Sistema Puerba de Esfuerzo CardioScan

Manual del usuario

Using the Various Review Programs


After the Stress Test is completed, several review programs can be accessed. These review programs include:

The review programs can be accessed by clicking on the icons found on the top right from either the “Home” display or the “Patient Database” display. It is preferable to access the review programs from the “Patient Database” display as it will allow the user to select from any of the prior patient tests.

A. SUMMARY

Reporte sumario

The Conclusion section can be freely edited. The physician can modify the information contained here, or re-write it altogether. Each physician can pre-program the format and text that they want. The Conclusion automatically incorporates numerical data from the Stress Test.

- ST and Heart Rate numbers can be edited

- A library of statements can be created

- The Summary page print-out can be created in several different data formats

Under “Custom Format” several physician names can be listed, each with their own data format. A click on the above “Auto” field will bring up the list of physicians. Select the desired physician’s name, and that customized format will be reflected in the Conclusion section.

B. TRENDS

Reporte de tendencias

The ST for all 12 Leads is shown, as well as the Heart Rate, Blood Pressure, and METS.

Clicking on the icons at the bottom of the page will change the referenced graph values, accordingly, for all 12 Leads.

By placing the cursor over a graph and left clicking, the user will cause a vertical, dotted (yellow) line to appear. Using the right and left arrows will result in the yellow line shifting and displaying the relevant values for any minute of the test.

Click on “Zoom” or double-click for an ECG display (see below).

Zoom

C. FULL DISCLOSURE

Despliegue completo

The above Full Disclosure display shows every beat for V5 from the beginning of the Stress Test to the end of Recovery. This display shows 19 minutes of Exercise and Recovery (each minute is on the left side of the display). A quick look by the physician shows the complete picture of arrhythmias during Exercise and Recovery.

The green vertical markers show the beginning of each Stage of the Stress Test. The brown vertical marker shows the beginning of Recovery.

The “Edit” icon allows the user to edit beats – Normal (N), VE (V), SVE (S), Pause (P), Artifact (F). The “Change Len” icon allows for various sizing of the ECG.

At any location on the Full Disclosure, the enlarged 12-Lead ECG can be accessed with the “Zoom” icon (or a double-click). You can use the arrow keys to place the yellow box (“area of focus”) on the desired location.

D. ECG STRIPS

Tiras ECG

The top of the screen shows 1-minute of ECG. Use the arrow keys to view different time periods. Press PgDn or PgUp to move forward or backward by one minute increments.

Heart Rate and R-R in ms are shown above each beat.

Any ECG marking during the Stress Test is auto-displayed.

An electronic Ruler is built into this display to precisely measure any intervals or amplitudes.

Any selected data from the Exercise or Recovery periods can be saved and/or instantly printed from this display.

E. ST SCAN

The display below shows Max J-Point and ST Depressions for all 12 Leads.

SCan ST

This minute-by-minute view of J-Point and ST Depression allows for a full review of Exercise and Recovery in less than 30-seconds.

Acercamiento

Purple vertical markers verify that the ST algorithm measured the PR baseline, the J-Point, and the ST at the proper locations. The Yellow bars represent minute-by-minute J-Point Depressions. The Red & Green graph is minute-by-minute ST Depressions. Move along the White line (using arrow keys) to view superimposed J and ST displays. Zoom to see 12-Lead ST.

F. 3D ST

Point and Drag to change aspect of 3D presentation of ST changes during the Stress Test.

3d ST

3d ST

G. HR RECOVERY

The rate of HR decrease during Recovery is an important diagnostic marker for an Exercise Stress Test. The less the HR decrease each minute, the more likely a positive Stress Test.

HR Recuperacion

The yellow graph shows HR increase during Exercise, and decrease during Recovery.

The solid vertical purple line is the software’s selection of the beginning of Recovery.

The vertical yellow line at the left side of the graph can be moved with the arrow keys. Move the long yellow line to the visual beginning of recovery to re-confirm the HR Recovery algorithm. As you can see, instructions are provided in the upper left of the display.

At the end of each minute in Recovery, the Heart Rate Recovery decrease is calculated and reported. This example shows a cumulative 24bpm HR decrease for the first minute, 38bpm at the end of the second minute, and 50bpm at the end of the third minute of Recovery.

H. TWA (T-Wave Alternans)

The CardioScan Stress Test software allows for T-Wave Alternans analysis without the need for special electrodes. Each beat is analyzed for TWA along each ECG Lead from the beginning of the Stress Test to the end of Recovery.

Alternancia Onda T

The top portion of the display shows the HR trend. The light blue section represents the 6-minutes of ECG displayed in the TWA analysis. The green vertical lines are the amplitudes of each T-Wave. If TWA is detected, the green lines will change to red. The “Re-Analyse” button in the lower right will allow the user to select the desired Lead. A double-click on the green lines will display the enlarged ECG, with the Gain multiplied (see below).

TWA

I. MAXIMUM

The top half of display shows the Max ST changes with the Absolute ST algorithm.
The bottom half shows the Max ST changes in the Delta ST mode for all 12 ECG Leads.

maximos

The screenshot below shows the resulting printable report. Max ST Averaged data is shown for Baseline, Max HR, Max ST, and Recovery ECG for Absolute ST measurements. There is a long rhythm strip for the Max ST Depression Lead at the bottom. At the upper right are graphs for BP, METS, HR, and ST. The right side shows Max Delta ST for the 12-Leads.

 

 

 

 

 

 

 

 

Derechos reservados.

Estas páginas no son un folleto de venta son explicaciones de cómo utilizar el sistema Prueba de Esfuerzo CadioScan de DMSoftware. El CardioScan cuenta con diferentes versiones y además es actualizado constantemente. El fabricante se reserva el derecho de agregar o quitar funciones. Las actualizaciones puede o no incluir las funciones de las versiones previas.


Dudas y comentarios alfonso@nafarrate.com