40 UT 60 96 dip in UT for 5 cycles 70 UT 30 96 dip in UT for 25 cycles Not Applicable lt 5 UT gt 95 dip in UT for 5 sec Electromagnetic environment guidance Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be at least 30 96 Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment If the user of the Cardiax PC ECG requires continued operation during power mains interruptions it is recommended that the Cardiax PC ECG be powered from an uninterruptible power supply or a battery Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment NOTE UT is the a c mains voltage prior to application
16. Record comment Menu Record Comment to recording Hotkey F4 Any item in the list of the ECG recordings can have a short comment up to 20 characters This will appear in the header of the print too e Patient comment Menu Patient Comment block Hotkey F2 You can attach a comment block to each patient up to 30000 characters It can also be printed out from its edit window e Further comments can be attached to the stress tests as a whole in addition to the Record comment and to its each phases separately e n case of long recordings not 8 16 32s snapshots so called online comments can be attached to specific moments of the record during the recording process or later when re viewing the ECG curve Revision 4 0 25 03 2015 33 Imed Ltd Cardiax PC ECG 5 ECG recording monitoring You can monitor the ECG with the Cardiax system if you have a connected and enabled Cardiax device During monitoring the ECG curve is displayed on the screen and you can save selected temporal segments of data You can turn on off the tremor filter the sound of the QRS detector or change the lead system the number of the displayed channels paper speed time resolution amplitude gain and the length of the recording to be stored If the device selected in the Setup is not available the followings are displayed Cardiax Cardiax aram A Change device Setup Ecg Ecg device 5 1 Start the monitori
17. Server After ES given the correct password the Client program connects to the server and the patient list of the remote database appears b The Server as the second card file From the Transfer menu the Open 2 card file function is selected A window opens and the Remote button on it s upper side must be clicked that opens the same window mentioned in the previous point Connection is established as described there The patient list splits into two In the upper part the Client in the lower the Server database can be seen This function is useful for copying and comparing data between two databases c Sending a patient s data to the Server uera The patient to be sent is selected in the patient list The Send to function under Transfer menu is selected Connection is established as described previously The patient file is transferred into the import directory on the server default is C Crx import from there it must be imported into the server program later This function is useful only if one patient s data must be transferred and there is no need for the Server s database to appear on the Client that would take significantly more time Revision 4 0 25 03 2015 19 Imed Ltd Cardiax PC ECG 12 5 Cardiax NetCenter Central server Users 9t cU jJ We H Operation Users run the Cardiax program on local workstations or laptops in client mode These wor
18. can radiate radio frequency energy and if not installed and used in accordance with the instructions may cause harmful interference to radio communications However there is no guarantee that interference will not occur in a particular installation If this equipment does cause harmful interference to radio or television reception which can be determined by turning the equipment off and on the user is encouraged to try to correct the interference by one or more of the following measures e Reorient or relocate the receiving antenna Increase the separation between the equipment and receiver e Connect the equipment into an outlet on a circuit different from that to which the receiver is connected e Consult the dealer or an experienced radio TV technician for help Contains component with FCC ID W7OMRF24WGOMAMB This device complies with Part 15 of the FCC Rules Operation is subject to the following two conditions 1 this device may not cause harmful interference and 2 this device must accept any interference received including interference that may cause undesired operation Revision 4 0 25 03 2015 14 Imed Ltd Cardiax PC ECG 1 7 Technical parameters 50 100 200 Hz software switchable 60 120Hz software switchable 85 Hz software tremor filter switchable 0 596 1 2 LSB Power consumption Both models used on USB port 5V 100 mA WiFi enabled model embedded battery 3 7 V Li
19. dialog opens and only the code need to be entered By hitting enter the server is asked for the other patient parameters from the server If the server could not provide them the dialog opens again and registration can be completed The new patient will immediately appear on the server too Revision 4 0 25 03 2015 82 Imed Ltd Cardiax PC ECG Double clicking the agent s tray icon a window opens that contains a listing with the technical details of the requests sent to the server WI CrxClientAgent Jn 20150323 092756 461 81150341 TS6FSNOT CRZ UP 40 n 107 7 20150323_092522 284 616AB20D_NVMPGMQR CRZ 40 273 104 273 Ok 20150323_092537_323_D036DC41_9D862HGU CRZ 40 371 104 409 Ok 20150323 092549 619 8AC18DBC_O8R49DF4 CRZ 40 371 104 401 Ok 20150323 092619 948 2EAE1291 O8R49DF4 CRZ UP 40 371 107 371 Ok 20150323 092630 502 E74D689D O08R49DF4 CRZ 40 371 104 401 Ok 20150323 092720 747 DEBACID1 08R49DF4 CRZ 40 371 104 401 Ok 20150323 092729 833 BE825C37 08R49DF4 CRZ 40 371 104 401 Ok 20150323 092748 274 D78C49EA TS6FSNOT CRZ 40 371 104 401 Ok 20150323_092756_461_81150341_TS6FSNOT CRZ UP 40 371 107 371 Ok 20150323 092818 119 CE985864_NQVC34BP CRZ 40 371 104 401 Ok ul drCarter Ok There are two buttons the first terminates the agent the upper right only minimizes to the tray and the second enables auto scrolling the list Central side server On the cent
20. hospital surgery information systems for tracking and handling referrals for ECG examination 12 7 Calling Cardiax from other applications The program can be used by other applications for making ECG recordings and viewing them later on The application can refer to a specific recording by a unique identification method The recording and all adherent data is stored in the database of Cardiax the calling application only needs to store the identifier There are two ways for invoking Cardiax the first results a single session that closes the program after the ECG is done the other leaves the program running ready for accepting further calls from applications e Wwincrx32 Qxxx ini e WCIxcl32 Qxxx ini In both cases a Qxxx ini parameter must be supplied where xxx ini is the name of the configuration file containing required data for identification with the following structure Patient Name Joe Smith Id 123 456 789 Sex 1 Weight 70 Height 170 Born 1930 12 30 Doctor Dr Walter Brown OEM 0 Files New 13214 txt 01d 21212 txt Record Date 2013 12 30 12 30 Request Mode 1 Revision 4 0 25 03 2015 85 Imed Ltd Cardiax PC ECG The calling application may use any name for the xxx ini file and it is the callers responsibility to generate unique names if needed e g in network usage scenario The d field is used to identify the patient The calling application should provide unique identifiers e g a
21. iv Print parameters from diagnosis window Picture export Picture size 6976 X 5000 Portrait pic export Ok Cancel In some cases especially with high resolution laser printers the grid is too light for this the printing style can be adjusted The Old style setting uses dots for the grid with the given point size while the New style draws lines as the grid using the step size Toggling Draw grid first may help in cases when grid is not printed correctly due to printer driver issues The Default gives the optimum settings for the most common recent printers Checking the Print 3x4 leads forces printing in lead format 3x4 always if printing from the monitor window regardless of the displayed lead selections Revision 4 0 25 03 2015 22 Imed Ltd Cardiax PC ECG On pages containing any ECG curve the diagnosis can be printed in the header by checking the specific box The selectable Picture size and the orientation is used for GIF and DICOM file exports from the print dialog The Diagnosis window awoke from the ECG display gives the possibility to print the diagnoses text and the parameter table on separate tabs By checking Print parameters from diagnoses window makes the parameter table be automatically printed with the diagnosis The Batch subcategories provide the possibility to select the pages for printing form the Findings window
22. nes 000 000 009 31 01 1930 04 03 2009 Weigh kg BO 000 000 010 06 01 1923 13 01 2011 eight kg 000 000 011 11 06 1940 15 05 2009 Doctor j fa 12 Demo Compare 000 000 012 25 11 1947 25 03 2011 fa 13 Demo Ergometria 000 000 013 16 11 1964 27 11 2006 Diagnosis amp 14 Demo Frank 000 000 014 27 09 1980 16 10 2007 amp Joe Smith 123 456 789 30 12 1930 15 09 2014 ECG Rest 1 CARDIAX Write beginning of the name in the list CACIX 15 0 When you start the program the Cardiax system displays the Card File window The right hand side of the window contains the Patient List the left hand side of the window shows the Patient Card of the patient selected from the list The Patient List contains the name code birth date and the date of the last ECG record The width of the columns can be adjusted or even hidden with the mouse by grabbing the delimiter in the table header The default order of the patients is alphabetical which can be changed by clicking on the header of the desired column code born last ECG or can be selected from the Sort menu The current sort mode is reflected by a tick mark in the corresponding header The easiest way to find a patient is to enter the starting letters of the patient s name in name sorting mode The cursor jumps automatically to the first line where letters are identical with the entered letters If sort mode is set to code the code can be entered for searching navigating in the
23. of the file is crc additional files may be created with the same name but with random extension the crc file needs them e CRN It can be created with the Patient name export CRN function Also proprietary for informational purposes contains patient data only A file selection dialog opens and the destination file will contain the data of the actual patient regardless of any selection if invoked from the patient list view Extension of the file is crn These export functions are also available in the popup menu of the list views invoked by right mouse clicking on an item or selected items File exporting can be initiated from the monitor window as well Under the Mode menu there is a File export CSV SCP DCM XML function that opens a file selection dialog to define the destination file and also the export format for the ECG record being viewed See chapter 6 5 Data export for details Raster based DICOM files can also be created with Cardiax Everything that can be sent to the printer in Cardiax can also be exported as DICOM encapsulated Jpeg images In the lower right corner of the Printing dialog in Cardiax there are two buttons for picture exporting One is for DICOM the other is for GIF format The DICOM file will contain patient data too while the GIF will have a text file created with ini extension holding the patient and other metadata For available picture settings see chapter 3 3 Print Cardiax can impo
24. of the test level Electromagnetic Immunity Revision 4 0 25 03 2015 11 Imed Ltd Cardiax PC ECG The Cardiax PC ECG is intended for use in the electromagnetic environment specified below The customer or the user of the Cardiax PC ECG should assure that it is used in such an environment Electromagnetic Immunity test Puede 993 ga environment guidance test level Portable and mobile RF communications equipment should be used no closer to any part of the Cardiax PC ECG including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance Radiated RF 3 V m d 1 2 NP 80to 800 MHz d 02 3 NP 800 MHz to 2 5 IEC 61000 4 3 80 MHz to 1 GHz GHz where P is the maximum output power rating of the transmitter in watts W and d is the recommended separation distance in meters m NOTE 1 At80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Revision 4 0 25 03 2015 12 Imed Ltd Cardiax PC ECG Recommended separation distances between portable and mobile RF communications equipment and the Cardiax PC ECG The Cardiax PC ECG is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled The customer or the
25. of their connection with faster if unconnected or slower blinking if connected regardless of the type of the connected WiFi network Blink patterns correspond to 2 seconds long interval e WiFi LED blue o persistent ECG recording through WiFi connection to an available WiFi fas Attempting network listed in connection the profile list m WH UU Ad hoc Android src Connected Infrastructure ELILLLLLIJ not specified o blinks very fast Parameter configuration phase Reset connection mode of the device First generation devices reset to their direct connection mode Ad hoc for surely being accessible wirelessly by the computer After the reset operation the first start will begin with a very quick blinking of the blue LED parameter configuration Any wireless local network profiles set up are left intact only the two built in profiles are ensured to be set into active state Revision 4 0 25 03 2015 111 Imed Ltd Cardiax PC ECG 13 5 Appendix E Pulse Oximeter setup Recent versions of Cardiax can display the online SpO2 curve acquired from the ChoiceMMed wireless bluetooth pulse oximeter unit The Cardiax program must be set up to communicate with the ChoiceMMed pulse oximeter device In the Setup menu under the Advanced category the Pulse oximeter sub category must be selected On the right hand side of the dialog after setting the device to ChoiceMMed the bluetooth settings become available There
26. panel shows the previous database and the lower panel shows the newly opened database If there is already patient data it will be displayed To change to the new database Menu Transfer Toggle card files Hotkey F6 To copy from one to the other Menu Transfer Copy Hotkey F5 Patient records that have been selected will be copied If no records are highlighted as selections the single record at the cursor will be copied All data including ECG recordings is copied 8 2 Backup synchronization Menu Transfer Backup Synchronization dme Backup can easily be done with this dium new tems function to create a duplicate mirror database When Backup is invoked the program will automatically select and copy patient records that do not already exist in the duplicate mirror database or that are newer than existing records The selection of the place of the mirror database is done in a directory selection dialog if there is no Cardiax database at the selected place a new one will be created More than one different databases can be backed up to the same mirror this way serving as a central collection of ECG data Following the backup process the mirror database stays open as a second database in the Cardiax window and the selection reflects the patients concerned in the backup If there is any selection remained in the original upper database it indicates that some records could not be copied lt new items
27. the device one with the computer Mobile ECG and the other with the Android application running on a mobile device and available on Google Play In these two cases the name of the networks are fixed and displayed only for information Preferences Categories ECG device LL ECG E B Print 1st generation device default connection points ECG iv Active Ad hoc network by Computer SSID Mobile ECG Ergometry Active Hotspot by Android device SSID Mobile ECG AP View of monitor and di amp Ergometry Local networks LAN the ECG device can connect to Ergometer program _ Network name SSID Workplace surgery Treadmill program M Active z Blood pressure Password amp l User I School Options M Active Network name SSID chool surgery 5 Advanced Password Loss RE E ali N k SSID ye M Active etwork name k Mail Password Auto backup Auto export M Active Network name SSID NetCenter Password Security groups Device number by USB Read profiles Send profiles 0612061116 2061116 4 n p Ok Cancel The order of the list in this case also determines the priority of connection in case more than one are available at the same time and each are signed active The topmost of the available active networks will be connected Revision 4 0 25 03 2015 110 Imed Ltd Cardiax PC ECG LEDs on the ECG device First generation devices report only the state
28. the recordings The header of the columns contains the heart rate HR calculated from the given curve the date of the recording and for stress tests the serial information related to load phases and time values You can magnify the median cells with the mouse click Above the magnified picture the program displays the global parameters and besides those the parameters characteristic to the individual lead ES Cardiac Demo Compare Col Jm Mode Leads Set Help 5 dg r9 n n ERM HR 55 HR 51 R 383 R 72 R 6 R 53 HR 55 12 09 1995 24 01 1996 06 02 1996 15 02 1996 16 02 1996 30 07 1996 Pd 102 ms 3 4 PQ 150 ms QRS 100 ms QT 414 ms QTcB 39 ms T ax 38 S d STJ 0 00m J40 0 02m4 J80 0 01m4 SLP 0 05 Ta Q 14m T a N gt x L g P 1 A un 1 d 6 paper EHEH VERNA J A c nd z z H ERE SR ee Revision 4 0 25 03 2015 44 Imed Ltd Cardiax PC ECG You can analyze and compare the medians in a much more vividly descriptive way by viewing them all together Cardiax can put together the related medians in a 3D figure Medians from different recordings appear one after another It is easy to see the differences in the length of the QRS complex the T wave etc Medians from every lead can be examined this way d Menu Mode 3D median compare T
29. version 4 09 or higher The Cardiax ECG program has two different kinds of modes for connecting WiFi ECG devices to fit different usage scenarios common in practice These modes are e the direct wireless connection when the ECG device acts as a WiFi access point AP mode that can be connected by the computer equipped with WiFi interface ean tS e andthe indirect connection in the so called Infrastructure mode In this mode the ECG device connects wirelessly to an existing WLAN router acting as a WiFi access point Host computers that connect the local network through a wired or wireless link can reach the ECG device e 4 Previous first generation devices establish direct connection in a different approach Ad hoc mode then the present models The differences in the operation are collected under a separate section gt WiFi g C 1979 a 2014 SN 0614012301 The second generation WiFi ECG devices are labeled on the back side with WiFi g g marking on the upper right side of the label In case of both generations pay attention to the fact that using direct modes will reserve the WiFi interface exclusively for the time the ECG device is connected disabling any other services if any for example Internet or LAN provided on that same interface With additional WiFi adapters installed on the system it is possible though to keep existing network connections alive during ECG device access T
30. wires Check that the computer must be placed at least 1 5m far away from the patient A mains adapter or an extension cable must not be used Other devices which are not part of the system must not be integrated into it When operating the Cardiax with other electric devices care must be taken that the devices do not disturb each other and that possibly all devices are connected to the same potential equalizer thus reducing the risk of current infiltrating through to other devices To avoid polarization voltage and possible baseline fluctuation all ECG electrodes applied on the skin surface should be of similar type Avoid reusing disposable electrodes or using mixed types of electrodes Revision 4 0 25 03 2015 7 o coo Imed Ltd Cardiax PC ECG During usage in operation Do not touch the electrodes and take care that neither the patient nor the electrodes connect with conducting objects e g metal parts of the examining bed equipment holding tripods etc If one or more electrodes become loose disconnected or are inexpertly placed an error message will occur on the computer monitor during ECG recording Replace these electrodes If required for patient safety switch off the device and disconnect the electrodes After using the device Immediately after use disconnect the lead wires from the electrodes then remove and dispose the electrodes Non disposable electrodes if used should be properly cleane
31. 015 113 Imed Ltd Cardiax PC ECG 13 6 Appendix F User rights in the Cardiax system The rights for security groups users of a database are stored with the database and are checked upon opening The database directory must be shared In this description the computer called CRXSERVER is used as an example A dedicated share name for the database is not a requirement it can also be inside of a shared directory CRXSERVER Shared Crx and CRXSERVER Crx are both applicable The file describing the rights is stored on the computer that contains the opened database by having a directory named CrxRights on the computer and that directory is shared using the same name like CRXSERVER CrxRights The CrxRights directory should be only readable but must be readable for all users so only authorized modification is allowed on the rights Those groups users are allowed to modify who have read write access to CrxRights directory on the containing computer For Administrators full access is recommended Top be able to use the security features with a database the filesystem of the database server is required to support read write access control for groups and users on files and directories This is on Windows NT networks using NTFS filesystems For the clients NT based operating system is also a requirement to use the secured database with the defined rights The first requirement for using rights in Cardiax is the presence of the sh
32. 1 Note the computer has to meet the requirements of the standard for business machines EN 60950 1 3 General instructions The equipment is designed for use by qualified medical personnel only Please read this User s Manual thoroughly before using the equipment oafe operation and accurate results can be achieved only when the Cardiax system is used according to this User s Manual Only Imed Ltd approved accessories should be used with the equipment 1 Instructions for storing and transporting Do not operate or store this equipment in places with high humidity in places with extreme atmospheric pressures or temperatures in any place where it can contact water or where poor ventilation dust or any chemical pollution or industrial gas is present This equipment must be stored on a flat surface It should be protected against dropping vibration shaking and extreme mechanical forces both during storage and transportation This equipment complies with IEC 601 1 type class II shock protection therefore the computer must always be operated with its supplied shock protected voltage connector Connect the computers voltage connector as specified taking care to match the voltage and frequency of the network with the voltage and frequency of the device Grounding the equipment is achieved through the network shock protection connector Revision 4 0 25 03 2015 6 Imed Ltd Cardiax PC ECG Cardiax may be used safely
33. 13032801 ECG access point AP Waiting for WiFi device Cancel WiFi Interface selection In case more than one WiFi interface are available on the computer Cardiax selects the one with no active connection free interface for Revision 4 0 25 03 2015 99 Imed Ltd Cardiax PC ECG communicating with the ECG device by default In case no free is available an interface is chosen and will be used to connect the ECG device by all means It is possible though to select a specific WiFi interface for Cardiax exclusively use without modifying the connection state of any other interfaces On the previously discussed WiFi device setup dialog a checkbox with the title Use specific WiFi interface can be found When clicked it opens the selection dialog what informs about the current interface used by Cardiax and lists the available WiFi interfaces in the system If a specific interface is selected non automatic selection then the checkbox will be checked on the setup dialog Wifi interface Currently used for ECG device connection 802 11n USB Wireless LAN Card 2 Specific for ECG device connection TP LINK 300Mbps Mini Wireless N USB Adapter 4 802 11n USB Wireless LAN Card 2 Refresh list Ok Cancel In those cases where only one interface is available in the system and internet access if required for Cardiax e g mailing or for other activity a solution is provided to allocate the WiFi int
34. 371 Ok profloe 20150320_143836_164_B42FDCB5 104 449 39 371 Ok prof oe 20150320 143838 539 BCCA921 104 417 39 371 Ok 0 unathorized 941 drCarter 20150320 144552 250 5BF2B4C5 104 273 39 273 0 unathorized 941 1 1 drCarter There are three buttons the first terminates the agent the upper right only minimizes to the tray the second enables auto scrolling the list and the third is for adding a new user described below User management On the server side having the agent already running and right clicking it s icon Fs on the tray a local menu pops up where selecting the Add new user opens a dialog for entering a new name password pair to have access to the server The same dialog opens if the key symbol is pressed on the opened agent window The usernames with password are case sensitive and are stored in the pass dat file at the same directory Cardiax is located default place is CA Crx exe Administering deleting users adding multiple users quickly changing passwords can be done by editing this text file where the syntax is one comma separated user name password pair by one line The listening TCP port of the server can be modified by editing the cardiax ini file in the NetCenter section by specifying listening port 1234 where 1234 is the desired port number Revision 4 0 25 03 2015 84 Imed Ltd Cardiax PC ECG 12 6 External requests Menu Transfer External requests Used in
35. 5 003 004 001 004 003 005 003 002 002 003 ST trend graphs ST trend ist Revision 4 0 25 03 2015 42 Imed Ltd Cardiax PC ECG 6 2 Comparison of recordings medians To compare recordings first select from the list of the Findings with the F3 key the key inverts the actual selection There are two possible ways of comparison 1 Comparision of ECG curves gd Menu Record Compare You can compare the specific leads of up to 6 rest or stress test recordings If there are more recordings selected only the first 6 will appear in the comparison The program displays the same lead of the selected records Select another type of lead from the Leads menu or using the toolbar icons The 35Hz filter is selectable ESI Cardiac Demo Compare k gt a Mode Lead Set Help BSS e w Ir Iamavcovr vi v2 v3 V4 vs ve 52 5 ens I 12 09 1995 14 02 25 mms 10 mmmh 10400 ms ee a Revision 4 0 25 03 2015 43 Imed Ltd Cardiax PC ECG 2 Median comparison i Menu Record Median compare The program displays in the case of a 6 channel recording a maximum of 6 and in the case of a 3 channel lead a maximum of 4 median recordings at a time If you have selected several recordings use the PgUp and PgDown keys to scroll forward or backward The median cells display the average beat of
36. 89 Imed Ltd Cardiax PC ECG Unspecified undetermined variations QRS left axis deviation O Z 4 QRS right axis deviation 1 11 1 1 QRS right superior axis deviation 11 abnomalQRSTange JJ nonspecific intraventricular block NEN EN NEN EN NN EN only in pediatric diagnose only in adult diagnose or amp and Revision 4 0 25 03 2015 90 Imed Ltd Cardiax PC ECG 13 2 Appendix B Electrode placements and lead calculations Extremal and Recordings with Stress test Precordial rest test Frank arrangement recordings recordings r X 0 78 0 78 A Leads and 0 22 C l calculation are the F L 2 Y 0 35 M 0 65 F H same as described Z 0 87 0 15 A i de 0 85 M 0 304 o 4E Inthe Precordia 0 27 C type lO gom D nr i R L F F L R 3 F L R 3 F L R 3 C1 E C2 AEFLERUS C208 A CA F L F L R 3 M C5 H C6 fo fD D SANONI lt lt lt QOQOCOOO oO RCOIN Revision 4 0 25 03 2015 91 Imed Ltd Cardiax PC ECG Nehb recordings aaa Revision 4 0 25 03 2015 92 Imed Ltd Cardiax PC ECG 13 3 Appendix C Heart Rate Variability Heart rate variability HRV is a measure of the beat to beat changes in heart rate Variations in circulation may be evaluated by a number of methods including heart rate variability variability of pulse blood pressu
37. Cardiax PC ECG USER MANUAL 201 5 revision 4 0 us Carian Phantom kahbr ci 2002 16 0 eum Manufacturer Imed Ltd Etele ut 59 61 H 1119 Budapest Hungary Tel Fax 36 1 481 1372 www imed hu CC Qe FELA Be embs wez e We vr ds 228349355 e o o o i e e o o o o o o o0 0 0o 09 8 8 e e 9 N Imed Ltd Cardiax PC ECG Contents Introduction 1 1 Features 1 2 Main system components 1 3 General instructions 1 4 Security instructions 1 5 Electromagnetic Compatibility 1 6 FCC Compliance Statement 1 7 Technical parameters 1 8 Explanation of symbols on machine Installation 2 1 USB connection on Windows 8 8 1 2 2 Hardware installation 2 3 Software installation Setting the default parameters 3 1 ECG device 3 2 ECG 3 9 Print 3 4 Setting the size and color of the Monitor window 3 5 Stress test setup 3 6 User 3 7 Upgrade options 3 8 Program elements and possibilities 3 9 WiFi device settings 3 10 Pulse oximeter 3 11 Mail settings 3 12 Auto backup and export 3 13 NetCenter 3 14 Security groups Using the Card File in Cardiax 4 1 Adding a new patient 4 2 Editing a patient card Revision 4 0 25 03 2015 2 e e o O9 N e e o o o 9e Q e e eoe o o gi e eee eO e e e oe e Qo Imed Ltd Cardiax PC ECG 4 3 Deleting from the patient list 4 4 Attached documents 4 5 Selecting card files 4 6 Findings list of stored ECG recordings 4 7 Comment ha
38. G there is no connected ECG device a simulated not real stored ECG curve is looped to simulate ECG recording ECG on USB USB version device is connected to USB port ECG on WIFI Wireless device on WiFi network TCP IP ECG device Controlling a remote device through TCP IP network Revision 4 0 25 03 2015 19 Imed Ltd Cardiax PC ECG For supporting obsolete already not manufactured and serviced but still working products two additional types of devices are available by selecting the ECG device category holding the lt Ctrl gt key pressed ECG on LPT1 or LPT2 or LPT3 printer port ECG device is connected to the specified printer port Inner ECG Cara Cardiax extension card is used which is built into the computer 3 2 ECG Settings for the ECG recording f Preferences o 8 Jm Categories Z Sound V Speaker Speed n J60 80 25 mm sec v 3 Print iv Enable automatic diagnosis Amplitude Batch rest ECG f Possible 10 mm mV m Batch ergometry View of monitor and dialogs M Unspec Record length Ergometry 16 Sec z Ergometer program M 35Hz Baseline filter Treadmill program QTc Blood pressure M 50Hz M 100Hz M 200Hz r User M 60Hz M 120Hz x Options amp Advanced Electrode placement Precordial amp Don fads Rhythm lll ad Free selected 3 Il V2 V5 Z Free selected 6 L LaVF V2 V4 V5 NJ 3D reconstruction Inverse Dower Z Ok
39. Po 2000 mAh To normal paper A4 with inkjet or laser printer connected to the computer Using the monitor video output of the computer Status indication Both models yellow LED slow blinking USB connected solid light ECG monitoring WiFi enabled model blue LED solid light active WiFi connection blinking searching WiFi network green LED battery charge level status Computer requirement Windows XP Vista Windows 7 32 or 64 bit operating systems Controls WiFi enabled model power on button touch Everything else from Cardiax software Accessories Standard 10 wire ECG cable otandard limb and precordial ECG electrodes optional otandard USB cable A mini B Continuous operation Revision 4 0 25 03 2015 15 Imed Ltd Cardiax PC ECG Operating temperature 0 C 50 C otorage temperature 40 C 70 C humidity pressure range 1 8 Explanation of symbols on machine System is BF type protected s against defibrillator This device has Class II shock protection Read User s Manual before operating sa Manufacturer a Year of fabrication N Device is equipped with WiFi qu e module Revision 4 0 25 03 2015 16 Imed Ltd Cardiax PC ECG 2 Installation 2 1 USB connection on Windows 8 8 1 The power management policies in Windows 8 and 8 1 systems have been defined stricter and as a consequence the USB connection of the ECG device can be unstable due to the frequent slee
40. ST trend Sevel ST trend ST evel I 0015 60 001 005 004 003 000 004 004 005 004 O02 003 003 0018 60 002 004 002 003 000 003 004 006 004 003 003 003 61 001 003 003 002 001 003 003 005 003 002 002 002 s 0024 60 001 004 004 002 001 004 003 005 003 002 002 002 0027 58 000 004 003 001 001 003 003 006 002 002 002 002 0030 59 001 004 003 002 000 004 004 006 002 001 002 002 0033 59 002 005 003 003 000 004 004 006 003 002 003 003 0036 59 002 0 004 003 001 04 003 006 003 002 003 003 0039 58 002 004 004 003 000 004 003 006 003 O02 003 003 0042 59 002 005 003 003 000 004 003 005 003 03 003 003 0045 58 002 005 003 004 001 004 003 005 003 002 003 003 0048 58 002 005 004 003 001 005 003 006 003 002 002 002 0051 62 001 003 002 002 001 003 004 005 003 002 003 003 0054 63 000 005 004 003 001 004 003 005 003 003 003 003 0057 62 0 01 5 003 0 03 001 004 003 005 003 002 003 003 01 00 001 005 004 003 000 004 004 005 004 002 003 003 0103 60 001 005 004 003 000 005 004 006 003 002 003 002 0106 61 000 003 003 002 001 003 003 005 003 002 002 002 0109 59 001 004 003 002 001 003 003 005 002 002 002 002 0112 58 001 005 003 002 001 004 004 006 003 001 002 002 0115 58 001 004 003 002 000 004 004 006 003 001 002 002 0118 59 002 004 004 002 000 004 003 006 003 002 003 003 0121 58 002 005 004 0 03 000 004 004 006 003 002 003 003 0124 58 002 005 002 003 000 004 003 006 003 003 003 003 0127 60 001 005 003 003 001 004 003 005 003 002 003 003 0130 58 002 00
41. ached to a patient that are stored in the database of Cardiax This command opens a folder inside the database that is assigned exclusively to the given patient Documents here can be manipulated copied moved opened deleted just like in the Explorer If a patient has anything in his her folder the paperclip icon will appear as non empty Revision 4 0 25 03 2015 30 Imed Ltd Cardiax PC ECG 4 5 Selecting card files Menu Select In the Select menu item you have the option to select only specific cards from the card file You can select names one by one by pressing the F3 key or by groups according to some common feature Furthermore holding the Ctrl key and moving the cursor up or down the selection sate of the new line is toggled Use the Select Group window to indicate the aspects of the selecting selection or deselection If the data are indicated with min max the two limit values are also included in the selection In the Code and the Diagnosis field you can search for character strings the Doctor field can be used to search by the initials of the doctor The number of the cards that have been found i e that meet the search criteria appears under the Patient list with the names of the appropriate patients highlighted You can select according to one or more criteria at a time and by specifying another criterion you can extend or reduce the number of the selected cards You can also create the in
42. admill speed and rise Test breakpoints If any one of the test breakpoints is reached the program enters the recovery phase However you can choose to continue the test at the current workload by pressing F3 within 15 seconds On the screen display below the test time indicators you can see the actual value of the workload measured in watts for the ergometer bicycle and as speed and grade for the treadmill 10 2 Recovery phase At the end of the last workload stage or when any test endpoint is reached the program automatically switches to the recovery phase t Menu Stress test Recovery If a limit value is reached the workload can be continued by pressing F3 within 15 seconds and the recovery phase will not begin In the recovery phase the workload is set to zero or to a minimum value and blood pressure measurements continue With ergometer bicycles controlled by the computer the workload is set to a minimum value automatically With ergometer bicycles that are not computer controlled the minimum workload must be set manually Revision 4 0 25 03 2015 68 Imed Ltd Cardiax PC ECG i Menu Mode Return Hotkey ESC Quits the program Be sure to the test is completed and saved before quitting 10 3 Blood pressure measurement Blood pressure BP measurements start automatically at the end of the rest load and recovery phases The blood pressure measurements can be done in two ways In manual BP mode the
43. agnetic environment exceeds limits specified in IEC601 1 2 the device could be disturbed such that malfunction or failure could occur Therefore to prevent malfunction or failure nearby interference or noise should be eliminated before operating the device Here are some of the common sources of interference and steps to prevent them The device is not grounded is not connected to a potential equalizer Remedy Connect the potential equalizer switch of the device with the one in the examination room with a potential equalizer cable Strong electromagnetic noise produced by nearby noise source e g mobile phone or radio station Remedy Eliminate the nearby noise source or if the source cannot be eliminated install the Cardiax system in another location Radio frequency noise produced by another device through the power supply of the system Remedy Search for the source of the noise and eliminate it if possible Alternatively try another power supply Direct or indirect effect of electrostatic discharge Remedy Before operating the system make sure that neither the patient nor the user is electrostatically charged The danger of electrostatic discharge can be reduced by suitable humidity and antistatic flooring Revision 4 0 25 03 2015 9 Imed Ltd Cardiax PC ECG 1 5 Electromagnetic Compatibility The Cardiax PC ECG needs special precautions regarding EMC and needs to be installed and put into service according
44. agnosis Edit diagnosis Parameters The analyzed part of the ECG 16 sec 15 beats shows no signs of Predefined texts abnormalities given the patient s age Penis infortunatus lateris sinistri Insert u Edit Save Diagnosis reset Lock Send New Delete x Print Export To clipboard Return The Parameters item displays the parameters of every lead system in a comprehensive table The upper part of the table contains the global parameters relating to the whole of the recording the lower part contains the specific parameters of each lead system The Automatic diagnosis provides a suggested rhythm and clinical diagnosis based on the evaluation of the morphology of the recorded ECG to assist in interpretation by the physician ANY FINAL DIAGNOSIS MUST Revision 4 0 25 03 2015 o3 Imed Ltd Cardiax PC ECG ALWAYS BE MADE BY A QUALIFIED PHYSICIAN The physician s diagnosis can be added by opening the Edit diagnosis item where the suggested Automatic diagnosis text will be displayed The text can be restored to the automatic suggestion or it can be password locked by a doctor registered in the Cardiax program to prevent modification Patient AGE must be entered by the user for the Automatic diagnosis function to operate children 1 15 years adults 16 years Without an entry for patient AGE in the patient card a warning appears The first statement of the diagnosis contains the length of the ECG recor
45. ailable WiFi slow double C d network in the E eee onnecie profile list o blinks very fast Parameter configuration phase e gt USB LED yellow ersistent ECG recording through USB E connection slow l o blinks ee USB connection established ETIIITIITI o off No USB connection Revision 4 0 25 03 2015 106 Imed Ltd Cardiax PC ECG Reset connection mode of the device The device can be reset to the default connection mode without connecting to a computer so it can be surely connected by a computer When turning the device on keep the on off button touched until the power LED turns into red Releasing the button starts the device with the restored settings The fast blinking of the blue LED shows the device is accessible in AP mode Any wireless local network parameters set up will remain intact only become inactive For first generation devices reset see the relating section From firmware version v4 42 the reset function can serve as a quick switch between operation modes between direct and indirect if any given without the need of a computer This can be beneficial in cases when the doctor uses the device at surgery on the local LAN and visits the patient with a mobile device laptop tablet using direct connection to the ECG device From the given version on the firmware activates all of it s given wireless local network profiles in the case the reset is committed in being in direct connection
46. ardiax NetCenter 12 6 External requests 12 7 Calling Cardiax from other applications 13 Appendix 13 1 Appendix A Diagnosis 13 2 Appendix B Electrode placements and lead calculations 13 3 Appendix C Heart Rate Variability 13 4 Appendix D WiFi ECG device usage guide 13 5 Appendix E Pulse Oximeter setup 13 6 Appendix F User rights in the Cardiax system Revision 4 0 25 03 2015 4 Imed Ltd Cardiax PC ECG 1 Introduction Cardiax is a complete 12 lead electrocardiogram ECG system that is personal computer PC based It provides a full featured portable ECG that has important advantages compared to traditional ECG machines 1 1 Features ECG data is easily collected and stored using the standard 12 lead configuration or using the Frank lead configuration In the Frank lead configuration a vector ECG is automatically stored Real time or stored ECG tracings are clearly displayed on a computer monitor and may be printed whenever desired on inexpensive standard printer paper Costly ECG paper is no longer needed Stored ECG data can be accessed at any time Multiple recordings from a single patient can be easily evaluated and compared The Cardiax database provides a user friendly interface that can accommodate even the largest clinical and research needs The system is capable of handling 2 million patients each with a maximum of 1000 ECG tracings ECG recordings can be stored and categorized in patient folders o
47. are two other possibilities for the Pulse oximeter device dropdown None for not displaying any SpO2 data It keeps the settings already set up only disables the usage of the pulse oximeter device if it is temporarily unavailable to speed up the initialization of an ECG session EnviteC for previous versions of Cardiax USB devices up to SN0611100750 with a piggybacked pulse oximeter solution This additional online SpO2 curve operation needs the feature password to be given for the ECG device in the Options preference category Preferences cu Categories z 3 Pulse oximeter device ECG device ECG ChoiceMMed M 3 Print ECG MS Bluetooth stack C User connected COM port Ergometry 21 I BE and dialogs Assigned device Device PIN 0000 Ergometer program BCOXM 110710796 Treadmill program Blood pressure User Search Options Advanced WiFi Mail Auto backup Auto export NetCenter Security groups Revision 4 0 25 03 2015 112 Imed Ltd Cardiax PC ECG In case of the ChoiceMMed pulse oximeter device the two radio button choices enable all kinds of Bluetooth adapter and software configurations to work with Cardiax e f the operating system has a Bluetooth radio device external usb dongle or built in for notebooks that required no software component to be installed that means it uses the native Bluetooth capabilities of the operating system the so called Microsoft Bluetooth stack
48. ared CrxRights directory The system Administrator needs to create it with the proper rights of access On Windows XP Professional systems defining rights for shared folders is possible if Use simple file sharing is turned off in My Computer T ools Folder options View window After this setting the rights is possible in the program in the list of Setup Security groups Revision 4 0 25 03 2015 114 Imed Ltd Cardiax PC ECG Preferences o 8 Categories superuser ECG device EUG Doctors iv New patient card Print v Edit patient data ECG john Delete patient card Ergometry sarah View of monitor and dialogs V Start new recording 3 Ergometry M Modify comment diagnosis Ergometer program M Delete recordings Treadmill program Blood pressure User M Data export Options M Data import 5 Advanced M Send e mail WiFi iv Receive e mail Pulse oximeter M Send direct to remote database Mail Auto backup Auto export Delete NetCenter M Change preferences Group User Ok Cancel Apply Add The names in the list correspond to users or groups that have rights defined in Cardiax Selecting one fills the checkmarks currently defined for the name Modification is possible for administrators In case a second database card file is also opened the setup is done on the database that has the focus in the user interface of the program Regarding a network databas
49. ark of the WiFi status icon on the toolbar If fulfilled meaning the assigned ECG device can be reached one just has to select the by WiFi option at the bottom of the Setup Advanced WIFI dialog before submitting the read operation ATTENTION If the current connection to the device can not be restored after applying the new settings due to switching to other mode or profile modification then under Settings ECG device the device must be reassigned in order to further use it Revision 4 0 25 03 2015 105 Imed Ltd Cardiax PC ECG LEDs on the ECG device The device also has an indication of its current WiFi state In the lack of WiFi connection the blue LED blinks faster in connected state is blinks slower Details of the visual feedback are given in the next tables by the means of the rhythm of LED blinking Blink patterns correspond to 2 seconds long interval e Power LED green orange red ersistent Device turned on id color corresponds to level of charge oblinks Device turned off under charge color corresponds to level of charge o off Device turned off no charging e WiFi LED blue For first generation devices other explanation applies ersistent ECG recording through WiFi oP connection Em m m N connection WC int AP m slow Gonnacied point AP mode EH IIIITI I o blinks ee ee f le ast double Attempting in UR IH I II Il 1 connection mode to an av
50. ation The Interpretation window above displays the most characteristic averaged or median beat for each lead The bottom part of the screen shows the rhythm curve Select one lead as the rhythm curve in the Setup ECG menu The medians appear in 50 mm sec time and 5 10 20 mm mV amplitude selectable resolution The parameters of the rhythm curve 8 sec length 25 mm sec and 5 mm mV The upper table on the right shows the global parameters relating to the whole of the analyzed curve whereas the lower table displays the more specific parameters relating to the selected lead You can click with the mouse on any selected median cell or click the corresponding icon in order to select and enlarge it The enlarged median curve will appear in the graphic part of the screen scc TIE in magnification with 20 25 Q2N Suy X I I IMaRaLavF vi V2 v3 va vs ve x S2 mm mV amplitude and Pa 86 ms 200 mm sec time aem resolution adus D On the magnified median markers show the interval related calculation points for all of the usual projection points on the ECG curve These points are the same for every lead as shown in the table above and to the right of the medians e PB PE beginning end of the P wave tb te RER ISP p E bebed AA A RT v 6 Brrr wo 99000 e B J beginning end of the QRS complex e SIM yellow mark half point between J and STE e STE end of the ST segment e TE end of the T w
51. ation of the average NN interval calculated over 5 min periods within the duration of the recording SDANN ms This parameter is an estimate of the changes in heart rate due to cycles longer than 5 minutes The square root of the mean squared differences of successive NN intervals RMSSD ms The number of pairs of adjacent NN intervals differing by more than 50 ms in the entire recording NN50 NN50 count divided by the total number of all NN intervals pNN50 76 The last three measurements reflect high frequency variations in the structure of HRV and thus are highly correlated Geometrical Methods The series of NN intervals can also be converted into several geometric patterns tachogram is a graph of HR BPM and time s Poincar plot looks like a cloud which consists of a number of points Abscissa of the point is the length of the previous NN interval Ordinate of the point it the length of the subsequent NN interval The decreased HRV is reflected in a greater density and smaller size of the cloud The type of the point distribution is determined by origin of QRS complexes SD1 and SD2 are two standard Poincar plot descriptors SD2 is defined as the standard deviation of the projection of the Poincar plot on the line of identity y x and SD1 is the standard deviation of projection of the PP on the line perpendicular to the line of identity y x s is the area of the ellipse determined by SD1 and SD2
52. ault schemes By selecting Shrink heigh the monitor window s height will change proportionally to the number of channels displayed It can be useful when other running programs also need to be seen on the display Medians in longtime monitor window displays the online calculated medians together with the curves Revision 4 0 25 03 2015 24 Imed Ltd Cardiax PC ECG Always on top ensures that the monitor window is always seen above other running applications When Multiple monitor windows is checked each ECG record opened appears in its own individual window e g for comparison Language can be selected for the program interface if changed the program restarts Therea are several English items with different date form UK US Islamic Persian Fontsize determines the used font size in all Cardiax windows Note that other operating system dependent fonts like in menus and on system message boxes cannot be changed here It is advised to choose the maximum size that fits your display resolution User interface timeout if greater than 0 the monitor window will close after the specified inactivity time as well as it steps back from any opened findings list or ergometry phase list windows to the Filer window This behavior can prove useful if a network database is used and a user happens to leave the monitor window open for a long time e g lunch break that would disable others to access t
53. ave The parameters within the table beneath and to the right of the medians are calculated on a lead by lead basis The calculation of the ST attributes can be done in two different ways press F5 to toggle it The calculation of the end of the ST segment is different e STE the middle point of the interval between the global cusp of the T wave and the J point e J80 J60 80ms right from the J point or 60ms if HR gt 100 Revision 4 0 25 03 2015 52 Imed Ltd Cardiax PC ECG The positions of the markers can be modified vertically lining up the mouse pointer with a marker changes the pointer to arrows pointing toward each other now holding the mouse button down enables to drag the marker The modified marker will become red The left mouse button click on the curve area restores the automatically calculated positions Only modifying the markers in the summed view X has influence on the diagnosis The modified marker becomes red here too In case of the medians of individual leads the green marks mean the actual position of the mark in the summed view where it can also be an already modified position In the individual view the markers can be modified too but it is important to understand that the red color in their case indicates the difference from the actual position on the summed view 7 3 Diagnosis and parameters Menu Mode Diagnosis Diagnosis Ho a Name Demo 09 Code RRGSDR65B06E704R Automatic di
54. ble as an access point AP ECG 2 zl amp Print ECG F Ergometry EE View of monitor and di Ergometry Local networks LAN the ECG device can connect to Ergometer program A Network name SSID Hospital cardiology Treadmill program Active l ae pase z Blood pressure Password H User Home ofige Home office Options Active Network name SSID _ offi amp Advanced Password pede ooo E WiFi Pads Active Network name SSID Mail Password Auto backup Auto export Active Network name SSID NetCenter Password ES Security groups Device number byUSB Send profiles 0613090945 4 Ok Cancel Setup as ECG access point The Directly connectable as an access point AP checkbox determines the mode of operation of the device it can be directly connected or it connects one of the given local wireless networks The two behaviors are exclusive changing the checkboxes can implicitly alter the other mode s checkboxes too For devices with most recent firmware version greater than and including v4 41 the WiFi channel number the device uses can also be selected to best fit specific RF radio frequency environments This can be useful in case other WiFi network coexistence and interference is experienced Channels 1 to 77 are supported with the additional possibility Auto to have the device always select a channel when switching the device on according to the then present WiFi channel usage t
55. channels in the recording Here you can select which 3 or 6 you want to see e 3D reconstruction Conversion method for vector ECG from normal 12 lead ECG Inverse Dower Regression Quasi orthogonal Revision 4 0 25 03 2015 21 Imed Ltd Cardiax PC ECG 3 3 Print General ECG printout setting can be modified in this Setup category Printing is possible from the monitor window that displays the ECG curve in this case the displayed Leads are printed Furthermore initiated from the findings view of a patient that lists the recordings several selected pages can be printed regarding the selected ECG s This is called batch printing The setting under the main Print options category control general and quality parameters for both types of printings In case of color printers the color of the curves the grid the lines and the texts can be selected separately or well established default schemes can be selected The background can not be modified it will be always white Preferences o bE Categories Printer colors Default schemes ECG device ECG Prin Grid E Batch rest ECG Batch ergometry Curve PF View of monitor and dialogs Li el C Black Ergometry sne Treadmill program Blood pressure Grid U cipe New style iv Draw grid first ptions amp Advanced Step 1 E ECG curve thickness 1 C Old style 6 Default iv Print 3x4 leads from ECG window M Diagnosis in header
56. cord Stress test First in the setting window make sure there is a checkbox next to RS232 connecting If the necessary patient information date of birth sex height weight is not specified on the patient card a warning appears You can continue without supplying the data or return to the PATIENT CARD enter the necessary data and restart the stress test After choosing the appropriate stress program begin monitoring by pressing START or F9 lnl x Mode Leads Lead Set Stresstest Help BFF la www wm r gv 2x HR 250 HR min 200 workload W BP LmrHg3 200 BP mmHg 130790 Simulated ECG Not from the patient e Revision 4 0 25 03 2015 67 Imed Ltd Cardiax PC ECG 10 1 Recording the stress test Monitoring begins with a resting ECG recording You can begin the workload stages as following X Menu Stress test Start Hotkey F9 The ergometer bicycle will begin with the initial workload and the storing of the full 12 channel ECG recording will also start The duration of workload stages will be that chosen in the Settings menu At the end of each stage an ECG is stored and the workload will be increased for the next stage The monitor window displays the following data e blood pressure or in case of automatic measuring the word display e time of blood pressure measurement e stage time and total test time in sec e actual load measured in W or in case of a tre
57. d 9 2 Load program Ergometer Treadmill The workload scheduling can be given here When using a cycle ergometer bicycle you can select a protocol or define a new one by giving a name and pressing New button The parameters Beginning of load Increase of load and Load interval are self explanatory The First recovery phase can be differentiated by assigning specific load and interval values to it This can be useful when the patient reached high load e g sportsmen and the doctor intends to introduce recovery phase gradually Subsequent recovery phase setting are given at Recovery load usually 25W and Recovery interval The Manual Revision 4 0 25 03 2015 64 Imed Ltd Cardiax PC ECG increase of load is used when pressing the W W buttons during stress test f Preferences o lB Exa Categories ECG device Ergometer without PC connection ECG amp Print l Enable automatic BP Background printing Batch rest ECG Batch ergometry Max heartrate bpm 0 Max workload W 0 View of monitor and dial Max systole mmHg 0 Max diastole mmHg 0 Ergometry Min SpO2 4 Manual increase of load W Ergometer program po MI i Treadmill program protocol name esztnyoms Blood pressure User New Rename Delete Options 1 amp Advanced lM Continuous increasing of load Conconi test Beginning of load W 40 Increase of load W 10
58. d Cee View of monitor and dialogs Confi d amp Ergometry ontirm new passwor PT Ergometer program Treadmill program __Delete password Blood pressure User Options Password for delete B WiFi me Pulse oximeter Mail New password Auto backup Auto export Confirm new password OO NetCenter Security groups Deletepassword Toolbar icons l Backup on exit iv Emergency ECG Automatic code generation iv External documents iv Android 3 8 Program elements and possibilities In the settings of the Advanced main category you can prevent the unauthorized usage of the program by creating an optional entry password After giving the new password you have to re type it to confirm If the new password and the confirmed password are not identical a warning message appears and the password is not changed When you next start the program the system will ask for the new password Checking Backup on exit ensures a backup process to happen at program termination for saving any new data into a given directory It is an automation of always selecting the Backup function from the Transfer menu at program exit Automatic code generation is suited for hospital application and information technology it automatically generates a unique random code for every new patient created The code can be refined later on Revision 4 0 25 03 2015 27 Imed Ltd Cardiax PC ECG Under the Toolbar icons the following functions can be enabled as t
59. d after each use with alcohol of appropriate clearing materials If needed the lead wires may also be cleaned as appropriate Maintenance and checking The Cardiax system and any accessories should be checked regularly monthly by visual inspection If the system has been stored or not used for a long period of time 6 month all components accessories must be checked carefully before using it again The device must be powered off before cleaning and disinfection The device must not be modified or altered any way The Cardiax system is calibrated by the manufacturer prior to delivery No additional calibration or scheduled maintenance needed under normal operation In case of malfunction manufacturer or distributor should be informed and the system should be taken out of service and labeled with visually prominent notice to prevent continued use Repair must be carried out by the manufacturer or a qualified agent of the manufacturer Disposal Should the ECG device get any non repairable failure or damage or for any other reason the user opts for disposition the device should be qualified as hazardous electronic waste equipment and at must exclusively be disposed at designated collection facilities Revision 4 0 25 03 2015 8 Imed Ltd Cardiax PC ECG 1 4 Security instructions This device complies with IEC601 1 2 international standards for electric medical devices and electromagnetic tolerance of devices If the electrom
60. de IN j EXE ces Remote monitoring is a feature that allows a workstation running Cardiax to monitor the ECG recording process running simultaneously on another workstation in the local network or on another properly configured place through the Internet using TCP IP It makes possible to supervise a long time ECG recording typically a stress test The ECG recording is done on workstation R while workstation M wants to monitor the curve being recorded In the Setup menu under the ECG device category of R the Allow remote monitoring must be checked Preferences o Jm Categories R ECG device Device number ECG on USB ECG 3 Print Batch rest ECG Batch ergometry Assign View of monitor and dial 3 Ergometry Ergometer program Treadmill program Blood pressure User c C Options Advanced z E M Remote ECG monitoring iv Allow remote monitoring Ok Cancel Apply On the monitoring side the Remote ECG monitoring has to be checked in the same Setup category as above and the IP name or address must be supplied in address field below Revision 4 0 25 03 2015 75 Imed Ltd Cardiax PC ECG R starts monitoring and optionally the long time recording or the stress test where long time recording is automatic M also starts monitoring and the curve on R is displayed M can not record this curve only R can s
61. ding used for analysis the total number of the beats analyzed and statements that refer to the normal non pathological attributes of the ECG Following this is a list of ECG alterations classified as pathological This list also includes findings in which pathological ECG findings are present but in which ECG parameters do not reach threshold values to make a diagnosis The diagnosis also lists non characteristic deviations that cannot be clearly related to a pathological ECG alteration but which should be further evaluated Revision 4 0 25 03 2015 54 Imed Ltd Cardiax PC ECG 7 3 Heart Rate Variability HRV Menu Mode HRV This function can be used for recordings longer than 2 minutes in case of stored ones and after the 2 minute of the actual online recording In this latter case analysis is done on the data gathered until the function call without interrupting the recording process The analysis method and parameters are described in appendix 13 3 C Revision 4 0 25 03 2015 55 Imed Ltd Cardiax PC ECG 8 Data transfer functions 8 1 Copying patient card Menu Transfer Open 2nd card file This function can be used for copying all patient data to another subdirectory or another drive The target drive and subdirectory where the data should be copied should be specified If a nonexistent directory is specified the program will offer to create it After pressing OK the patient list is divided into two parts The upper
62. e only the user with write permission to the server s CrxRights directory can commit changes A database becomes secured if at least one user group is listed on the menu in the Setup Security features of the database are gone if all users groups are deleted from that list Attention If rights have been defined to a database and someone s user name or his group is not listed in Setup and can not write the CrxRights directory for that database that user is not allowed to use the database If this database is given as the first one the program will not start Revision 4 0 25 03 2015 115
63. e Mass Storage protocol well known on USB drives is used In the list all devices connected in either way will appear including simple USB drives not only the tablets and smartphones according to the operating system MTP support is included in the Windows operating system from the Vista version by default on previous versions the support can be installed A line in the list refers to a device beginning with the name of the device and at the end there will be if the device contains Cardiax Mobile database and grecum if the database is not found Cardiax Windows Portable Devices L GE Nexus 4 crx mobile Generic STORAGE DEVICE Qualcomm IncorporatedMas crx_mobile Import recordings Export patient cards Export recordings Copy anyway Cancel Android Revision 4 0 25 03 2015 62 Imed Ltd Cardiax PC ECG The following tasks can be accomplished one at a time Import recordings read all recordings from the mobile device and insert them into the Cardiax database Export patient cards copy the selected or all patient cards without the recordings to the mobile device Export recordings copy the selected or all patient cards and the recordings to the mobile device The Copy anyway option ensures to copy the data regardless of the synchronization state of the device According to the characteristics of the Cardiax Mobile software only 8 16 and 32 seconds long recordings a
64. e set beforehand otherwise it won t be detectable for the Cardiax program This process is described in the section Setup the WiFi connection mode of the ECG device For proceeding to update the available device list e Touch the on off button to turn the ECG device on The blue LED starts blinking e Soon the WiFi list in the Preferences window will be filled with data of the devices enumerated like the serial number SN and the IP address with battery information of connected devices The enumeration process is automatic and continuous while the ECG device is set to WiFi type the results will follow the presence and on off state of available ECG devices 4 With the help of the Device number SN select the device Assign the selected device by pressing the Assign button or double clicking the selected line The Assigned device field will display the serial number of the selection 5 Press the OK button to save settings and close the dialog or press the Apply button to continue setup with the assigned device After set up an assigned device the communication with it can be checked by selecting the Options category in the Preferences dialog or by starting the ECG monitor from the main window 239 or F9 If the device becomes unavailable turned off moved out of WiFi range a window will inform about the current state of the connection than can also be cancelled Connecting WiFi ECG device SN 06
65. ed A non zero value for the Mail check field provides automatic checking of inbound mails into the local inbox The sending procedure e select the patient cards ECG recordings to be send F3 e select the Transfer Send by mail function F11 e input or select previous recipient address in the pop up window Send patient data by e mail Send 1 patient s data file to ecg expert heart org iv Send to mobile device only 8 16 and 32 sec records Ok Cancel Mail sending can also be initiated from inside an ECG recording while viewing in the monitor window by pressing key F11 The receiving procedure The program checks automatically in the specified intervals for inbound mails New ones are downloaded and added to the Cardiax database automatically accompanied by a notification window Checking for new mail can be initiated anytime using the menu Transfer Receive by mail or by pressing key F12 Revision 4 0 25 03 2015 61 Imed Ltd Cardiax PC ECG 8 6 Data exchange with mobile Android device o 1 g Menu Transfer Mobil device With the advent of the Cardiax Mobile application under the Android system this dialog provides the possibility to synchronize move the ECG database between the desktop computer and the mobile device tablet smartphone The Android systems from version 3 0 Honeycomb on prefer the MTP protocol for file transfer while in previous versions th
66. en again Revision 4 0 25 03 2015 81 Imed Ltd Cardiax PC ECG User side client For accessing the central server the address and optional port number of it must be set beforehand by starting Cardiax normally The required settings are in the Setup menu under the Advanced NetCenter category The default port 3920 is used if the field is left blank m Preferences o a x Categories ECG device Server surg2 hosp1 hu ECG Print Port Batch rest ECG Batch ergometry View of monitor and dialog Ergometry Ergometer program Treadmill program Blood pressure User Options Advanced WiFi Pulse oximeter Auto backup Auto export NetCenter Security groups mes ww For NetCenter functionality Cardiax must be started with the parameter netclient on the client side At start the program asks for the user name and password to the server Cardiax then loads the Crx Client Agent background process This program runs on the tray and is responsible for the TCP IP data transfer with the server on the client machine The following icon with up arrow is placed onto the system tray The client agent may stay loaded for a while after the main program is terminated until it finishes any ongoing synchronization with the server Finally it terminates automatically The process of adding a new patient is a slightly different the code field is activated as the
67. eous pulsoximerty curve and data with the ECG Select the appropriate field in the Record menu item to make a new ECG recording to replay evaluate delete or copy a stored ECG recording or to compare the ECG recordings and the medians Deleting an ECG recording x Menu Record Delete Hotkey Del After selecting this function you have to confirm your decision The deleted recordings cannot be recovered Selecting ECG You can select one or more recordings by F3 from the stored ECG curves Select a recording in order to replay or evaluate it or select several recordings to compare the ECGs and or their medians or to copy or print the ECGs You can also create the inverse of the selection The selection is valid until you cancel it or until you quit the patient card Copying ECG Menu Record ECG Copy Hotkey Ctrl c Patient records can be copied to other patient s records This could be useful if you are trying to merge the mistakenly twice registered patient s distinct records into one or if you just want to see records of different patients in one listing After selecting the records to copy you have to select the target patient in the patient list and enter his her records Menu Record ECG insert Hotkey Ctrl v After you have confirmed your operation the records will be inserted into the list in the correct chronological order Revision 4 0 25 03 2015 32 Imed Ltd Cardiax PC ECG 4 7 Comment handling e
68. erface for direct connection to the ECG device only for the time of recording This can be achieved by checking the Only establish direct WiFi connection while recording option As a result connection to the ECG device only begins by starting the recording and it restores the original as soon as the process is stopped no need to exit the monitor window Running the Cardiax from a server installation is not possible this way since that requires continual network connection with the server Revision 4 0 25 03 2015 100 Imed Ltd Cardiax PC ECG WiFi items on the toolbar When selecting WiFi ECG for device a WiFi icon appears on the right most side of the toolbar line indicating the state of connection to or the availability of the assigned ECG device If the connection mode is selected as direct AP or Ad hoc a button with blue WiFi icon appears on the toolbar main menu line for controlling connection initiation or disconnection WiFi button WiFi state LI J regi Patient Record Sort Select Transfer Setup Help dada o Io min Sees H gen T ER Bom Last EC Name 01 Demo eb 000000 001 23 11 1979 02 12 2013 After successfully establishing direct connection AP or Ad pem to the device the connection is not broken automatically while the program is running The pushed state of the WiFi button also reflects this Switching the WiFi button off the connection can be broken and the WiFi interface can be restored to its p
69. et Sound Hotkey F6 It is possible to toggle on off the beat detection sound Filters Menu Set Filter 35Hz Hotkey F7 Toggles the 35 Hz tremor filter Menu Set Baseline filter Spline filter for reducing the baseline wander Other filters can be controlled from the Setup ECG menu The average pulse HH beats per minute and the time between the last two R waves RR msec can be seen in the top right corner of the screen Revision 4 0 25 03 2015 35 Imed Ltd Cardiax PC ECG 5 3 Selecting a lead system Menu Leads The system supports three types of electrode placement from which the following lead combinations can be displayed see also Appendix B 1 Placing only the limb electrodes e Limb I Il Ill aVR aVL aVF e Cabrera aVL I aVH Il aVF Ill e Standard I Il III e Unipolar aVR aVL aVF The stored recording is indicated as Extremal 2 Standard placement of all 10 electrodes the previous four plus e Precordial V1 V2 V3 V4 V5 V6 e Precordial 1 3 V1 V2 V3 e Precordial 4 6 V4 V5 V6 e Free selected 3 leads can be set in Setup ECG e Free selected 6 leads can be set in Setup ECG e 12 leads I Il ll aVR aVL aVF V1 V6 e Cabrera Precordial aVL aVH Il aVF lll V1 V6 The indication of the stored recording is Precordial 3 Frank placement of 10 electrodes the first four plus e Frank X Y Z The stored recording
70. he database English units is for entering and displaying patient height and weight in foot inch and pound However this setting does not affect any treadmill speed setting those are dependent only on the device type set 3 5 Stress test setup See the chapter 9 Settings for the Stress test for details 3 6 User Institute Set the data of the institute This will appear in the header of every printed page Doctors The first column of the table is for the doctor s initials the second for his her full name max 255 characters Initials are used on the Patient Card to indicate which doctor the patient belongs to In printing only the full name appears Also for diagnosis locking at least one user must be given here A maximum of 100 doctors can be defined 3 7 Upgrade options You can see information about the version numbers ECG device Cardiax software and the list of possible options An option is enabled if it is checked in the list Revision 4 0 25 03 2015 25 Imed Ltd Cardiax PC ECG Options are the following Network database enables the use of the software over a local area network Recording is possible using the server software running on an other computer with the ECG device connected The database on the server can be viewed on all workstations Stress test if the stress test option is enabled then the device can automatically control the ergometer bicycle as well as save and store s
71. he device can determine For devices with older firmware not supporting this settings the used channel is displayed but can not be changed the control is grayed All WiFi g devices can be firmware upgraded for this function to be Revision 4 0 25 03 2015 104 Imed Ltd Cardiax PC ECG available Setup for connecting wireless LANs Four WLAN networks can be given to the device for automatic connection both for first and second generation ones This eases the usage of the ECG device at multiple places hospital office surgery the device automatically connects the one that is available e Type the name SSID and password of the WLAN to be automatically connected into the topmost available place e he unchecked Active mark can temporarily disable connection attempts to the specific network without deleting its parameters The password fields of the user defined WLAN networks can individually be displayed visible using the asterisk button on the right side of the specific field After the settings are done press the Send profiles button to set WLAN parameters of the device The device will restart to apply the received settings If USB cable is not available e g forgot to bring with the laptop one can set profiles by an established WiFi connection to the device too The procedure is the same as with the cable only the WiFi availability of the device must be previously ensured this is shown by the green checkm
72. he picture below illustrates a 3D median from the V1 lead The spatial view can be zoomed using the slide on this window The cross hair provides a way for ETT 3 rotating the diagram Time labelling can be used for better so EX E identification In the listbox the Autozoom Ww displayed lead can be selected The 35Hz tremor filter can be E ME applied to the displayed signal Revision 4 0 25 03 2015 45 Imed Ltd 6 3 Vector ECG precordial Frank a Menu Mode Vector The Cardiax program can display the vector ECG from the Frank ECG recording You need the special placement of the precordial electrodes in order to make a Frank ECG recording see Appendix B The Frank recording displays the orthographic projection of the ECG vector in the X Y and Z planes leads The program creates and displays the Cardiax PC ECG vector diagram from the segment marked out in the ECG ruler by the x markers i The left window shows the frontal horizontal and sagittal H m es _ projection the right window shows the 3 D curve Clicking any of the 2D projections shows it on the right in more details RN Clicking on it again restores the 3D view The list box of the control window can also select the displayed content 3D 2D The 3D graph can be rotated using the cross hair and the both the 2D and 3D sizes can be changed with the sliders independently The endpoi
73. his Revision 4 0 25 03 2015 96 Imed Ltd Cardiax PC ECG can increase efficiency on notebook computers if email transaction is required and can be a requirement in sessions where network ECG database is accessed In direct connection mode the ECG device acts as a WiFi access point AP with an individual SSID name like for example ECG 0613032801 that can be connected by the computer equipped with WiFi interface In Infrastructure mode the ECG device connects wirelessly to an existing WLAN router acting as a WiFi access point Host computers that are connected the local network through a wired or wireless link can reach the ECG device Revision 4 0 25 03 2015 97 Imed Ltd Cardiax PC ECG Device assignment to the Cardiax application For using the wireless ECG the device must be assigned to the Cardiax program Select Setup from the main menu to open the preferences dialog The following figure summarizes the procedure of the device assignment true for both direct modes and for the indirect mode independent of device generation pn Apply e Lojk Categories ECG devi x ECG device gt Mode of connection Assigned device ECG ECG on WiFi Direct AP ME 0613032801 amp Print Batch rest ECG WiFi Batch ergometry Device numb Device at address Battery Assign View of monitor and dialogs 0613032801 ECG access point AP amp Ergometry 4 Erg
74. in patients with pacemakers or other implanted devices Like any ECG the pacemaker or other device will not disrupt or be influenced by the operation of Cardiax However equipment operators and supervising physicians should be aware of the presence of pacemakers or other devices The Cardiax system is designed for external skin surface ECG recordings only It must not be used for intracardiac recordings and must never be directly connected to the pericardium with internal electrodes 2 Using a defibrillator Although the ECG input is protected against electric discharge the electrodes must not connect with or otherwise contact the defibrillator pads or paddles To avoid injury the patient s bed the patient and all equipment or devices being used on the patient must not be touched by any personnel during defibrillation 3 Using a high frequency device during surgical procedures When the Cardiax system is used simultaneously with a high frequency device such as electrocautery make sure that the ECG electrodes are placed as far as possible away from the surgical field to prevent skin injuries that might result from malfunction of the neutral electrodes of the high frequency device Only experienced personnel should place these neutral electrodes and special care must be taken 4 Before using the device Check that the device is in its usual state Verify the correct connection of cables especially the patient electrodes and lead
75. injury in anterior amp septal amp lateral amp linferior location acute pericarditis myocardial ischemia in anterior amp septal amp lateral amp inferior location myocardial ischemia or digitalis effect in anterior amp septal Revision 4 0 25 03 2015 88 k k k k Imed Ltd Cardiax PC ECG amp llateral amp jnferior location O 1 1 jpolngedQT J O Possible pario oda abnormalities 2nd degree AV block 1 1 1 11 _ left posterior fascicular block O Z 1 11 11 Wolff Parkinson White pattern type A typeB right left atrial enlargement oO biatrial enlargement O Z o0 M right left ventricular hypertrophy with repol abn with possible a abn m biventricular hypertrophy with repol abn with possible repol abn Mod withQRS widening ul myocardial infarction in anterior amp septal amp lateral amp inferior amp posterior location M subendocardial injury in anterior amp septal amp lateral amp inferior location acute pericarditis 1 1 m myocardial ischemia in anterior amp septal amp lateral amp inferior location NM myocardial ischemia or digitalis effect in anterior amp septal amp lateral amp linferior location NEN ENM ST abnormality probably digitalis effect prolonged QT Revision 4 0 25 03 2015
76. is indicated as Frank 4 Placing 3 extremal electrodes in the Nehb arrangement e Nehb D A J The stored recording is indicated as Nehb Revision 4 0 25 03 2015 36 Imed Ltd Cardiax PC ECG 5 4 Storing the ECG recording Menu Mode Save Hotkey F9 You can use this function to save the immediately preceding 8 16 or 32 sec of ECG tracing that you have been monitoring snapshot The ECG curves are always stored without the 35 Hz filtration The length of the ECG to be stored can be specified by E Menu Set Record length 8 16 32 sec Hotkey F8 Pressing F8 repeatedly will cycle through the three options It is also possible to continuously save the whole ECG curve forward in time To activate Menu Mode Continuous save This will cause the actually displayed curves to be stored continuously on the storage device The timer on the right side of the screen shows the length of the ECG recording that has already been saved by the program Saving can be terminated any time by pressing the Stop ll button or by exiting the monitoring window Online comments Menu Mode Insert comment Hotkey F4 During the saving of the ECG signal or later at reviewing it there is the possibility to attach comments to specific moments of the ECG curve These are the online comments max 390 characters each Revision 4 0 25 03 2015 37 Imed Ltd Cardiax PC ECG Online comments o CE 00 04 a
77. isplayed in this mode Direct connection to the assigned ECG device has been initiated No WiFi interface is available for direct connection The assigned ECG device is being connected directly on the WiFi interface Pictogram not used in this mode e Direct connection to the assigned Y ECG device has been established Assigned ECG device is not found on any available network Assigned ECG device is found on one of the available networks WiFi interface is available but not k used for direct connection to the ECG device F Pictogram not used in this mode No network adapter available on the computer No WiFi interface is available on the computer grayed Revision 4 0 25 03 2015 102 Imed Ltd Cardiax PC ECG Setup the WiFi connection mode of the ECG device Both generations of WiFi ECG devices can be configured to automatically connect to specific wireless networks WLAN defined by the user with the use of profiles Only in the case of first generation devices two built in profiles are also available their description is given in the referring section Preferences fol Categories 2nd generation device WiFi g ECG device WiFi channel ECG z Print ECG 1st generation device default connection points Ergometry Ad hoc network by Computer SSID View of monitor and dialogs Ergometry Hotspot by Android device SSID E
78. kstations connect to the central database using TCP IP network protocol Connection can be made on a LAN Intranet or on the Internet The locally stored recordings are copied onto the database of the specified central server The workstations connected to the server see only their own local database while their database is continually synchronizing with the central database When the user adds a new patient or views the card of an existing one the client checks if the patient is already available on the server If so it asks for the existing recordings from the server and merges them with its local database The short recordings snapshots are downloaded instantly For performance reasons the long recordings and stress tests are downloaded only on demand if viewed For patient identification the Code field is used In case a new ECG record is made short long recording stress test the record is placed into an upload queue Uploading is done in the background while the user can work with the program normally without interruption Security On the central machine name password pairs must be defined When Revision 4 0 25 03 2015 80 Imed Ltd Cardiax PC ECG starting Cardiax in client mode on the workstations the client agent opens a dialog for entering user name and password to access the server Then the agent checks the server whether the user has the right to use NetCenter At restart the username and the password must be giv
79. lcoholic smell Predefined texts 0 4 Ims alcoholic smell iv Print with ECG curve Return Delete Print Delete On the left side the listing of all the comments attached to this record can be seen in the edit field below the new one can be entered On the right there are the predefined texts easy to insert New ones can also be defined max 345 characters but it is recommended to prepare them beforehand opening any long time recording it is possible to open this window for editing the global predefined texts In the list of predefined texts a row can be positioned to adapt to the usage frequency with the help of the arrow buttons or with the up down cursor keys while holding down the Ctrl While recording the list of the comments can be printed using the Print button When re viewing stored ECG records the Print with ECG curve checkbox enables to print the 12 lead curve around the given moments the comment belongs to 5 5 Common task automation Macros There is a Macro menu in the monitor window that enables to select specific tasks related to the monitor window that can be executed one after the other to speed up the workflow The key F2 can be used to start the selected tasks Those can be the following the list reflects the order of execution Stop Bl Save Gif export m GIF BDT GDT export Print Return P Exit B Revision 4 0 25 03 2015 38 Imed Ltd
80. list You can move in the patient list with the Up and Down keys PgUp and PgDn are for the bigger jumps pages Jump to the beginning end of the list with Home and End In case the folder icon in front of the name is orange a new recording is made for the patient or an existing recording was opened or printed This eases the daily tracking of the program usage Revision 4 0 25 03 2015 29 Imed Ltd Cardiax PC ECG 4 1 Adding a new patient a Menu Patient New patient Hotkey Insert You can start to start fill out the patient card The patient card includes the following fields name code birth date sex height weight doctor diagnosis The label of the diagnosis field can be edited here The entered dates can be stored by pressing Enter or by clicking on OK 4 2 Editing a patient card 4 Menu Patient Patient card Hotkey Tab The patient card can be modified any time The last line of the patient card contains read only information about the number of stored rest or stress test ECG recordings 4 3 Deleting from the patient list b Menu Patient Delete Hotkey Del All data for the patient will be deleted after confirmation IMPORTANT the deleted cards cannot be undeleted All patient data including ECG records will be lost 4 4 Attached documents ww Menu Patient Documents Other non Cardiax specific documents pictures texts other application specific documents can be att
81. mmed workload with the value set as the Manual increase of the load in the ergometry program settings W increase by the set amount decrease by the set amount Once the desired change in workload set it should be saved by pressing F9 within 10 seconds to store the new workload value It is also possible to hole the workload constant and cancel the pre programmed increases in workload In this case the workload will remain constant until it is cancelled W With this choice the displayed workload value watts blinks and the workload remains constant until this choice is again selected to cancel Revision 4 0 25 03 2015 70 Imed Ltd Cardiax PC ECG 11 Evaluation of the Final report The final protocol of a stress test is displayed in the list of recordings and identified as Final report Press Enter or double click to open a Final report for evaluation The Final report consists of 4 main parts List Graphs ST Trend ST List List of workload stages The recording list shows the ECG recordings made during the stress test and parameters of each stage The ECG list of an ergometer bicycle stress test contains the time load blood pressure BP heart rate HR revolutions per minute and ST values of the phases In case of a treadmill stress test the fields for load and the revolutions per minute are replaced with data relating to the speed grade MET values and the Double Product or Cross Product
82. nd amplitude settings The Batch ergometry sub category allows the following report items of the stress test to be printed besides the ECG properties on the ECG tab that are also available independently from the rest ECG batch settings in the previous sub category Likewise the ead selections speed amplitude settings and single lead parameters are also independent of the rest ECG batch settings ECG Ergometry List of phases iv ST level Graphs v Conconi iv ST trend M Median of phases 3 4 Setting the size and color of the Monitor window You can customize here the general appearance of the windows monitor ECG ruler medians in Cardiax Preferences ESEEGE fata Categories Colors Default sche ECG device Background EE S a ECG Blue qs oc NNNNEEEE Batch rest ECG C z Batch ergometry owe 1 White View of monitor and dialogs Line Ergometry C Black Ergometer program Text Treadmill program Blood pressure Language User M Shrink height Options English UK date D M Y z 3 Advanced M Medians in longtime monitor window d ll Always on top Fontsize Multiple ECG windows Automatic 12 l ECG curve thickness 1 User interface timeout min 0 English units b Ok Cancel Apply Colors can be set separately for the elements of graphs by clicking its button and selecting from the upcoming dialog or you can choose from three presets Def
83. nd type of a recording then Cardiax will automatically display the given recording In the Record section the recording to be displayed can be given indirectly under the Date field The Request section s Mode field can specify the operation to be committed by Cardiax 0 view default 1 make rest ECG recording 2 make stress test recording Revision 4 0 25 03 2015 86 Imed Ltd Cardiax PC ECG 13 Appendix 13 1 Appendix A Diagnosis Normal ECG The analyzed part of the ECG sec beats shows no signs of abnormality for one of the patient s age Pathological abnormalities short PQ sinus bradyarrhythmia arrhythmia tachyarrhythmia ii atrial bradycardia rhythm tachycardia low right atrial bradycardia rhythm tachycardia a atrial flutter with slow ventricular response with normal ventricular frequency with rapid ventricular response irregular atrial function with slow ventricular response with normal ventricular frequency with rapid ventricular response ui atrial fibrillation with slow ventricular response with normal left atrial bradycardia rhythm tachycardia ventricular frequency with rapid ventricular response accelerated ventricular rhythm ventricular bradycardia tachycardia Revision 4 0 25 03 2015 87 Imed Ltd Cardiax PC ECG n premature ventricular complex es or aberrantly conducted n premature sinus at
84. nded to be created This way Cardiax at P starts monitoring immediately and opens a TCP port for listening for incoming Expert side connections No data is stored at location P From now on the user at P has nothing to do expect for supplying the IP address of P computer to E in case not already known This address appears on the lower side of the monitoring window Practically a communication channel should be established between P and E chat skype telephone since operations must be synchronised and patient data is also entered by E At place E in the Setup ECG device must be selected as TCP IP ECG device and the IP address of P must be supplied Afterwards the Cardiax program can be used as regularly for recording the signal coming from of P Firewalls must be set to enable the listening port on P and the connection establishment on E too If P is connected to the internet from behind a NAT a proper port forwarding must also be set up on the NAT router The default TCP port used is the 7778 but can be modified at P the cardiax ini file has the following entry for overriding ecg iNetDevicePort2xxxx and at E the Device address field can have the port number after the address separated by a colon e g fire2 fs org xxxx Revision 4 0 25 03 2015 77 Imed Ltd Cardiax PC ECG 12 4 Server Client remote database operation In this operational mode the Cardiax program ru
85. ndling ECG recording monitoring 5 1 Start the monitoring 5 2 Display control 5 3 Selecting a lead system 5 4 Storing the ECG recording 5 5 Common task automation Macros Stored ECG recordings 6 1 ECG ruler manual measuring 6 2 Comparison of recordings medians 6 3 Vector ECG precordial Frank 6 4 Replay of recordings 6 5 Data export 6 6 Longtime recordings Evaluation of the ECG recordings 7 1 Manual evaluation in the ECG ruler 7 2 Median calculation 7 3 Diagnosis and parameters 7 3 Heart Rate Variability Data transfer functions 8 1 Copying patient card 8 2 Backup synchronization 8 3 Copying and inserting ECG recordings 8 4 Exporting and importing files 8 5 Send receive by mail 8 6 Data exchange with mobile Android device Revision 4 0 25 03 2015 3 Imed Ltd Cardiax PC ECG 9 Settings for the stress test 9 1 Ergometer bicycle blood pressure measurement and RS 232 control 9 2 Load program Ergometer Treadmill 10 Stress test 10 1 Recording the stress test 10 2 Recovery phase 10 3 Blood pressure measurement 10 4 Manual change of workload 11 Evaluation of the Final report 11 1 Calculation of maximum exercise performance 11 2 Stress test graphs 11 3 ST evaluation 12 Network operation multi user features 12 1 Local network operation 12 2 Remote monitoring 12 3 Remote device netdevice operation 12 4 Server Client remote database operation 12 5 C
86. ng E Menu Hecord ECG record Hotkey F9 Monitoring can be started both from the Filer view and the Findings view of a patient E Cardiax 12 Demo Compare 67 Co JE File Mode Leads Lead Set Macros Help 9S QoB ow 29e0e8J eze Nd Dies QT 408 ms QTcB 402 ms a c3 mvs mae pulse detecte Simulated ECG and pulse oximeter Not from the patient Saved 1 Revision 4 0 25 03 2015 34 Imed Ltd Cardiax PC ECG 5 2 Display control The time and amplitude resolution of the ECG recording starts with the default parameters selected in the Setup but these can be changed during the recording Monitor window resizing 2 AR Ae Menu Set Inc dec monitor window Hotkeys Ctrl Ctrl Increases or decreases the size of the monitor window in all directions by ensuring proper layout Paper length resize LT Menu Set Inc dec paper length Hotkeys Shift Shift Increases or decreases the horizontal size of monitor window along the time axis by ensuring proper layout Time resolution dib PIi Menu Set Time resolution Hotkeys Speed can be 25 50 100 or 200 mm s Amplitude A CU w amp Menu Set Amplitude Hotkeys Up Down Amplitude can be 5 10 or 20 mm mV Sound Menu S
87. nning on a local computer Client connects to the database of a Cardiax running on a remote computer Server using TCP IP protocol Starting the server program is possible from the Transfer menu by selecting Start server When starting for the first time a password must be given by LT clicking the Password button on the window just appeared TCP IP This button can be used later as well if the password needs to be changed This same password given on the server Baceived Command side has to be used on the Client side when connecting Next the Listen function must Command Status be started and the network port can be set if necessary If the port number is appropriate the Continue button places the Server program into communication ready state OFFLINE Password Exit Revision 4 0 25 03 2015 78 Imed Ltd Cardiax PC ECG Starting the Client program We have three possibilities to connect to a remote Server s database a The Server holds the whole database patient list From the Transfer menu the Remote database function must be selected Then the following window appears Using the Setup button the IP address and the listening port of the server can be set These values are remembered in new sessions after exiting the program but can be modified if the server changes By clicking the Connect button the program asks the password ms for accessing the
88. nt of the Filter 35Hz on off 1 Inverse Dower Regression C Quasi orthogonal 3D z Return selection that is displayed can be trimmed with the lowest slider so the progress of the curve in time can be examined The S ow button serves a similar purpose it redraws the curve in slow motion When Auto zoom is checked the graph always fits the window The tremor filter is optional on the displayed curve In case of precordial recordings the applied 3D reconstruction method can also be selected inverse Dower regression quasi orthogonal Revision 4 0 25 03 2015 46 Imed Ltd Cardiax PC ECG 6 4 Replay of recordings 4 Menu Mode Playback Displays the stored recordings in a form that simulates the monitoring mode All functions valid during monitoring are also valid here except the recording da Menu Set Baseline filter During playback it is possible to view the original signal without applying the baseline filter The tremor filter can also be switched off The HRV analisys is available at this time too and the navigator window can also be opened where the markers follow the playback position Both extra beats and online comments can be inserted or edited Revision 4 0 25 03 2015 47 Imed Ltd Cardiax PC ECG 6 5 Data export Menu Mode File export It is possible to use the data of the displayed record in other applications as well The output file format can be cho
89. nto one and delete the unnecessary record e f recordings of a common type are to be examined for example myocardial infarction patients it is possible to create a record called Myocardial Infarction and collect the recordings in that card Revision 4 0 25 03 2015 57 Imed Ltd Cardiax PC ECG 8 4 Exporting and importing files Cardiax can export the measurements in several file formats most of them are commonly used in the medical industry like SCP HL7 or DICOM Menu Transfer From the patient list or from the record list the selected items or the actual item can be exported using the Transfer menu in the following formats SCP With the File export SCP function a directory browsing dialog opens and after selecting or creating the desired destination directory the concerned recordings are written as SCP files containing patient data too Concerned recordings are all the rest or stress ECG records of the selected patients or if none is selected only of the actual one If the function is selected in the record list of a patient concerned recordings are the selected actual rest or stress ECG records File names are generated from the creation time of the recordings and have the extension scp HL7 With the HL7 export function a confirmation window pops up and after selecting OK the concerned recordings see above are written in HL7 format files into the EXPORT directory of Cardiax default is C C
90. o no data of the actual patient of M will be altered This function is also an option and therefore requires a password On the Windows firewall of R the transfer must be enabled and if a router is also involved in the transfer the necessary port forwarding and or firewall settings must be given The default inbound port on R is 7777 M uses it also as default but can be overridden by merging the port number after the address separated by a colon e g office2 hosp org 7697 On R the inbound port number can be modified in the cardiax ini file overriding the following entry in the ecg section ecg RemoteMonitorPort 7697 Revision 4 0 25 03 2015 76 Imed Ltd Cardiax PC ECG 12 3 Remote device netdevice operation P patient side E expert side OOS Using this function an ECG expert is able to advise a non specialist In another way the expert makes an ECG recording originating the signal from a distant place Let place P be the location where ECG is measured and place E where it is coordinated from Both places run a normal installation of Cardiax At P the user sets up the Cardiax program for normal recording e g Setup ECG device ECG on USB If P can surly access the ECG device locally then the program must be started restarted with the parameter netdevice for behaving as a netdevice For frequent use a shortcut with the modified command line is recomme
91. ometer program Treadmill program Blood pressure F Only establish direct WiFi ECG connection while recording User Options Computer s WiFi connection l Use specific WiFi ing rface Advanced Disconnected M Remote ECG monitoring M Allow remote monitori Ok Cancel h a Select ECG device category 2 Select ECG on WiFi from the ECG device drop down list and press the Apply button The controls related to Cardiax s WLAN settings and the list displaying the enumerated WiFi devices get enabled From this point all modifications related to WiFi ECG devices will apply automatically to ease the flow of setup but can be cancelled to revert back to the original state unless no explicit push of the Apply button happened The restoration true for the assigned serial and the interface selection also 3 The default operating mode of a newly purchased WiFi ECG device is ECG access point and the drop down list of modes also defaults to it on fresh installs Other modes should be selected in this step if needed Press the Apply button to commit the mode change Revision 4 0 25 03 2015 98 Imed Ltd Cardiax PC ECG After mode change the list of the enumerated devices and the current assigned device number will be cleared and new assignment must be done from the enumeration result in the new mode ATTENTION The desired WiFi mode in the device must also b
92. oolbar icons e Emergency ECG recording with generated patient data p that can be later specified e Opening the storage place of External documents stored in the Cardiax database e Start data exchange with mobile devices 3 9 WiFi device settings Settings for the ECG device with WiFi connection See the section Setup the WiFi connection mode of the ECG device of appendix D for details 3 10 Pulse oximeter Settings for the optional pulse oximeter device Detailed in Appendix E 3 11 Mail settings See in the chapter 8 Transfer functions for details 3 12 Auto backup and export Hospital specific application 3 13 NetCenter See in the chapter 12 Network operation multi user features for details 3 14 Security groups Hospital specific application in the first place see in Appendix F Revision 4 0 25 03 2015 28 Imed Ltd Cardiax PC ECG 4 Using the Card File in Cardiax S8 Cardiax CoJo mE Patient Record Sort Select Transfer Setup Hel a 5 3545 s P ras ie i ELI Last ECG m Name 01 Demo OD AEN 000 000 001 TEE 23 11 1979 04 02 2011 l f 02 Demo 000 000 002 13 09 1946 24 01 2011 Code 000 000 001 000 000 003 20 09 1960 26 09 2011 TE 000 000 004 25 12 1927 10 11 2006 orn 23 11 1979 000 000 005 07 02 1934 23 04 2007 c Mal 000 000 006 09 04 1945 20 12 2010 ale 000 000 007 09 02 1926 27 06 2011 Height cm 85 000 000 008 15 12 1958 07 09 2010 euhomr
93. or window can be re activated but this navigator stays open The two windows work in synch if the selection markers on the navigator are moved the monitor window will display that selection and vice versa Revision 4 0 25 03 2015 49 Imed Ltd Cardiax PC ECG Printing Length of recording Number of pages 2 The printer icon will print the C 50mm s selected lead from beginning to 25 mmis end The scale of the printing can C 10 mm s 10 mm mV be selected mm s mm mV and C 5mm s C 5mmimV the number of pages used are C 2mmis also displayed for information rire oe Cancel In the navigator window several markers are displayed on the ECG signal The two tallest black ones enclose the section of the curve that is currently disoplayed in the monitor window Their middlepoint will be positioned to mouse pointer in case a left click has happened The shorter orange marker indicates the extra beats The cyan markers denote online comments attached to the curve A right mouse click opens a pop up menu with the possibility to edit delete or insert new extras as well as comments In this menu the signal section for HRV analisys can also be set light green markers will be placed at the ends of the selected signal section Positioning the mouse cursor over any marker will pop up a tip box with the information about the marker type time Revision 4 0 25 03 2015 50 Imed Ltd Cardiax PC ECG 7 Evalua
94. p states The USB LED on the device goes off in this case This behavior can be turned off for the connected ECG device after the following detailed installation by starting the Cardiax program with administrative rights one time The start icon of Cardiax on the Desktop or the line for starting it from the Start menu both contain a right mouse click option for Run as Administrator that can be used It is important to have the ECG device connected for which this feature is to be turned off at the time starting the program this way 2 2 Hardware installation The parts of the system e ECGsampling device connected to a USB port or with WiFi connection e Standard USB cable A mini B max 3 m e Patient cable Operating system Windows XP Windows Vista Windows 7 Windows 8 8 1 The ECG device is connected to the computer using a standard USB cable shipped with the device The cable has two different connectors one that fits into the device and the other into the computer The operating system of the computer automatically recognizes the ECG whereupon the yellow LED on the device lights up and starts blinking When the online monitoring is started in the Cardiax program the LED will light continuously due to the data transmission The standard ECG electrodes can be ordered optionally must be attached to the patient as regular see appendix 13 2 B Revision 4 0 25 03 2015 17 Imed Ltd Cardiax PC ECG 2 3 Software installa
95. r by common features Stored recordings can also be easily copied archived or re analyzed Context sensitive help messages make the system easy to use A built in text editor can be used to create edit store and print notes and comments Automatic evaluation and diagnostics facilitate the physician s diagnoses The Cardiax system is also designed to readily interface with commonly used peripheral devices in the Exercise Stress Testing or physiology laboratory The system can automatically control a treadmill or cycle ergometer bicycle while recording the 12 lead ECG The Cardiax system can be easily installed on any appropriate PC with a USB interface It can be used in local networks or can be installed on a portable computer notebook for mobile use The Cardiax system can also be interfaced with medical database systems Revision 4 0 25 03 2015 5 Imed Ltd Cardiax PC ECG 1 2 Main system components The main parts of the system are e Cardiax ECG recorder USB only connection or both USB and WiFi connection e USB cable for connection to PC A mini B e Cardiax software Together these cooperating components are referred to as the Cardiax system Minimal computer requirements A personal computer configuration desktop or notebook or netbook optionally equipped with inkjet or laser printer with installed and working operating system from the following list Windows XP Windows Vista Windows 7 Windows 8 8
96. ral computer the program must be started with the parameter netserver Cardiax starts the Crx Server Agent background process This program runs on the tray and is responsible for the TCP IP data transfer with the clients on the server machine The following icon with down arrow represents the server agent on the system tray Meanwhile the main program opens only a dialog where the server events queries status and the error messages are displayed This dialog can also be minimized to the tray and reopened from there RB NetCenter server events bes x ISERVER20150320 1420150320 144552 250 5BF2B4C hello Ok SERVER2015 00320 1 1420150320 143341 15 52 19F47CA2 GQ72H3DS CRZ 2015 50320 143346 833 REC Ok hello ISERVER 2015 00320 14120150320 14364 3 183 5B54472A GQ72H3DS C RZ 20150320 7143649 831 REC Ok 03 Demo 000 000 003 down SERVER 20150320_ 142015 50320 143710 098 FCE40624 GQ72H3DS CRZ UP 20150320 ege 385 REC Ok 03 Demo 000 000 003 up single SSERVER 2015 00320 14120150320 143748 851 EEA8E73 TK671GH1C RZ 20150320 143755 7 REC Ok pon me 564564 down SERVER2015 0320 14120150320 143822 914 4E6283F2 T4KJKOKB CRZ 20150320 343829 3 REC Ok h SERVER 20150320_ 142015 30320 143825 914 37FFE20D D RZ 20150320 143832 350 REC Ok 101 Demo 000 000 001 down ISERVER20150320 14120150320 143828 914 D96292D1 VHDOYXCO CRZ 20150320 143835 383 REC Ok 05 Demo 000 000 005 down
97. re stroke volume maximal volume and linear speed of the bloodstream in aorta and other vessels Other periodic processes occurring in the cardiovascular system may also be analysed Methods of obtaining the HRV parameters 1 Time domain methods 2 Frequency domain methods 1 Time Domain Methods The basis of these methods is either the heart rate at any point in time or the intervals between successive complexes In a continuous electrocardiographic ECG record each QRS complex is detected and the so called normal to normal NN intervals i e intervals between adjacent QRS complexes resulting from sinus node depolarisation or the instantaneous heart rate is determined Statistical Methods The measures obtained after analyses of a series of instantaneous heart rates or NN intervals can be divided into 2 classes e those derived from direct measurements of the instantaneous heart rate or NN intervals e those derived from the differences between NN intervals The variables to be obtained are the following Mean heart rate HR int min Mean NN interval mNN or mRR ms e Standard deviation of the NN interval SDNN ms the square root of variance between the NN intervals Since variance is mathematically equal to total power of spectral analysis SDNN reflects all the cyclic components responsible for variability in the period of recording Revision 4 0 25 03 2015 93 Imed Ltd Cardiax PC ECG otandard devi
98. re sent to the mobile device Revision 4 0 25 03 2015 63 Imed Ltd Cardiax PC ECG 9 Settings for the stress test Menu Setup Ergometry In the main category Ergometry the device can be selected while in the following two subcategories the workload parameters can be set In the third subcategory the blood pressure device can be selected and enabled 9 1 Ergometer bicycle blood pressure measurement and RS 232 control Before beginning the stress test select the serial port Port item and the type name of the connected device If the type of bicycle or treadmill used for the stress test is not listed or if it cannot be controlled by a computer then choose Ergometer or Treadmill without PC connection When using the Treadmill you have the option to choose the units of speed measurement km h or mph Use the Check button to test the connection If successfully connected then a HS 232 control message appears If the program is unable to control the device the warning message No RS 232 connection appears There are several possible reasons for this warning message e the device is not connected properly e the device is turned off e the selected device is not identical with the connected device e the appropriate COM port has not been chosen e the COM port is not set up correctly e the serial cable is not appropriate or it is broken With the Command test button the individual control commands can be teste
99. ress test the right hand side of the screen display shows an evaluation of exercise performance The maximum expected performance from the patient can be calculated according to the weight and the body surface area by the method of DuBois The display also shows achieved performance as a percentage of maximum predicted If the HR during the stress test has reached the limits defined for the PWC calculation 130 150 170 min the program gives the absolute and relative PWC values as well as the normal PWC values according to age and sex in a table For a treadmill stress test the program displays to the right of the table the calculated oxygen consumption VO2 the Double product product of the maximal HR and the maximal systolic BP and MET values 11 2 Stress test graphs HR min 250 Bp mmHg Sp02 94 5 10 15 20 25 You can view the diagrams and tables giving a comprehensive evaluation of the stress test Ergometer Bicycle On the left hand side of the screen the first graph displays the heart rate and if available the SpO2 percentage as a function of time and the blood pressure measurements Predicted HR maximum HR and the maximum GP values shown in the top right corner Beneath this graph the workload is displayed as a function of time On the right you can see the table of the PWC The third graph displays the trend of heart rate as a function of exercise performance with the PWC values marked Revision
100. revious state So it can be used for serving other simultaneously arising needs using the program e g need of Internet or LAN access for transferring ECG records Pushing the WiFi button initiates the direct mode connection to the assigned ECG device in the background for the device to be immediately available at the time of starting a new recording process If no device assignment exists and the mode is set to direct Access point or Ad hoc the Preferences dialog opens automatically to select and assign an ECG device Automatic control of this button can be selected to provide the optimal behavior in certain usage scenarios e g mailing synchronization the previously described option ensures this The battery state of the connected device is showed on the status line both in the Card File and in the Monitor windows a black flash icon indicates if charger is connected The color follows the power LED of the device while the fill ratio is proportional to the charge level 10 Demo 000 000 1923 0 2011 01 13 C Cre data d6 KJD42XN5 crx CACIX 14 0 E Battery state Revision 4 0 25 03 2015 101 Imed Ltd Cardiax PC ECG The following table summarizes the possible effects and meanings of the WiFi control items on the toolbar Direct mode Indirect mode EKG access point AP Infrastructure LAN WiFi button WiFi interface is available but not used for direct connection to the assigned ECG device The button is not d
101. rgometer program Treadmill program Local networks LAN the ECG device can connect to Blood pressure Network name SSID User E Options Password amp Advanced UB DU candies x Network name SSID Mail Password Auto backup Auto export i NetCenter E Network name SSID Security groups Password Network name SSID Password m Device number by USB Read profiles Initially all variable fields are grayed and become only available after reading the profile of a device according to its type Follow the next steps to setup mode of operation and connection points of the WiFi ECG device e Touch the on off button W to turn the ECG device on e Connect the ECG device to the host computer running Cardiax by a USB cable The yellow LED starts blinking e Select Setup from the main menu and choose the Advanced WiFT category e Pressthe Head profiles button to download the profiles stored on the device Leave the drop down list on by USB The profiles with the Active checkboxes determine the WiFi networks the Revision 4 0 25 03 2015 103 Imed Ltd Cardiax PC ECG device attempts to connect to The order of the list determines the priority of connection in case more than one are available at the same time and each are signed active The topmost of the available active networks will be connected im ml Categories 2nd generation device WiFi g E EE ECG device M Directly connecta
102. rial complex es Mod with QRS widening n pair of consecutive sequence of consecutive premature junctional complex es Mod with QRS widening n aberrantly conducted complex es n other form complex es n ventricular escape complex es n sinus atrial junctional escape complex es Mod with QRS widening bigeminy pattern dextrocardia _dextrocardia o Wolff Parkinson White pattern type A type B low voltage QRS 1 HL low voltage QRS right left atrial enlargement biatrial enlargement incomplete right bundle branch block with repol abn with NER NEM a EN EE a NEN C NE d NE M possible repol abn py mu a EN NEK u ul incomplete right bundle branch block plus right ventricular enlargement with repol abn with possible repol abn right bundle branch block with repol abn with possible repol abn right bundle branch block plus right ventricular enlargement with repol abn with possible repol abn incomplete left bundle branch block left bundle branch block left anterior fascicular block right left ventricular hypertrophy with repol abn with possible repol abn biventricular hypertrophy with repol abn with possible repol abn Mod with QRS widening myocardial infarction in anterior amp septal amp lateral amp inferior amp posterior location myocardial
103. rt files in its own CRC and CRM format The latter is used by the Cardiax Mobile application The function can be invoked by selecting Import from file crc crm under the Transfer menu Then a directory browser opens for selecting the place where the files to be imported are located All the patient cards and ECG recordings in the directory will be imported Upon successful import the files are deleted This function is only accessible in the patient list window Revision 4 0 25 03 2015 59 Imed Ltd Cardiax PC ECG 8 5 Send receive by mail Menu Transfer Mail send Mail receive Hotkey F11 F12 Patient cards and ECG recordings can be transmitted by e mail with an appropriate Internet connection If records are received in a routine fashion by e mail not only casual it is strongly recommended to set up a dedicated mailbox merely for receiving Cardiax ECG data It ensures that the a receiver process of Cardiax is not slowed down by parsing other m non ECG mails Required settings must be given previously in the Setup menu under the Advanced Mail category The addresses of the remote and local mailboxes are obvious The SMTP and POP server names can be obtained from the mailer client if set or from the IT professional of the Institute Internet provider Some servers may require secure connection which can be set by checking the SSL box The ports are also need to be obtained from the IT professional
104. rx EXPORT There is a setting in the initialization file default is cardiax ini that enables the ECG curve data to be written into the HL7 file as well The setting is under the hl 7 section as wave 1 File names are generated from the creation time of the recordings and have the extension rep DICOM With the DICOM wave export function a directory browsing dialog opens and after selecting or creating the desired destination directory the concerned recordings see above are written as DICOM files with waveform data containing patient data too File names are generated from the creation time of the recordings and have the extension dcm XML The files containing both waveform and patient data are placed into the selected directory like in the above cases The format is compatible with the MUSE R cardiology information system File names are generated from the creation time of the recordings and have the extension xml CRC It can be created with the File export CRC function It is a proprietary format and can contain the records of a patient so when more patients are selected when exporting a directory browser opens for selecting the destination of multiple files one for each patient while if a record or selected records from a single patient are involved a file selection dialog opens where the name can be Revision 4 0 25 03 2015 58 Imed Ltd Cardiax PC ECG specified too Else a random name is used Extension
105. s reflected as a green checkmark on the status icon In the following tables the differences are emphasized to ease orientation WiFi button Direct mode Indirect mode Ad hoc Infrastructure LAN WiFi interface on the computer is available not used for direct released connection to the assigned ECG device o The computer is directed to create Pu Dos ad hoc WiFi network accepting p x a oushed direct ECG device connections No WiFi interface is available for grayed direct connection Revision 4 0 25 03 2015 108 Imed Ltd Cardiax PC ECG WiFi icon status Direct mode Indirect mode Ad hoc Infrastructure LAN Ad hoc network is created by the computer and waiting for direct connection of ECG devices Pictogram not used in this mode Direct connection to the assigned ECG device has been established Assigned ECG e i WiFi interface on the computer is device is not CP suene not used or deri found on avaiable networks Assigned ECG device is found on one of the available networks Pictogram not used in this mode m No network No WiFi dios no on the adapter on the p computer grayed Revision 4 0 25 03 2015 109 Imed Ltd Cardiax PC ECG Setup the WiFi connection mode of the ECG device In case of the first generation devices above the local network profiles there are two built in connection profiles listed Both are responsible for directly connecting
106. se of using the program in a network configuration the software must be installed only to the server computer It can be executed on each workstation that uses the common database located on the server A patient s card can be accessed from several places this way and possible changes can be tracked from those places without intervention The parameters set in the Setup menu are valid for each workstation When a user wishes to use custom configuration the program can be started with the i option and the name e g station01 of the INI file containing the custom settings wincrx32 exe istation01 If the given file does not exist the program will create one but a unique name selection is important in the network environment In network operation ECG recording on a workstation is possible only after enabling the option with a password For these workstations the Network database option must be bought as well as other options that are needed on the workstation see chapter 3 7 Options Network operation introduces some limits only one user can access a patient s card at a time and a card cannot be deleted when more than one user is accessing the database This kind of operation is available not only on Local Area Network but also Revision 4 0 25 03 2015 74 Imed Ltd Cardiax PC ECG on other compatible remote networks e g Virtual Private Network 12 2 Remote monitoring R recording side M monitoring si
107. sen csv scp dcm xml More about the formats in chapter 8 4 In case of the CSV format the signal amplitude values as integer numbers will be stored in text form separated by commas This provides an easy way for making Microsoft Excel IJ presentations as well as for custom scale statistical and signal analytical computations This File export can be started from the Ruler and from the window of the Medians too In the latter case the median curve values will be exported in the selected form In the Diagnoses window the export button allows to save the edited diagnoses and the parameter table values in csv format Revision 4 0 25 03 2015 48 Imed Ltd Cardiax PC ECG 6 6 Longtime recordings With saved Longtime ECG curves besides the previously mentioned measurement and other functions it is also possible to obtain a view of the whole recording This can be done within the Navigation window Menu Mode Navigation window The Navigation window will display a single channel ECG picture that the user can scroll through Orientation is made easier by the time stamps on the left ters e 3 BS wwe A amp nw I I Makar Vi V2 V3 V4 V5 V6 00 00 00 Peep ap T 00 00 30 00 01 00 00 01 30 00 02 00 00 02 30 00 03 00 00 03 30 00 04 00 00 04 30 The scaling arrows control the time and amplitude resolution of the displayed signal selected by the lead buttons of the toolbar Using the A icon the monit
108. social security id All the other fields are optional but recommended and stored in the Cardiax database If a patient with the given d exists in the database his her list of recordings will be shown Otherwise it will be treated as a new patient and his her data will be inserted to the database In case the caller cannot provide unique identifiers the Cardiax generated inner ID can also be used It is returned after the first call with a new patient when it is inserted into the database and can be used in subsequent calls for identification However this id must be supplied in the Crx d field not in the d field After the call Cardiax appends the following two lines to the Patient section of the xxx ini file CrxOk 1 CrxId yyyyyyyy The CrxOk item is used to ensure that the file was processed by Cardiax and will not be read at subsequent calls The Crxld field is an 8 character long alphanumeric inner identification string This can be used at later calls to identify the patient The Name field can contain accented characters using either the Windows Ansi character set or the 852 character page DOS OEM In the 852 case the OEM field should be set to 1 In the New filed of the Files section the caller can supply the name of a file where the time and type of the recordings of the given patient will be written In this same section Old filed may be used to define the name of an existing file If this file contains the time a
109. tion Turn on the computer After starting Windows place the installation CD labeled Cardiax into the CD drive If the automatic insert notification is enabled the Cardiax installer will auto start Otherwise browse to the root folder of the CD ROM and execute the installer shown with the following icon m Choose the destination directory If there is a previous version already installed we recommend that the new version be installed to the same directory In this case the new version will automatically use the previous database Choose the language After successful installation Cardiax can be started by clicking on the following icon on the desktop or by launching wincrx32 exe Revision 4 0 25 03 2015 18 Imed Ltd Cardiax PC ECG 3 Setting the default parameters Menu Setup Default parameters concerning the functions listed on the left can be adjusted here 3 1 ECG device The user selects the source for the incoming ECG data Preferences o Je Categories ECG device ECG device Device number ECG ECG on USB z 0613032801 d Print Demo simulated ECG Batch rest ECG nant i ECG on WiFi Batch ergometry X TCP IP ECG device View of monitor and dialogs ECONEt Cardio M device 3 Ergometry Ergometer program Treadmill program Blood pressure a User Options a Advanced M Remote ECG monitoring M Allow remote monitoring Demo simulated EC
110. tion of the ECG recordings The Cardiax system allows you to evaluate and analyze your stored ECG recordings in an offline fashion subsequent to data collection The automatic evaluation Interpretation from the ECG ruler produces the averaged median beats from the recording performs the rhythm and contour analysis and prepares a table of the related parameters If the selected recording is incomplete the ECG sign does not appear on a channel or one of the leads is too noisy an error message appears and the program does not perform the automatic evaluation 7 1 Manual evaluation in the ECG ruler s Menu Mode Interpretation Hotkey F8 The median calculation determines the most characteristic beat in each lead and displays these median beats for all 12 leads It also calculates the time and amplitude values necessary for the rhythm and contour analysis draws the rhythm curve and displays a table of the diagnostically important parameters As a result of rhythm and morphological analysis for adults at least 15 years old and for children between 2 and 14 years the Cardiax proposes a diagnose EE Cardiax Demo 09 17 01 2012 11 22 Demo oS Mode Lead Set Help Yo QET X 1 UMarvarvivvywvyvwe SAXA E BF ee wr Ep Gees zu ERRA EE f Pd 90 ms QTcB 404 ms T ax 69 Rs Revision 4 0 25 03 2015 51 Imed Ltd Cardiax PC ECG 7 2 Median calcul
111. to the following EMC information provided Portable and mobile RF communications equipment can affect the Cardiax PC ECG Electromagnetic Emissions The Cardiax PC ECG is intended for use in the electromagnetic environment specified below The customer or the user of the Cardiax PC ECG should assure that it is used in such an environment Electromagnetic environment Compliance missonstest Compliance guidance The Cardiax PC ECG uses HF energy only for its internal function a Therefore its RF emissions are very RF emissions CISPR 11 Group 1 low and are not likely to cause any interference in nearby electronic equipment RF emissions CISPR 11 Class B The Cardiax PC ECG is suitable for use in all establishments including Haravonieemiesions domestic establishments and those IEC 61000 3 2 Not Applicable directly connected to the public low voltage power supply network that supplies buildings used for domestic purposes Voltage fluctuations flicker emissions IEC 61000 3 3 Not Applicable Revision 4 0 25 03 2015 10 Imed Ltd Cardiax PC ECG Electromagnetic Immunit The Cardiax PC ECG is intended for use in the electromagnetic environment specified below The customer or the user of the Cardiax PC ECG should assure that it is used in such an environment Compliance level Immunity test Electrostatic discharge ESD IEC 61000 4 2 Electrical fast transient burst IEC 61000 4 4 Surge IEC
112. tress test 12 lead ECGs Remote monitoring online observation of ECG monitoring over a network This function is useful for example during stress tests when an observing doctor is able to view the ECG curves on another computer Pulse oximeter enables the storage and display of the data from the compatible pulsoximeter devices simultaneously with the ECG recording NetCenter enables to use the Cardiax as a central database service that aggregates the users patients and records Other authenticated Cardiax users can synchronize their local database with it Handy6 connection only available in case this kind of older model is connected to the computer on an LPT port and for ECG device also ECG on LPT is selected This option enables the data transfer with the device reading its stored records max 10 and using it for real time ECG recording If you want to purchase a new option Send the device number of your system and the list of requested options to your Cardiax distributor You will receive a new password Enter this password by clicking the Change button then the new options will be available Revision 4 0 25 03 2015 26 Imed Ltd Cardiax PC ECG In the following chapters the settings under the Advanced category will be described Preferences Sao j Categories ECG device Entry password ECG 3 Print Vr o LALLLLL E ZZ ECG Ergometry New passwor
113. user of the Cardiax PC ECG can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the Cardiax PC ECG as recommended below according to the maximum output power of the communications equipment Rated maximum Separation distance according to frequency of transmitter output power of transmitter m 150 KHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz d 1 2 NP d 12 NP d 23 NP 0 23 0 74 2 3 7 4 3 For transmitters rated at a maximum output power not listed above the recommended separation distance din meters m can be estimated using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies NOTE2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Revision 4 0 25 03 2015 13 Imed Ltd Cardiax PC ECG 1 6 FCC Compliance Statement This equipment has been tested and found to comply with the limits for a Class B digital device pursuant to part 15 of the FCC Rules These limits are designed to provide reasonable protection against harmful interference in a residential installation This equipment generates uses and
114. user types in BP measurements in the following form BP mmHg systole diastole Before the end of each workload stage the program provides a beep signal and a schematic figure of a sphygmomanometer appears under the pulse values The BP measurements are to be entered 40 seconds after the beep tone a white stripe in the schematic figure indicates the time remaining With an automated BP measurement device connected the computer acquired and stores the data The program displays the last measured BP values It s also possible to take BP measurements more than once in each stage or phase or to leave out BP measurements This option is set in Extra BP measurement f this field is empty or 0 then each stage or phase will have one BP measurement performed If this field is set to 1 2 3 4 then there will be 2 3 4 or 5 measuring per phase 1 2 3 4 then the 1st 2nd 3rd and 4th phases will not have BP measurements taken Examples e Interval 180 e Extra BP measuring 2 e Time interval for BP measuring 180 1 2 60 e Interval 90 e Extra BP measuring 1 e Time interval for BP measuring 90 1 1 180 At the end of extra BP measurements 40 sec after the beep there will also be an additional ECG saved The measured BP values will be added Revision 4 0 25 03 2015 69 Imed Ltd Cardiax PC ECG to this ECG recording 10 4 Manual change of workload It is possible to increase or decrease the pre progra
115. verse of the selection Moving between selected lines is possible by holding the Shift key while using the Up and Down arrows 4 6 Findings list of stored ECG recordings Entry from the Patient List with Enter or double click A Cardiax Patient Record Sort Select Transfer Setup Help 19 x ZEHN Ber arnim Name 12 Demo Compare G 27 11 2006 16 15 Stress test El 11 12 2007 10 56 Precordial 16s Code 000 000 012 l 17 04 2008 09 54 _Precordial 16s i E 09 05 2008 09 18 Precordial 16s Born 25 11 1947 El 29 07 2008 11 31 Precordial 16s E EHE El 01 08 2008 12 10 Precordial 16s i a El 25 03 2011 08 03 Precordial 16s Heigh cm ss Bi25 03 2015 1253 Precordial 43s SpO2 Weight kg 78 Doctor Diagnosis EGG Rest 7 Str 1 CARDIAX List of records CACH 8 0 The left hand side of the Findings screen shows the card of the selected Revision 4 0 25 03 2015 31 Imed Ltd Cardiax PC ECG patient the right hand side displays the list of the stored ECG recordings sorted by date The list of the recordings shows the date time and the lead system of the recording and the record comment The green tick mark on the record s icon indicate the presence of edited diagnoses regarding that specific record Stress test ECG records have cyan folder icons referring to the collection of the test phases The SpO2 text indicates that the record has simultan

User`s Manual

Contents

Download Pdf Manuals

Related Search

Related Contents