Operating Manual
132 Pages
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Cardio Menu Service Manual
CARDlOVlT AT- 60
VerSon 3.2
SCHILLER
SCHILLER
CARDlOVlT AT- 60
Version 3.2
SCHILLER A
M
E
R
I
C
3002 Dow Avenue Building 138 Tustin, CA 92680 (714) 730-4900 Fax (714) 730-0650 (800) 247-8775
Art.-No.: 2.51 0152 Issue: November 1994
A
Terms of Warranty
The CARDIOVIT AT-60 is warranted against defects in material and manufacture for the duration of one year (as from date of purchase). Excluded from this guarantee is damage caused by an accident or as a result of improper handling. The warranty entitles free replacement of the defective part. Any liability for subsequent damage is excluded. The warranty is void if unauthorized or unqualified persons attempt to make repairs. In case of defect, send the apparatus post-paid to your dealer or directly to the manufacturer. The manufacturer can only be held responsible for the safety, reliability, and performance of the apparatus if: assembly operations, extensions, re-adjustments, modifications, or repairs are carried out by persons authorized by him, and the CARDlOVlT AT-60 is used in accordance with the operating instructions.
Appendix to Operating Manual AT-60 TABLE OF CONTENTS Short Information of Available Options HARDWARE OPTIONS
SCHILLER TM 400s Treadmlll SCHILLER ERG 1 Video Monitor 3.5" Floppy Disk Drive
Flow Sensor SP-100, SP-160
INFO - 3
Info - 3 Info - 3 Info - 3 Info - 3 Info 3
SCHILLER Measurement Program (M)
Info - 4
SCHILLER Interpretation Program (C)
Info 4
Vectorcardiography (VM, VC)
Info 4
SORWARE OPTIONS
INFO 4
-
Late Potential Analysis
Info - 4 Info - 4 Info - 4
Heart Rate Variability
Info 4
EXEC Analysis Program for Exercise ECGs Pacemaker Measurement
SPECIAL OPTIONS
Pulmonary Function
ODtion 1
-
INFO - 5
-
Info 5
SCHILLER ECG Measurement Program (M)
INTRODUCTION
OPT1 -3
RESULTS OF THE ECG MEASUREMENT
OPTl-4
Heart Rate (HR)
OPT1 - 4
Intervals
OPT1 - 4
Electrkal Axes
OPT1-4
Detailed Measurements for Each Lead
OPT1-5
Appendix
- 111
CAROIOVIT AT-60 lssue November 1994
Appendix Table of Contents
Option 2
SCHILLER ECG Interpre&tion Program (C)
INTRODUCTION
OPT2-3
EXPLANATION OF INTERPRETATIONSTATEMENTS
OPT2-4
Rhythm
OPT2-4
Electrical Axis
OPT2-6
Atrial Activity
OPT2-7
ECG Voltages
OPT2-8
Blocks
OPT2-8
QRS Abnormalities
OPT2-9
Myocardial Infarctions
OPT 2
ST-T Morphology
OPT2-11
QT Interval
OPT 2
Hypertrophy Miscellaneous Statements
OPT 2-14
Low Sensitivity Statements
OPT2-16
Option 3
- 10 - 13
OPT 2-16
Frank Vectorcardiography
Documented in Chapter 5 in "Operating Manual CARDlOVlT AT-60"
Option 4
EXEC Analysis Programm for Exercise ECGs
INTRODUCTION
OPT4-3
PERFORMANCE OF THE EXEC PROGRAM
OPT4-4
Determination of the Dominant Q R S Cycle
OPT4-4
QRSClassification Signal Processing Classes Mediil Classes
OPT4-4 OPT4-4 OPT4-5
Construction of the Representative Cycles (Averaging)
OPT4-5
Analysis of the ST Segment
OPT4-5
Rhythm Analysis Ventricular Extrasystoles (VES) VES-Types Frequency of VES Arrhythmia
OPT4-6 OPT4-6 OPT4-6 OPT4-6 OPT4-6
Determination of the Heart Rate
OPT4-7
Interpretation
OPT4-7
Determination of the CAD Probability
OPT4-7
-
ST HR Trend Plots
Appendix - IV
OPT4-8
WORKING WITH EXEC
OPT4-9
Define ST Amplitude Measurement
OPT4-9
Select Lead for Enlarged QRS Complex
OPT4-10
Define Format for Final Report ST Trends ST-HR Diagram ST Segment interpretation Average Cycles Rhythm Leads
OPT 4 10 OPT4-10 OPT4-11 OPT4-11 OPT4-11 OPT4-11
Define Coronary Artery Disease (CAD) Probability Data Entry Displayed Values
OPT4-12 OPT4- 12 OPT 4 - 13
SCREEN PRESENTATIONS
-
OPT4-14
- 14 OPT 4 - 15
Standard Presentationof Exercise Test
OPT 4
Change Screen Presentation Display of Chest Leads
OPT 4 - 15
Option 5
Pacemaker Measurements
INTRODUCTION
OPT5-3
PACEMAKER MEASUREMENT
OPT5-4
Actlvatddeactivate Measurement
OPT5-4
Displayed Information Clear Displayed Information Print Displayed Information
OPTS-4 OPT5-4 OPT5-5
Print Pacemaker Signals
OPTS-5
Option 6
Pulmonary Function Testing
INTRODUCTION
OPT6-3
PREPARATIONS FOR PULMONARY FUNCTION TESTS
OPT6-4
Connect the Flow Sensor
OPT6-4
Enter Patient Data
OPT6-4
Select the Pulmonary Function Test
OPT6-5
EXECUTION OF PULMONARY FUNCTION TESTS
OPT6-6
Display Presentation
OPT6-6
Start Tests
OPT6-6
interrupt Tests
OPT6-6
Delete Measurements
OPT6-7
Select Pre-/Post Medication
OPT6-7
Forced Vital Capacity (FVC) Test
OPT6-8
Slow Vital Capacity (SVC) Test
OPT6-9 Appendix- V
Table of Contents
CARDIOVIT AT-60 Issue November 1994 OPT 6
Maximum Voluntary Ventilation (MVV) Test
OPT6-11
PRINTING OUT MEASUREMENT RESULTS
- 12
OPT 6
Printed Informations with FVC Test
OPT 6
Printed Informations with SVC Test
OPT6-12
Printed Informations with MV Test
OPT 6
Printed Informations with M W Test
OPT6-13
Printed Informations with Post-medication Test
OPT6-13
Abbreviations of Pulmonary Measurement
OPT 6 14
- 12 - 12 -
OPT6- 15
Diagnosis for USA and Canada
- 15 OPT 6 - 15
Standards for Countries Outside the USA ECCS Quanjer Austria Swedish (Berglund) Finnish
OPT 6 16 OPT6- 16 OPT 6 - 16 OPT6-17 OPT6-18 OPT6- 18
Standards for USA and Canada Monis CraPO Knudson Composite
OPT 6 19 OPT6-19 OPT6-19 OPT 6 - 20 OPT 6 21
Diagnosis for Countries Outside the USA
CALIBRATIONOF THE FLOW SENSOR
OPT 6
-
-
-
OPT 6
- 22
Use of the Calibration Pump
OPT6-22
Settings for the Calibration
OPT 6 23
CARE AND MAINTENANCE
-
OPT 6 - 24
-
Cleaning and Sterilising the Flow Sensor
OPT 6 24
Reassemblingthe Flow Sensor
OPT 6 24
-
Printed Informations with Resistance Test
OPT 6 - 25 OPT 6 - 26
Cleaning and Assembling the Resistance Sensor Cleaning Assembleing
OPT 6 26 OPT 6 - 26 OPT 6 27
RESISTANCE MEASUREMENT WITH FLOW SENSOR SP-llO/R
Execution of Resistance Test
- VI
OPT6- 12
Print Test Results
DIAGNOSISAND STANDARDS
Appendix
- 10
Expiredor Minute Ventilation (MV) Test
OPT 6 25
-
-
CAUDJOVIT AT-60 Issue November 1984
Option 7
Appendix
Table of Contents J
Late Potential Analysis
INTRODUCTION
Analysis of Cardiac Cycles EXECUTION OF THE LATE POTENTIAL ANALYSIS
OPT7-3
OPT7-3 OPT7-4
U s e d Leads
OPT7-4
Activating the Late Potential Analysis Preconditions U s e of Activation Menu
OPT7-4 OPT7-4
Late Potential Analysis Reports Presented Signals Measurement Results
OPT7-5 OPT7-5 OPT7-6
Data Evaluation Criteriafor the Presence of Late Potentials
OPT7-6 OPT7-6
Option 8
OPT7-4
Heart Rate Variability
INTRODUCTION
OPT8-3
BASICS OF HEART RATE VARIABILITY
OPT8-4
Influencing Factors Respiration Further Factors
OPT8-4 OPT8-5 OPT8-5
Results from Long-term ECG Examinations
OPT8-5
SELECTABLE PARAMETERS BEFORE THE ANALYSIS
OPT8-6
DETAILS OF THE RR ANALYSIS
OPT8-7
Printed Diagrams
OPT8-7
Interpreted Parameters During Analysis
OPT8-8
Comments on Diagrams RR Tachogram dRR Tachogram Frequency Distribution Frequency Spectrum
OPT8-8 OPT8-8 OPT8-8 OPT8-9 OPT8-9
FREQUENCY ANALYSIS
OPT8-11
Signals in the Frequency and Time Range
OPT8-11
Transformation from Frequency to Time Domain The Fourier Transformation Performance of the Fourier Transformation Time Limitation of Signals (Windowing) Optimal Window Types Standardisation Analysed Ranges
OPT8-12 OPT 8 12 OPT8-13 OPT8-14 OPT 8 - 14 OPT8-15
EXECUTION OF THE RR ANALYSIS
-
OPT 8 12
-
OPT8-16
Appendix - VII
CARU~OVITA r-60 issue November 1994
Appendix Table of Contents
Option 10
floppy Disk Drive
INTRODUCTION
OPT10-3
SElTlNGS FOR STORAGE
OPT10-4
Select Resting ECG Data
OPTlO-4
Select Exercise ECG Data
OPT10-5
Select AutomatidManual Storage
OPT10-5
DATA STORAGE
OPT 10-6
Preconditionsfor Data Storage Handling of Floppy Disks Formatting Floppy Disks Error Messages with Formatting
OPT 10-6 OPT 10-6 OPT 10-7 OPT 10-7
Starting Data Storage Error Messages with Storing
OPT10-8 OPT10-8
MANAGING YOUR ECGS
OPT10-9
ERROR MESSAGES
OPT 10- 12
Appendix - Vlll
Short Information
CONTENTS HARDWARE OPTIONS SCHILLER TM 400s Treadmill SCHILLER ERG 1 Video Monitor 3.5" Floppy Disk Drive
SOITWARE OPTIONS
INFO - 3
Info - 3 Info - 3 Info - 3 Info 3
INFO - 4
EXEC Analysis Program for Exercise ECGs
info - 4 info - 4 Info - 4
Pacemaker Measurement
Info 4
Late Potential Analysis
info 4
SCHlLLER Measurement Program (M) SCHlLLER interpretation Program(C) Vectorcardiography (VM, VC)
Heart Rate Variability SPECIAL OPTIONS
info 4
-
info - 4
INFO - 5
-
Pulmonary Function
info 5
Flow Sensor SP-100, SP-160
Info 5
-
Info
-1
CARDIOVIT AT-60
Issue November 1994
lnfo - 2
Hardware Options SCHILLER TM 400s Treadmill The ideal treadmill for exercise testing.
SCHILLER ERG 1 The bicycle for optimal completion of your ergometry measurement site. The load range is between 25and 999 W.
Video Monitor Increases the flexibility of viewing an ECG recording by means of a remote video display.
3.5" Floppy Disk Drive The ideal media to archive up to 220 ECGs in one 1.44 MB diskette (documented in "User Manual CARDlOVlT AT-60"). The storage capacity depends upon data selection. Resting ECGs, exercise ECGs, late potential analyses, heart rate variability analyses as well as pulmonary function tests can be stored to diskette.
Info
-3
CARDIOVIT A r-60 issue November 1994
Software Options SCHILLER Measurement Prouram (MI Software upgrade providing additional measurement program for restingand exercise ECGs (seeOption 1).
SCHILLER Interpretation Program (C) Software upgrade providing additional measurement and interpretation program for resting ECGs (see Option 2).
Vectorcardiography (VM,VC) Software upgrade for the plotting of vector loops (saggital, frontal and horizontal) based on the Frank XYZ leads (documented in “User Manual CARDlOVlT AT-60”). In order to use this option, option 1 ”Measurement Program (VM)” or option 2 “Interpretation Program (VC)” have to be installed.
EXEC Analysis Program for Exercise ECGs Provides continual construdionof average complexes, ST measurements and rhythm analysis, probability of coronary artery disease (CAD) together with a comprehensive final report (seeOption 4).
Pacemaker Measurement Software for the measurement of stimulation intervals and duration for both single and dualchamber pacemakers (seeOption 5).
Late Potential Analysis Program especially designed for the detection of prolonged electrical activi after depohrisation (seeOption 7). To use this option, the option 1 “Measurement Program (M)” and option 2 ”Interpretation Program (C)” have to be installed.
Heart Rate Variability Special program for detection and analysis of the variability of RR intervals (seeOption 8).
To use this option, the option 1 “Measurement Program (M)”and option 2 “Interpretation Program (C)”have to be installed. Info - 4
Special Options Pulmonaw Function Software for the recording, evaluation and printout of four modes for the Testing measurement and calculation of inspiratory and expiratory values with visual presentation of all tests and clearly documented test results in conjunction with the SP-100 or SP-160 flow sensor (see Option 6).
Flow Sensor SP-100, SP-160 Flow Sensors especially designed for pulmonary function testing. A further option, the SP-1OO/R enables resistance measurements to be performed (see Option 6).
Info - 5
CARDIOVIT AT-60 Issue November 1994
lnfo - 6
SCHILLER ECG Measurement Program (M)
CONTENTS INTRODUCTION
OPT1-3
RESULTS OF THE ECG MEASUREMENT
OPTl - 4
Heart Rate (HR)
OPT 1 - 4
lntewals
OPTl - 4
Electrlcal Axes
OPTl - 4
Detalled Measurements for Each Lead
OPTl - 5
OPT 1
-1
I
O P T1-2
Introduction The SCHILLER ECG fneasuImmOnt pwram measures the EGG signal and provides the folkwing clearly documented results: heart rate, intervals, electrical axes and detailed measurementsfor each lead. This data k the Wts for an lntelpretatknwith the SCHILLER ECG Interpretation prtb gram or a diagnosis by the physician.
OPT 1 - 3
Results of the ECG Measurement Heart Rate (HR) Average heart rate (HR) calculatedon the bask of the entire 10 second recording and shown as nu+er of beats per minute.
Intervals RR:
Average time interval between two consecutive ventricular complexes, computed on the basis of the average heart rate.
P:
Duration of P wave (interval between markings 1 and 2 of the average ECGs). P-Q interval, i.e. period of time between beginning of P wave and beginning of
PQ:
QRScomplex (markings 1 and 3 of average ECGs). QRS:
Duration of QRS complex (time interval between markings 3 and 4 of average ECGs).
QT:
Interval between beginning of QRS (beginning of ventricular depolarisation) and end of T wave (end of repolarisation phase).
QTC:
Normalized QT interval. As the QT interval is dependent on the heart rate, it is
often converted into the normalized QTC interval (i.e. the QT the patient would show at a HR of 60/min). Usually, the QTC amounts to 390 f40 msec. The conversion is achieved according to the following formula:
QTC = QT
*I?
Electrical Axes The electrical axes of the heart are determined separately for the P, T and QRSwaves. They indicate the main spreading direction of the electrical vector in the frontalplane. The SCHILLER measurement program calculates the axes on the basis of the maximum deflection of the relevant waves in leads I and aVF. The following formula is used for the calculation: axis a = arc tan [max (aVF) / max (I)]
NOTE:
OPT 1 - 4
Large discrepancies may be found between two measurements with faint P and T waves. It is also a known that breathing and the position of the patient (recumbent or standing) result in changes of the electrical axes.
Detailed Measurements for Each Lead The SCHILLER mesurement program prints a table with lead-specific measurement results.
,
In 12 columns, i.e. for each standard lead, the amplitude values of the P, Q, R, S, R', S' T, and T'waves, the J point and the ST integralare l i e d in millivolts (mv). The amplitude measurements relate to a reference value that coneponds to the signal value immediately before the beginning of the QRS complex (marking 3 on the average
ECGs). m e duration of the Q, R, S, R' and S' waves is indicated in milliseconds (ms). m e measurements are designated as follows: P: amplitude of P wave Q:
amplitude of Q wave
Qd:
duration of Q wave
R:
amplitude of R wave
Rd:
duration of R wave
S:
amplitude of S wave
sd:
duration of S wave
R':
a m p l i of R' wave
R'd:
duration of I?' wave
S':
amplitude of S' wave
S'd:
duration of s'wave
J:
amplitude of J point (marking 4 of average ECGs)
ST:
ST integral: averaged ampldude of ST segment (from J point to half the distance between J-point and T wave maximum)
T: T':
amplitude of T wave amplitude of T'wave (in case of a diphasic T wave)
OPT1-5