Cardiosys Extra
CARDIOSYSBASIC improved with blood pressure measurement (noninvasive blood pressure, NIBP) and autonomic neuropathy monitoring option allows the observation of vascular and neuropathic responses occurring simultaneously with the cardiac effects.
The system can be applied, with the corresponding accessories, for examination of adults or children, and is available in installed and portable versions.
All systems are supported by the same software background, thus the users need not learn new skills when changing to another version.
Ewing’s cardiovascular reflex tests examining the autonomic nervous system functions with automatic management of the examinations and their analysis:
Examination of the parasympathetic functions:
- Heart rate response to deep inspiration and expiration,
- Heart rate response to the Valsalva maneuver,
- 30:15 ratio: heart rate response upon standing up.
Examination of the sympathetic functions:
- Decrease in systolic blood pressure upon sanding up,
- Handgrip strength test: rise in diastolic blood pressure upon sustained handgrip.
System
For this examination, only measurement of blood pressure (NIBP) and recording of the second lead (II) of ECG is needed. The module can be activated via the System drop-down menu, by selecting Ewing. |
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Configuration of the tests is done in the Protocol board. Beside the basic protocols found in the literature, further protocols, applied successfully at the examination facility can be added and used. All protocols can be modified according to the user’s preferences. | |
The system gives assistance in performing the sympathetic and parasympathetic tests by written instructions and audible signals. Automatic management and evaluation (Score value) of the test significantly increases the throughput of patient care and results in higher cost-efficience. | |
In the Valsalva maneuver, the patient has to perform exhalation for 15 seconds at a pressure of 40 mmHg. Heart rate response is given by the ratio of the longest RR distance after, and the shortest RR distance during, the maneuver.
In examining the heart rate response to six deep inspirations and expirations per minute, the difference between the maximal and minimal heart rate can be measured. |
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30:15 ratio: After lying as given in the protocol, the patient will stand up and remain standing. From the continuously recorded ECG curves, ratio of the RR distance of the 13th and 15th (or nearby) cycles following standing up can be calculated. Decrease in systolic blood pressure upon standing up: Changes in systolic blood pressure upon standing up can be examined by using the same measurement configuration by including blood pressure measurement. |
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In Handgrip strength test, the patient will grip the rubber pump and exert at first as much strength as he/she can do, then will maintain squeezing with 70% lower strength for 3 minutes. During the test, rise in diastolic blood pressure is measured. | |
The evaluated results summarized in the Ewing Score Table will be transcribed automatically into the provided basic medical report. Users can also edit the documents according to their preferences. |
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For detailed presentation of cardiac function recording (ECG) see CARDIOSYSBASIC products.
For detailed presentation of blood pressure measurement (NIBP) see CARDIOSYSPLUS products.
Specification
CARDIOSYSEXTRA (installed) ECG module |
CARDIOSYSEXTRA (portable) ECG module |
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Program run on Windows-based 64-bit OS |
Program run on Windows-based OS |
Standard 12 channel ECG recording |
Standard 12 channel ECG recording |
Screen speed: 5, 10, 25 or 50 mm/sec |
Screen speed: 5, 10, 25 or 50 mm/sec |
Amplitude display: 5, 10, 20 or 50 mm/mV |
Amplitude display: 5, 10, 20 or 50 mm/mV |
Each input is defibrillator proof |
Each input is defibrillator proof |
12-lead monitoring: real-time ECG curve monitoring and recording or review of stored records |
12-lead monitoring: real-time ECG curve monitoring and recording or review of stored records |
Manual and automatic mode |
Manual and automatic mode |
Continuous ECG monitoring with heart rate display |
Continuous ECG monitoring with heart rate display |
Baseline drift correction |
Baseline drift correction |
AC power noise filtering algorithm (50/60Hz) |
AC power noise filtering algorithm (50/60Hz) |
Muscle motion (tremble, tremor) filtering algorithm |
Muscle motion (tremble, tremor) filtering algorithm |
Digital sampling |
Digital sampling |
Sampling frequency: 1000 sample/sec/channel |
Sampling frequency: 1000 sample/sec/channel |
CARDIOSYSEXTRA (installed) BP module |
CARDIOSYSEXTRA (portable) BP modul |
Power supply from PC RS232 communication interface |
Power supply from PC RS232 communication interface |
Configuration and measurement controlled by the software |
Configuration and measurement controlled by the software |
Suitable for blood pressure measurement of infants, children and adults |
Suitable for blood pressure measurement of infants, children and adults |
Oscillometric measurement |
Oscillometric measurement |
Maximal cuff pressure is 300 mm Hg for adults and 150 mm Hg for infants |
Maximal cuff pressure is 300 mm Hg for adults and 150 mm Hg for infants |
Real-time measuring, recording, or reviewing the stored data |
Real-time measuring, recording, or reviewing the stored data |
Pressure measuring ranges for adults: systolic pressure 25-280 mm Hg, diastolic pressure 10-220 mm Hg Pressure measuring ranges for infants: systolic pressure 20-150 mm Hg, diastolic pressure 5-110 mm Hg |
Pressure measuring ranges for adults: systolic pressure 25-280 mm Hg, diastolic pressure 10-220 mm Hg Pressure measuring ranges for infants: systolic pressure 20-150 mm Hg, diastolic pressure 5-110 mm Hg |
Manual and automatic mode |
Manual and automatic mode |
Measurement frequency in automatic mode: 1, 2, 3, 4, 5, 10, 15, 30, 60, 90 min |
Measurement frequency in automatic mode: 1, 2, 3, 4, 5, 10, 15, 30, 60, 90 min |
CARDIOSYSEXTRA (installed) Ewing module |
CARDIOSYSEXTRA (portable) Ewing module |
Pressure sensor to perform measurements of neuropathy |
Pressure sensor to perform measurements of neuropathy |
Measuring range: 0-200 mmHg |
Measuring range: 0-200 mmHg |
Manual and automatic mode |
Manual and automatic mode |
How can it help?
Cardiovascular autonomic neuropathy (CAN) often occurs in patients with diabetes, liver disease, autoimmune disease, in regular alcohol consumers, but can also occur in people suffering from metabolic syndrome. The importance of CAN is based on the complications threatening the quality of life and life expectancy of the patients. CAN is the most commonly examined form of autonomic nervous system dysfunctions, which is explained – beyond its clinical importance – by the easily performable and reproducible testing methods. The involvement of the autonomic nervous system may also affect cardial electrical activity, including ventricular repolarization. Its signs may also manifest as pathological changes of the surface ECG QT interval. Variable degree of damage in the adrenergic innervation of the myocardium results in the inhomogeneity of sympathetic influence, which can lead to inhomogeneous QT prolongation. Inhomogeneous prolongation of the QT interval, that is, of ventricular repolarization, may predispose to ventricular tachyarrhythmias. Increased QT dispersion is – besides silent myocardial infarction – an important risk factor of sudden cardiac death which can be traced back to malignant ventriculararrhythmia and is common in diabetic patients.
Assessment of the autonomic nervous system functions can be done most easily by the reproducible and properly standardized cardiovascular reflex tests (CRTs) described by Ewing. The examination is based on analysis of the ECG and blood pressure values recorded continuously during the reflex tests. One group of the reflex tests (orthostatic hypotension, handgrip strength test) mainly investigates sympathetic nervous system functions, while others (heart rate response to deep inspiration and expiration, Valsalva maneuver, 30:15 ratio) characterizes the functioning of the parasympathetic nervous system.
The importance of examining autonomic neuropathy has been generally recognized by now. Widespread application of this method was hampered because the methods of registration and evaluation of data were time-consuming. Our company has solved this problem successfully by automating the management of the examination at software level, and enabling simultaneous evaluation of data. Quick and easily identifiable data management provided by the software offers new ways in following-up patients with chronic diseases. Furthermore, this system can be perfectly applied in prevention, since cost-effectiveness and shorter examination time makes it suitable for health status surveys in large populations.
Available models
You find details by clicking on the product code.
Media
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