eps320_quick_reference_ver_3-19.pdf
Page 1
Bard Electrophysiology
POWER UP PROCEDURE
Turn on the SGU (stimulus generation box) at the back power switch.
Switch the CPU on.
• The main MicroPace stimulator screen will appear automatically after boot-up, and the computer software will then
establish a serial link with the SGU box. This may take a minute. If the software asks you if you want to reset or reconnect to the SGU box, press ‘y’ for yes. Recheck that the SGU box is switched on by the presence of a green (not
yellow) light above the MAINS POWER label on the panel.
•
•
BACK UP AND EMERGENCY PACING
Pressing the F12 key allows S1 to pace at 600ms in both channels 1 and 2.
BACK-UP PACING
EMERGENCY PACING
Failure of the computer is detected by the SGU, which
displays an error message ‘NO PC’ on its LED display.
The user may then invoke the BACKUP MANUAL PACING
MODE by pressing the BACKUP ENABLE button,
whereupon the SGU functions as a stand-alone
programmable pacemaker. This mode is indicated by the
extinguishing of the PC PACE LED and lighting of two 7segment LED numerical displays on the front panel
indicating set Pacing Interval and Current. These can be
adjusted by pressing adjacent up/down arrows. Pacing
may be then toggled on/off by the RED PACE ON/OFF
button. This mode may be forced by the operator, e.g. if
the computer appears to be malfunctioning by pressing
the BACKUP ENABLE button at any time.
Should the Stimulus Generator Box itself appear to fail
by a lack of stimulation pulses or by displaying an alarm
on its LED display and the patient requires urgent pacing,
an independent analogue circuit pacemaker is available
for emergency pacing. Remove the green Stimulus Cable
plug from the green PACE OUTPUT socket on the
Stimulus generator Box front panel and plug it into the
red EMERGENCY FIXED RATE BACKUP PACING socket
immediately to the right of it.
Pacing will start
immediately (by sensing the applied lead resistive load)
at 100bpm, 5mA and 2ms pulse in the Ventricular
channel only. This emergency facility has a separate
battery and will function even in the unlikely event of a
failure of all other systems.
HELP MENU
• HOTKEYS: Most used Hotkeys are Highlighted and Underscored. For all hot keys go to H for help
menu #4 Command Summary will give Basic Hotkeys, Page down will give you all advanced Hotkeys.
• PARAMETERS: To find out how each Parameter works choose the short cut hot key for
that protocol and parameter and go to the Help (H) menu #1 Present Parameter.
• PROTOCOLS: To find out how each Protocol works choose the short cut hot
key for that protocol and go to the Help (H) menu #2 Present Protocol.
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The MicroPace Screen & Keyboard
Title Bar will give you Current Set up, Version and Page
STIMULUS Menu allows setting of
stimulus pulse and train parameters
PACE STATUS
displays sense site
and result of pacing
Protocol Menu, set Stim
train Protocol, selectable
with Hot Keys T,N,S etc.
Pace Site Menu, select
Stim Channel selectable
with Hot Keys A,V etc.
More
Hotkeys
Menu
displays
menu of
extra Hot
Keys
Stimulus
Symbol
Display
Resulting
sensed
ECG
Display
Pacing
Intervals
Pause,
Length of
time before
pacing
begins
between
stims
Summary of Activity
Status of SGU (Under PC Control)
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STIMULUS MENU
• CURRENT Hotkey C, Sets Current
• Applicable keys: Numerals, +/-, Ctrl +/-, Ctrl-Ins, Ctrl-Del, Alt +/• Values: 0.1, 0.2, 0.3… 4.8, 5,6,7… 10,15…25 mA.
• Ctrl-Ins forces current to 20 mA.
• Ctrl-Del Restores current from 20 ma to previous values
• DURATION Hotkey U, Sets duration on Stimulus pulse in ms.
• Applicable keys: Numerals, +/• Values: 0.5, 1, 2, 3…10ms
• TRAIN Hotkey I, Sets # of Stim or # of sensed beats
• Applicable keys: Numerals, +/-, Del
• Del key sets INF = Infinite train or continuous pacing
• DECREMENT Hotkey D
• Applicable keys: Numerals, +/-, Ins, Del, Alt-L, Alt-U
• Del turns of decrementation
• Ins turns on decrementation, Ins with Tbl will bring up the table
• SYNC TO Hotkey Y
• Applicable keys: Y toggles between P/R and Off
• Off pacing commences asynchronously
• P/R pacing start after next sensed P/QRS
• ECTO pacing starts after next sensed premature P/QRS
• PACE MODE No Hotkey
• User must highlight parameter with the ‘Up Arrow’ and adjust using the +/- key
• Asyn pacing correspond to AOO and VOO pacing
• Inhb pacing correspond to AAI and VII pacing
PACE STATUS
• SENSE SITE: Active ECG Sense site/source, yellow subscript indicates the
ECG Gain, adjustable in QRS Detect Menu (Alt-Q).
• PQRS Sense / RR-average: Beat to Beat PQRS Sense interval and Average
PQRS Sense interval are displayed in msec.
• Heart Rate: in bpm.
• Time Paced: Timed paced in seconds.
• Impedance: Pacing circuit impedance is measured with each pulse to aid
the user in determining the integrity of the pacing circuit.
• Pulses Snt: Number of stimulus sent.
• During Pacing , the blue ECG display bar
will display vertical Stim markers(short bars
for S1, longer bars for S2-S7 and Channel 1
above Channel 2). The sensed ECG trace
and QRS markers are displayed in the lower
half.
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PROTOCOLS
• THRESHOLD: Hotkey T. Helps determine the
pacing threshold by continuously decreasing or
increasing the pacing current amplitude.
• The user needs to stop pacing when capture fails,
and accept or modify default current.
• NODAL_ERP: Hotkey N. Provide up to 3 autodecremented extra-stimuli for AV Node refractory
measurements. S2-S4 may be auto-decremented
by 50 msec above a value set by Config Var-36 and
by the Decrement Auto parameter below that.
• SNRT: Hotkey S. Displays an elapsed-seconds
alarm timer and automatically decrements S1 after
stopping pacing according to a SNRT. Table
accessed by pressing(Ins) with the screen focus on
the AUTO_DECREMENT OR S1 parameters while in
the SNRT protocol. Note SNRT value calculation
may not function correctly with catheter-tip
sensing; use external EcG sensing to obtain SNRT
calculation by the EPS320 Stimulator
• PACE: Hotkey P. Select the Pace protocol to
pace at a fixed interval set by S1 into selected
pacing site.
• BURST_PACE: Hotkey B. Regular pacing at S1
interval for a number of pulses defined in Train
Variable.
• Intra-burst decremental S1 pacing may be set by
setting Decrement parameter to a desired
decrement value. S1 will be decremented by this
amount every 400ms, to the value set in Config
Var-2.
• See Config Var-18 to set up Rate Adaptive.
• WENCKEBACH:
decrements S1.
Hotkey
W.
Continuously
• Decrementation may be paused by continuous
press of the (Spacebar) or optionally terminated by
manual adjustment of S1.
• See more options in the help menu for this
protocol.
• Multi_SX: Hotkey Z. Provides up to 6 autodecremented
extra-stimuli
primarily
for
programmed ventricular stimulation.
• Defibrillator warning can be turned off by Config
Var-38 to 0.
• Manual adjustment of last Sx suspends next
auto-decrementation and BSP key undoes last
auto-decrement.
• Double tap on Sx will take the Sx back up 10
msec and then return to the last Sx.
• RSYNCED_SX: Hotkey R. Produces a train of
up to 3 extra-stimuli coupled to a train of sensed
complexes.
• DELAYED_AV:
Hotkey E.
Provides AV
sequential pacing where S1 is the basic pacing
interval and the S2 interval sets the AV delay.
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PROTOCOLS continued
• ATP-AICD: Hotkey L. ATP may be delivered at a
preset % of the sensed VT cycle length set by S2
or at a fixed starting cycle length in ms set by S1.
• S1 and %(S2) can be adjusted by the user prior
to pacing.
• Train length set by I. Auto decrement set by D.
• A minimum S1 specific to this algorithm and
intra-train S1 decrementation may be set by Config
Var-4 and Config Var-19(Hotkey K).
• OD_BURST: Hotkey O. Regular pacing at S1
interval for a number of pulses defined in Train
Variable.
• Intra-burst decremental S1 pacing may be set by
setting Decrement parameter to a desired
decrement value. S1 will be decremented by this
amount every 400ms, to the value set in Config
Var-2.
Press ‘G’ to return to previous protocols
and parameters.
• See Config Var-18 to set up Rate Adaptive.
• X-RS2: Hotkey X. Produces a train of up to 3
extra-stimuli coupled to a train of sensed
complexes.
PACE SITE
• ATRIUM Ch1: Hotkey A. Ch1 output. For optimum stimulator automation,
this channel is typically used to stimulate the HRA, or the more proximal pacing
site in the conduction tree.
• VENTRIC Ch2: Hotkey V. Ch2 output. For optimum stimulator automation,
this channel is typically used to stimulate the Ventricle, or the more distal
pacing site in the conduction tree.
• STIM3 Ch3: Hotkey ‘. General purpose channel. It shares the current
generating circuit with Ch1, so EPS320 can’t stimulate both simultaneously.
• STIM4 Ch4: Hotkey /. General purpose channel. It shares the current
generating circuit with Ch2, so EPS320 can’t stimulate both simultaneously.
• JOINED 1+2: Hotkey J. Simultaneous Ch1 and Ch2 stimulation.
• In protocols without extra-stimuli, stimulation is simultaneous only
into Ch1 and Ch2.
• In protocols with extra-stimuli, a Menu allows independent
connections of S1 to S7 pulses into either one or both channels.
• The default menu setup is for S1 to pace both Atrium and Ventricle
and extra-stimuli to pace only ventricle.
• JOINED 3+4: Hotkey ]. Simultaneous Ch3 and Ch4 stimulation.
SENSE SITE
• OFF: Hotkey ALT F. Turns of sense site.
• ATR-Ch1/3 tip: Hotkey ALT A. Senses from the Atr stimulus channel pacing electrodes,
which in Four channel pacing may be connected to either output channels CH1 or Ch3.
• Note that you cannot Pace Ch3 and sense from Ch1 or visa versa.
• VEN-Ch2/4 tip: Hotkey ALT V. Senses from the Ventr stimulus channel pacing
electrodes, which in Four channel pacing may be connected to either output channels CH2
or Ch4.
• Note that you cannot Pace Ch4 and sense from Ch2 or visa versa.
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SENSE SITE continued
• EXT_ECG-1(A): Hotkey ALT 1. Senses from ‘ECG-1 Input’ at the rear of the SGU.
• This should be connected to a HRA IECG (RTO) channel for optimal EPS320 performance.
• EXT_ECG-2(V): Hotkey ALT 2. Senses from ‘ECG-2 Input’ at the rear of the SGU.
• This should be connected to a RVA IECG (RTO) channel for optimal EPS320 performance.
• AUTO_EXT: Hotkey ALT X. Senses from Ext_ECG-1(A) when pacing Atrium-Ch1 and from
Ext_ECG-2(V) when pacing Ventr-Ch2.
• Sense site remains Ext_ECG-1(A) when pacing Ch3 or Ch4 or Joined Ch 1+2 or 3+4.
• AUTO_TIP: Hotkey ALT I. Automatically senses from the paced catheter tip.
• Sense site is left unaltered when pacing Joined Ch 1+2 or 3+4.
QRS DETECT MENU
• QRS Detect Menu: Hotkey ALT Q. Graphically displays the sensed ECG,
and the process of QRS detection>
• User can interactively adjust QRS-detecting parameters
• Red line is ECG, Green line is QRS threshold, White line is baseline.
• To change parameters, use hotkey or place cursor over parameter and press
‘+’ or ‘-’ keys to adjust.
• While in QRS Detect Menu enter H for help and description of parameters.
HOTKEYS
SOFTWARE CONFIGURATION
• CONFIG Menu: Hotkey K. Software configuration including various safety limits and options may be changed by the Config
utility. Password ‘service’.
• To modify values, place the cursor over the variable and enter the new value.
• Obtain help on any variable by pressing Hotkey H, when the cursor is over the variable.
• CAUTION: Changing configurations will affect all users.
• Programming of default Protocol Parameters: Hotkey ALT S. Default
protocol parameters are loaded from a user definable defaults setup. To
save new defaults for any protocol, set up parameters in the protocol as
desired and press ‘ALT S’ and [enter].
• Default values for other parameters such as SyncToQRS, Train, Decrement
and so on may be programmed similarly.
• Storing multiple Protocol Defaults: Hotkey ALT S. You may store up to
5 different sets of Protocol Parameter defaults.
• Store parameters as above except after pressing ‘ALT S’, enter a memory
number from 1 to 5. Highlight number you want and press insert to rename
Setup.
• Retrieve a protocol by the ‘ALT-R’ hotkey, followed by the number of the
memory. The currently loaded Parameter setup is displayed in the top left
hand part of the screen.
• The setup memory loaded is ‘1’ by default. This default may be altered by
Config Var-39 to any value between 1 and 5.
• Restoring factory Presets: Restore Config variables to factory defaults
by selecting Config Var-40. This resets all Config variables to factory
presets.
• Restore Protocol parameters to factory presets by recalling memory ‘0’ by
pressing ‘ALT-R’ and entering ‘0’ and then [enter].
WARRANTY SERVICE AND REPAIR
Equipment Hotline:
800-872-3527
• Please consult appropriate product labels and inserts for indications,
contraindications, hazards, warnings, cautions, and directions for use.