CardioVisions guide for programming and evaluating

measurements made by

ABPM-04, ABPM-05, BlueBP-05,

ambulatory blood pressure monitors

CardioTens, card(X)plore
combined ambulatory blood pressure
and ECG monitors

CardioMera, CardioBlue24
full disclosure Holter ECG recorder

CardioClip, CardioBlue
looping ECG event recorders
Table of contents

General Information .................................................................................................................................... 3

ABPM-04, ABPM-05 and BlueBP-05 ambulatory blood pressure monitors ...................................... 4
Programming ............................................................................................................................................ 4
Downloading ............................................................................................................................................ 6
Evaluation ................................................................................................................................................ 6
Report ....................................................................................................................................................... 8
CardioTens ambulatory blood pressure and ECG monitor .................................................................. 9
Programming ............................................................................................................................................ 9
Downloading .......................................................................................................................................... 11
Evaluation .............................................................................................................................................. 11
Report ..................................................................................................................................................... 19
card(X)plore Holter ECG and ambulatory blood pressure monitor .................................................. 20
Programming .......................................................................................................................................... 20
Downloading ......................................................................................................................................... 23
Evaluation .............................................................................................................................................. 23
Report ..................................................................................................................................................... 32
CardioMera and CardioBlue24 Holter ECG devices ............................................................................ 33
Programming .......................................................................................................................................... 33
Downloading .......................................................................................................................................... 36
Evaluation .............................................................................................................................................. 36
Report ..................................................................................................................................................... 43
CardioClip and CardioBlue looping ECG event recorders.................................................................. 44
Programming .......................................................................................................................................... 44
Downloading .......................................................................................................................................... 47
Evaluation .............................................................................................................................................. 47
Report ..................................................................................................................................................... 50
General Information

CardioVisions is an integrated software which operates with:

- ABPM-04, ABPM-05 and BlueBP-05 ambulatory blood pressure monitors
- CardioTens and card(X)plore combined ambulatory blood pressure and ECG monitors
- CardioMera and CardioBlue24 Holter ECG recorders
- CardioClip and CardioBlue looping ECG event recorders

The software ensures programming, analysis and reporting functions by providing 4 screens:
- Home screen ( icon)
If you enter the software as a User, this screen comes up at first with 4 large buttons at the
center, which can be modified in the ’Tools/Options/Main/Large buttons’ menu.
- Database screen ( icon)
Database screen consists of 3 frames. The ’Select folder’ frame enables you to select and rename
a folder or create a new one. The ’Patients frame’ contains all the existing patients. If you select a
patient, you can see all the related examinations in the ’Examinations frame’.
- Evaluation screen ( icon)
The Evaluation screen has 4 frames in all cases, but different viewing formats can be displayed
depending on the device type and the settings. More details about this screen for each specific
device can be found below.
- Report editor screen ( icon)
The Report editor is a word processor where the results of the monitoring period can be written
and printed.

The most important settings of the software are available in the ’Tools/Options’ menu or by
clicking , which is an intelligent icon. If you stand on a frame, it leads you to the appropriate
menu in the ’Tools/Options’ menu.

More detailed information on the use of CardioVisions can be found in the ’Help’ menu of the
software.
ABPM-04, ABPM-05 and BlueBP-05 ambulatory blood pressure monitors
Programming

Programming of ABPM-04, ABPM-05 and BlueBP-05 is mainly the same, therefore the
following information relates to all of the devices if otherwise is not indicated.

First you should start CardioVisions, select your device from the drop-down list and click
icon. In the appearing screen select or add a new patient then click the 'OK' button. There are 4
tabs In the ABPM programming window: 'Summary', 'BP settings', 'BP special settings' and 'Time
list'. If you click on the 'Load' or the 'Save' button, you can upload or save your default settings.

I. Summary
Here you can:
- check out the patient’s data
- check out the communication between the device and the PC
If you have ABPM-04 or ABPM-05 device, you should simply connect the device with your
optical cable to the PC. In case of BlueBP-05, make the device Bluetooth-discoverable by
pressing and holding the START (triangle) and the EVENT (heart) button on the device for
more than 3 seconds, click ’COM’, then ’Add’ in the appearing screen. If you see a moving torch,
the software tries to establish communication between the device and the PC. If the device is
found, BB5_XXXX appears in the screen where XXXX is the last four digits of the serial
number. Select it, then click ’OK’. Enter the last four digits of the serial number as a passkey in
the appearing window and finish the identification. If the device switches back to stand-by mode
meanwhile, make it Bluetooth-discoverable again.
- set the starting time and the lenght of the measurement
- check out the PC date and time
- send your final plan to the device
II. BP settings
Here you can:
- set the start and the end time of the day/night/morning/special periods if you have checked
out the related 'Enable morning period' and 'Enable special period' boxes previously.
- select measurement intervals
- select the manual day/night shift function (in case of ABPM-05 and BlueBP-05 only)
If this function is enabled, the patient can manually shift the measurement frequency period by
pressing ’DAY/NIGHT’ (Moon) button on the device. This function is available two hours
before the preset shift.

III. BP special settings

Here you can:
- check the 'Display during measurement' box, if you want to see the results during the
monitoring session
- choose the cuff type and the maximum pressure of a measurement
- check the 'Permission to modify PIN' checkbox (in case of BlueBP-05 only), if you want to
change the authentication number which is the last four digits of the serial number of the device.
IV. Time list
Time list enables you to add, edit and delete the preset time intervals.

Downloading

To start reading data from an ABPM, you have to connect the device to the PC (ABPM-04,
ABPM-05) or make the device Bluetooth-discoverable (BlueBP-05). You should select your
device from the drop-down list and click icon. At the end of the process, data will be
automatically saved into the database. Further steps can be choosen in
’Tools/Options/Communication/Device reading’. The Evaluation srceen includes 4 frames:
'Blood pressure chart', 'Blood pressure statistics', 'Histogram' and 'List of data'.

Evaluation

I. Blood pressure chart

The frame has 2 viewing formats: Blood pressure list and BP hourly means, both can be selected in the
List of data frame. If you select Blood pressure list, the recorded data, the preset pathological limits
and the pulse rate can be seen in the frame. BP hourly means shows the averages of the
measurement.
II. Blood pressure statistics
Available statistical data can be selected in the 'Options/Blood pressure/ Statistical items' menu.

III. Histograms
The distribution of BP data diagrams can be checked out here. You can adjust the scales in the
'Options/Blood pressure/Histogram' menu.
IV. List of data
This frame has 2 viewing formats as well. In 'Blood pressure list' you can see all events during the
measurement period. Related settings can be changed in 'Options/Blood pressure/List of data'
menu. 'BP hourly means' is another viewing format which contains average data for each hour.

Report

At the end of each evaluation process a report can be made. The Report editor screen is a word
processor which can be edited and printed. Most important settings and default reports can be
found in ’Tools/Options/Standard reports’ menu.
'Add standard report to the report' icon adds your preset report frames, which are available
in 'Options/Standard reports' menu, to the printable report.
'Add active frame to the report' adds selected frames from the 'Evaluation screen' to the
printable report.
CardioTens ambulatory blood pressure and ECG monitor
Programming

Start CardioVisions, select your device from the drop-down list and click icon. In the
appearing screen select or add a new patient then click 'OK'. There are five tabs in the
CardioTens programming window: 'Summary', 'BP settings', 'Electrode settings', 'Storage
parameters' and ’Triggers and actions’. If you click on 'Load' or 'Save', your default settings can
be uploaded or saved.

I. Summary
Here you can:
- check out the patient data
- check out the communiation between the PC and the device
- set the start time and the lenght of the monitoring period
- check out the PC date and time
- send the monitoring plan to the device

II. BP settings
Here you can:
- carry out programmed BP measurements both in the morning and special period
- set the start and the end time of the monitoring plan and the intervals of the measurements
III. Electrode settings
The tab offers the possibbility to choose the electrode placement and start real-time ECG by
clicking the ’Electrode check’ button.

IV. Storage parameters

Here you can:
- enable ECG measurements and set the level of the ECG compression (strong, medium, poor)
- at ’Automatic ECG recording’ put a tickmark next to ’With programmed BP’ checkbox, if you
want to start an ECG recording beside each BP measurement. Here you can also set the lenght of
the ECG recording. If you want to start automatic ECG measurements independent of the BP
measurements, put a tickmark next to ’At intervals of’ checkbox and set the interval and the
lenght of the automatic ECG recordings
- if ’Manual ECG recording’ is enabled, the pre-event lenght is 10 sec by default, but you can set
and the total duration of the measurement.
V. Triggers and Actions
The tab enables you to set the limits for each channel, HR and pause which will initiate extra
ECG/BP recordings, if you have previously put a tickmark next to the related ’Start BP/Start
ECG’ checkboxes. If you select ’McHenry’, the device will trigger extra ECG/BP measurements
when combined ST and slope exceeds the McHenry criteria.

Downloading

CardioTens records both blood pressure and ECG data, and as a result, the Evaluation screen
optionally contains BP and ECG related frames as well. In order to download data from the
device, start CardioVisions software, select your device from the drop-down list and click
button. Data will be saved into your database automatically. Further steps can be choosen in
’Tools/Options/Communication/Device reading’.
Evaluation

I. Step-by-step ECG evaluation

The order of ECG evaluation frames can be set in 'Options/Start of evaluation' menu. The
selected frames appear in the selected order on the Evaluation screen where you can move by
clicking button on the right side of the toolbar.

II. Blood pressure

The ’Blood pressure’ screen contains 4 frames:
a) Blood pressure chart
The frame has 2 viewing formats which can be set in the List of data frame. If you select BP
data, recorded data are indicated by red lines, preset pathological limits by dotted black lines,
pulse rate by empty squares connected with a blue line. BP hourly means show the hourly
average of the measurement.

b) Blood pressure statistics

After presetting required statistical items in 'Options/Blood pressure/ Statistical items' menu,
selected frames can be seen here.
c) Histograms
The diagrams show the distribution of BP data. Scales can be adjusted in 'Options/Blood
pressure/Histogram' menu.

d) List of data
List of data has 5 frames, each of them shows the events
in chronological order. Data within the preset
pathological limits appear in blue, they are red above the
highest limit, and green below the lowest limit. Related
pathological limits can be changed in the ’Options’ menu.
Settings for ’Blood pressure list’ and ’BP hourly means’
can be changed in ’Options/Blood Pressure/List
items’menu. ’HRV statistics-related’ items can be selected
in ’Options/ECG setups/HRV list’ menu. Items for
’ECG spikes list’ are available in ’Options/ECG
setups/Spike chart’ menu. If ’Automatic selection’ is
checked as well, each event during the measurement
period will be displayed in the List of
data frame.

III. ECG annotation

After downloading of data, it is advisable to check ECG and select erroneous recordings
manually at first. Having done it, annotation can be created by clicking button in the
Evaluation screen. In the ECG annotation frame, it is possible to:
- create annotation groups by dragging a beat in the ECG detail frame and dropping it to one of
the beat-type buttons:
- merge annotation groups by drag and drop function or by right clicking on the annotation
group, selecting 'Merge groups', choosing a destination group then clicking 'OK' button.

Most important buttons for this frame:

'show selected types only' button
'beat-type' buttons for inserting individual beats

'run ECG' for the continuous fast review of the QRS of the selected group.

'subgroups' for providing access to the subgroups of the selected annotation group.
'ECG tablo' for the quick overview of the beats in the selected group.
'beat distribution' button turns the beat distribution bar, which shows ECG beat
occurrence during the monitoring period, on or off.
'scroll bar' enables to go through the ECG beats step-by-step.

'baseline filter'
'channel on/off'
'RR interval' button shows RR distance between beats in ms.
'HR interval' button shows heart frequency in 1/min.
'events' button turns the indication of events on and off

IV. Spike chart

It is the event annotation of the examination. The selected event can be displayed either with
ECG, blood pressure or ST graph depending on the preset viewing format. Events on the vertical
axis can be set in the 'Options/'ECG setups'/Spike chart' menu. If ’Automatic selection’ is
checked as well, each event will be displayed during the measurement period.
V. ST graph
It displays recorded ST data and shows ST-elevation or ST-depression during a
measurement. The horizontal red lines indicate those pathological limit values which can be set in
the 'Options'/' ECG setups'/ ST pathological limits' menu. Data are also available for HR and
Slope in the drop-down menu. ST graph can also be seen in different viewing formats either with
the ECG frame, blood pressure graph or tachogram.

IV. ST analysis
The limits of statistical calculations can be set in 'Options/'ECG setups'/ST pathological limits'
menu. ST statistics is based on all ST and HRV data.

V. Tachogram
Tachogram shows time on the horizontal axis and RR distance in msec on the vertical axis.
Minimum and maximum RR interval values are pink, the averages are red. Tachogram is available
in different viewing formats together with ECG and ST and it can be seen in ’HRV long time 1’,
’HRV long time 2’ and ’HRV Spectrum analysis’ frame as well.
VI. HRV long time 1
This screen contains 4 frames:
a) Tachogram

b) HRV statistics
The statistics of the time period selected in the HRV tachogram frame can be seen here.

c) HRV bar chart

This frame calculates time domain parameters for each completed hour. Several other
diagrams can be displayed by right-click menu. The selected index is on the top of the frame.

d) List of data

VII. HRV long time 2

This screen contains 4 frames:
a) Tachogram
b) HRV 2d chart
’HRV triangular index’ shows the number of NN intervals in time relation. The height of the
triangle corresponds to the most frequent category.

The left column of the ’risk diagram’ represents the values of the time interval selected in the
Tachogram. The right column shows 24-hour values. The risk types can be divided in low, mid
and high levels. The diagram shows either HRVti or SDNN, depending on your choice in the
right-click menu, but you can switch it off as well.

The ’Lorenz graph’ analyses HRV with geometrical methods.

c) HRV 3d Lorenz
It analyses pulse rate variability using geometrical methods within a time frame. There is the
possibility to move it and see different positions.

d) List of data

VIII. HRV Spectrum analysis

This screen contains 4 frames:
a) Tachogram

b) PSD (Power Spectral Density) chart

It analyses HRV and (PSD) in the frequency range. Abbreviations:
LF – low frequency
HF – high frequency
c) Compressed Spectral Array
It summarizes the PSD chart in frequency range. There is the possibility to move it.

d) List of data
IX. ECG statistics
The content of this frame is created automatically when annotation is made. Chart or text style
format can be choosen in the right-click menu or in ’Tools/Options/ECG setups’.
X. ECG 2 details
Here you can view all ECG recordings. You can watch the whole frame with the scroll bar on the
right, which enables you to find and filter the critical periods.

Most imprtant buttons for this frame:

'Baseline filter'
'Channel on/off'
'Set marked event to noisy' button marks those ECG strips noisy which have been selected
previously. These strips will be left out from the annotation.
'Add event' button selects events which can be added to 'Spike chart' frame
'Continuous stepping with specified speed' button helps to overview the frame on a preset
speed
'Stop': stops scrolling of the frame

Report

At the end of each evaluation process a report can be made. The Report editor screen is a word
processor which can be edited and printed. Most important settings and default reports can be
found in ’Tools/Options/Standard reports’ menu.
'Add standard report to the report' button adds your preset report frames, which are
available in 'Options/Standard reports' menu, to the printable report.
'Add active frame to the report' adds selected frames from the 'Evaluation screen' to the
printable report.
card(X)plore Holter ECG and ambulatory blood pressure monitor

Programming

Start CardioVisions, select your device from the drop-down list in the HOME screen and click
button. In the appearing screen select or add a new patient then click the 'OK' button. In
card(X)plore programming window there are five tabs: 'Summary', 'BP settings', 'Electrode
settings', 'Storage parameters' and ’Triggers and actions’. If you click on the 'Load' or the 'Save'
button, you can upload or save your default settings.

I. Summary
Here you can:
- check patient data
- check the communiation between the PC and the device
- set the start time and the lenght of the monitoring period
- check PC date and time
- check your final BP and ECG settings
- choose the size of your memory card
- decide between online or offline programming
Offline programming enables to write the monitoring plan to the memory card even if you lack
the device.
- send the monitoing plan to the device
II. BP settings
Here you can:
- enable programmed BP measurements and morning/special periods
- set the start time, end time and the intervals of the measurements
- enable measurement repeat in case of measurement error due to excessive movement
- enable manual day/night shift
If this function is enabled during programming of card(X)plore, the patient can switch the unit to
passive night blood pressure measurement frequency or back to active mode by pressing and
holding the ’Event’ button for more than 5 seconds. The function is available 2 hours before
starting the actual period.

III. ’Electrode settings’ enables you to check the right electrode placement and watch real-time
ECG if you click ’Electrode check’ button.
IV. Storage parameters
At Storage parameters you can find ECG and BP-related settings. If ECG recordings are enabled,
you can select the appropriate ECG frequency storage (150 Hz or 300 Hz) and enable pacemaker
function. If you want to see blood pressure measurements during the monitoring session, put a
tickmark next to ’Display during measurement’ then select the cuff type and the maximum
pressure. If the movement detection function is enabled, you will be able to check the patient’s
position during the monitoring period.

V.Triggers and actions

The tab enables you to set limits which can trigger extra blood pressure measurements if you
have put a tickmark next to ’Start BP’ checkbox. If you select ’McHenry’, the device will trigger
extra BP measurements when combined ST and slope exceeds the McHenry criteria.
Downloading

card(X)plore records blood pressure and ECG data and as a result, the Evaluation screen
optionally contains both BP and ECG related frames. Insert the memory card intoa cerd reader
unit. Start CardioVisions, select your device from the drop-down list and click button. After
data reading, all data will be saved into your database automatically. Further steps can be choosen
in ’Tools/Options/Communication/Device reading’.

Evaluation

I. Step-by-step ECG evaluation

The order of ECG and blood pressure evaluation frames can be set in 'Options'/'Start of
evaluation' menu. The frames appear in the selected order in the Evaluation screen
where button, which can be found on the right side of the toolbar, helps the step-by-step
evaluation of the measurements.

II. ECG quality

The screen contains 4 frames:
a) ECG quality graph
Here you can see the ECG quality graph for each lead. The better a recording is, the closer the
graph is to the 100% front line. Actual noise limit is marked by a red horizontal line. If you select
a time period, related ECG can be seen in the ’ECG overview’ frame below. There is the
possibility to set marked events noisy.
b) ECG Spike Chart
It is the event annotation of the examination. Events on the vertical axis can be set in the
'Options/'ECG setups'/'Spike chart' menu. If ’Automatic selection’ is checked as well, each event
during the measurement period will be displayed.

c) ECG overview
Here you can view all ECG recordings. You can check the whole frame with the scroll bar on the
right, which enables you to find and filter critical periods.

Most imprtant buttons for this frame:

'Baseline filter'
'Channel on/off'
'Set marked event to noisy' button marks those ECG strips noisy which have been selected
previously. These strips will be left out from the annotation.
'Add event' button selects events which can be added to 'Spike chart' frame
'Continuous stepping with specified speed' button helps to overview the frame on a preset
speed
'Stop' button stops scrolling of the frame

d) List of data
List of data has 7 viewing formats, each of them show events in chronological order. Settings for
’Blood pressure list’ and ’BP hourly means’ can be changed in ’Options/Blood Pressure/List items’
menu. Data may be coloured in these viewing formats. Within the preset pathological limits data
appear in blue, they are red above the highest limit and green below the lowest one.
 Viewing formats:
'ECG event list' shows all ECG-related events.
Items for 'HRV statistics' can be selected in
'Options/ECG setups/HRV list' menu.
There are no ST-statistics related settings.
Items for 'ECG spikes list' are available in 'Options/ECG
setups/Spike chart.'
'QT analysis' viewing format shows QT-related statistical
values. There are not any settings for this farme.

III. ECG annotation

After downloading of data, it is advisable to check ECG and select erroneous recordings
manually at first. Having done it, annotation can be created by clicking button in the
Evaluation screen. In the ECG annotation frame, it is possible to:
- create annotation groups by dragging a beat in the ECG detail frame and dropping it to one of
the beat-type buttons:
- merge annotation groups by drag and drop function or by right clicking on the annotation
group, selecting 'Merge groups', choosing a destination group then clicking 'OK'.

Most important buttons for this frame:

'show selected types only' button
'beat-type' buttons for inserting individual beats

'run ECG' for the continuous fast review of the QRS of the selected group

'subgroups' for providing access to the subgroups of the selected annotation group
'ECG tablo' for the quick overview of the beats in the selected group.
 'beat distribution' button turns the beat distribution bar, which shows the ECG beat
occurrence during the monitoring period, on or off.
'scroll bar' enables to go through the ECG beats step-by-step.

'baseline filter'
'channel on/off'
'RR interval' button shows RR distance between beats in ms.
'HR interval' button shows heart frequency in 1/min.
'events' button turns the indication of events on and off

IV. ST analysis
The limits of statistical calculations can be set in 'Options/ 'ECG setups'/'ST pathological limits'
menu. ST statistics is based on all ST and HRV data.

V. ST graph
ST graph displays recorded ST data and shows ST elevation and depression during a
measurement. The horizontal red lines indicate those pathological limit values which can be set in
the 'Options/'ECG setups'/'ST pathological limits' menu. Data are also available on HR and
Slope in the drop-down menu. ST is available in different viewing formats with tachogram, spike
chart or ECG.
VI. Tachogram
It displays time on the horizontal axis and RR distance in msec on the vertical axis. Minimum and
maximum RR interval values are pink, the averages are red.

VII. Blood pressure

The screen contains 4 frames:
a) Blood pressure chart
The frame has 2 viweing formats: 'BP data' and 'BP hourly means'. The latter shows the hourly
average of the measurements, while the former indicates recorded data (red lines), preset
pathological limits (dotted black lines) and pulse rate (empty squares). BP graph is available with
spike chart, ST or ECG.

b) Blood pressure statistics

Those statistical items can be seen here which have been preset in the 'Options/Blood pressure/
Statistical items' menu.
c) Histograms
Diagrams show BP data distribution. Scales can be adjusted in the 'Options/Blood
pressure/Histogram' menu.

VIII. HRV long time 1

The screen contains 4 frames:
a) Tachogram

b) HRV statistics
The statistics of the time period selected in the HRV tachogram frame can be seen here.

c) HRV bar chart

This frame calculates time domain parameters for each completed hour. Several other
diagrams (RR count, NN count, HRVti, RR, TINN, SDRR) can be displayed by right-
click menu. The selected index is on the top of the frame.
d) List of data

IX. HRV long time 2

The screen contains 4 frames:
a) Tachogram

b) HRV 2d chart
’HRV triangular index’ shows the number of NN intervals in time relation. The height of the
triangle corresponds with the most frequent category.

The left column of the ’risk diagram’ represents the values of the time interval selected in the
Tachogram. The right column shows 24-hour values. The risk types can be grouped in low, mid
and high levels. The diagram has 2 viewing formats: HRVti and SDNN.

The ’Lorenz graph’ analyses HRV with geometrical methods.

c) HRV 3d Lorenz
It analyses heart rate variability using geometrical methods in a time frame.

d) List of data

X. HRV Spectrum analysis

The screen contains 4 frames:
a) Tachogram

b) PSD (Power Spectral Density) chart

PSD chart analyses HRV and PSD in a frequency range. Abbreviations:
LF – low frequency
HF – high frequency

c) Compressed Spectral Array

Compressed Spectral Array frame shows each PSD chart in a frequency range.

d) List of data

XI. ECG statistics

The content of this frame is created automatically when annotation is made. ECG statistics is
available in chart or text style format.
XII. Actigraphy
a) Activity overview
The height of the columns indicates the strength of the movement. If the strip at the bottom is
blue, it means standing position, while reclining position is white.

b) Activity data
card(X)plore has 2 acceleration sensors. Higher activity is indicated by higher amplitudes, while
resting position by straight parts of the line.

Report

At the end of each evaluation process a report can be made. The Report editor screen is a word
processor which can be edited and printed. Most important settings and default reports can be
found in ’Tools/Options/Standard reports’ menu.
'Add standard report to the report' button adds your preset report frames, which are
available in 'Options/Standard reports' menu, to the printable report.
'Add active frame to the report' adds selected frames from the 'Evaluation screen' to the
printable report.
CardioMera and CardioBlue24 Holter ECG devices
Programming

Start CardioVisions, select your device from the drop-down list and click button. In the
appearing screen select or add a new patient then click 'OK' button. There are 5 tabs in
CardioMera and CardioBlue24 programming window: 'Summary', 'Electrode settings', 'Storage',
'Special settings' and ’Modem’. If you click on the 'Load' or the 'Save' button, you can upload or
save your default settings.

I. Summary
Here you can:
- check patient data
- check if the device is connected properly to the PC
In case of CardioMera you should simply connect the device (with a battery and a memory card
in it) to the PC with an optical cable and click 'COM' button.
In case of CardioBlue24, place your Bluetooth dongle into the PC and a battery and a memory
card in your device. Press and hold the small button on the device for at least 3 seconds but less
than 8 seconds until it switches to Bluetooth discoverable mode. If you are ready, press the
'COM' button, then click 'Add' and wait until the system finds the device. If the new device has
been found, select it than click 'OK'. The system requires you to give the authentication code,
which is the last four digits of the device serial number by default.
- set start time and the lenght of the monitoring period
- check PC date and time
- choose the size of the memory card
- send the monitoring plan to the device
- choose between online and offline programming
Offline programming enables to write the monitoring plan to the memory card even if you lack
the device.
II. Electrode settings
Here you can:
- select colour codes (European or American)
- select the mode of the ECG recording (bipolar or unipolar)
- select the number of channels (1, 2, 3 or 5)
- start real-time ECG to check whether the electrodes are placed properly to the patient’s body

III. Storage
The tab enables you to choose between Diagnostic, Holter and Rhythm quality. Your settings
influences the free space of your memory card. If you want the device to identify paced beats,
you can put a mark next to 'PM detection enabled'.
IV. Special settings
At Special settings you can decide if you want the device to emit special sounds during the push
of the button, electrode drop offs or errors. You can also put a mark next to LED enabled if you
want to activate the Satus or Communication LEDS on the device.

V. Modem
It enables you to permit the communication with a modem and enter necessary information to
send real-time ECG.
Downloading

Data are stored on a standard memory card, so you will need a card reader to download them.
After placing your card into the card reader unit, select your device from the drop-down list and
click button. At the end of the process, data will automatically be saved into the database.
Further steps can be choosen in ’Tools/Options/Communication/Device reading’.

Evaluation

I. Step-by-step ECG evaluation

The order of ECG evaluation frames can be set in 'Options'/'Start of evaluation' menu. The
selected frames appears in this selected order in the Evaluation screen where button, which
can be found ont he right side of the toolbar, supports step-by-step ECG evaluation.

II. ECG Quality

Here you can see the quality graph of the ECG for each lead if the measurements have been
downloaded. The better a recording is, the closer the graph is to the 100% front line. Actual
noise limit is marked by a red horizontal line.
III. ECG annotation
After downloading of data, it is advisable to check ECG and select erroneous recordings
manually at first. Having done it, annotation can be created by clicking button in the
Evaluation screen. In the ECG annotation frame, it is possible to:
- create annotation groups by dragging a beat in the ECG detail frame and dropping it to one of
the beat-type buttons:
- merge annotation groups by drag and drop function or by right clicking on the annotation
group, selecting 'Merge groups', choosing a destination group then clicking 'OK'.

Most important buttons for this frame:

'show selected types only' button
'beat-type' buttons for inserting individual beats

'run ECG' for the continuous fast review of the QRS of the selected group.

'subgroups' for providing access to the subgroups of the selected annotation group.
'ECG tablo' for the quick overview of the beats in the selected group.
'beat distribution' button turns the beat distribution bar, which shows the ECG beat
occurrence during the monitoring period, on/off.
'scroll bar' enables to go through the ECG beats step-by-step.

'baseline filter'
'channel on/off'
'RR interval' button shows RR distance between beats in ms.
'HR interval' button shows heart frequency in 1/min.
IV. ST analysis
The limits of statistical calculations can be set in 'Options/'ECG setups'/ST pathological limits'
menu. ST statistics is based on all ST and HRV data.

V. ST graph
ST graph displays recorded ST data and shows ST elevation and depression during a
measurement. The vertical red lines indicate those pathological limit values which can be set in
the 'Options/'ECG setups'/ST pathological limits' menu. Data are also available for HR and
Slope in the drop-down list.

VI. Spike chart

It is the event annotation of the examination. The actual event can be seen in the 'ECG detail'
frame. Events on the vertical axis can be set in the 'Options/Spike chart' menu.
VII. HRV long time I.
The screen contains 3 frames:

a) Tachogram
It indicates time on the horizontal axis and RR distance in msec on the vertical axis. Minimum
and maximum RR interval values are pink, the averages are red.

b) HRV statistics
It is where you can see the statistics of the time period selected in the HRV tachogram frame.

c) HRV bar chart

This frame calculates time domain parameters for each completed hour. Several other
diagrams (RR count, NN count, HRVti, RR, TINN, SDRR) can be displayed by right-
click menu. The selected index is on the top of the frame.
VIII. HRV long time II.
The screen contains 3 frames:

a) Tachogram

b) HRV 2d chart
’HRV triangular index’ shows the number of NN intervals in time relation. The height of the
triangle corresponds with the most frequent category.

The left column of the ’risk diagram’ represents the values of the time interval selected in the
Tachogram. The right column shows 24-hour values. The risk types can be divided in low, mid
and high levels. The diagram shows either HRVti or SDNN.

The ’Lorenz graph’ analyses HRV with geometrical methods.

c) 3d Lorenz graph
It analyses heart rate variability using geometrical methods within a time frame.

IX. HRV Spectrum analyses

The screen contains 3 frames:

a) Tachogram

b) PSD (Power Spectral Density) chart

PSD chart analyses HRV and PSD in a frequency range.
 LF – low frequency
HF – high frequency

c) Compressed Spectral Array

Compressed Spectral Array summarizes each PSD chart in a frequency range.

X. ECG statistics
The content of this frame is created automatically when the annotation is made. Chart or text
style format can be choosen in the right-click menu.
XI. ECG 2 details
Here you can view all ECG recordings. You can watch the whole frame with the scroll bar on the
right, which enables you to find and filter the critical periods.

Most imprtant icons for this frame:

'Baseline filter'
'Channel on/off'
'Set marked event to noisy' button marks those ECG strips noisy which have been selected
previously. These strips will be left out from the annotation.
'Add event' button selects events which can be added to 'Spike chart' frame
'Continuous stepping with specified speed' button helps to overview the frame on a preset
speed
'Stop': stops scrolling of the frame

XII. List of data

List of data contains 5 viewing formats

’ECG event list’ shows ECG related events.
’HRV statistics’ shows statistical data on HRV. Related
items can be selected in ’Options/ECG setups/HRV list’
menu.
’ST statistics’ shows statistical data on ST. Related limits
can be adjusted in ’Options/ECG setups/ST pathological
limits’ menu.
’ECG spikes’ shows the event annotaion of the
measurement. Related items can be adjusted in
’Options/ECG setups/Spike chart’ menu.
’QT analysis’ shows the distribution of QT, QTC and
RR within a time period without any related settings.
Report

At the end of each evaluation process a report can be made. The Report editor screen is a word
processor which can be edited and printed. Most important settings and default reports can be
found in ’Tools/Options/Standard reports’ menu.
'Add standard report to the report' button adds your preset report frames, which are
available in 'Options/Standard reports' menu, to the printable report.
'Add active frame to the report' adds selected frames from the 'Evaluation screen' to the
printable report.
CardioClip and CardioBlue looping ECG event recorders
Programming

Programming of CardioClip and its wireless version, CardioBlue is mainly the same, therefore the
following explanation relates to both of the devices, unless otherwise is clearly indicated.
Start CardioVisions, select your device from the drop-down list and click button. In the
appearing screen select or add a new patient then click the 'OK' button. In
CardioClip/CardioBlue programming window there are 5 tabs: 'Summary', 'Electrode settings',
'Storage', 'Special settings' and ’Modem/Bluetooth’. If you click on 'Load' or 'Save' button, you
can upload or save your default settings.

I.Summary
Summary enables you to:
- check patient data
- check if the device is connected properly
In case of CardioClip you should simply connect the device (with a battery in it) to the PC with
the optical cable and click 'COM'. In case of CardioBlue, place your Bluetooth dongle into the
PC and the battery in the device. Press and hold the small button on the device for at least 3
seconds but less than 8 seconds until it switches to Bluetooth discoverable mode. If you are
ready, press 'COM', then click 'Add' until the system finds the device. If the new device has been
found, select it then click 'OK'. The system requires you to give an authentication code which is
by default the last four digits of the device serial number.
- adjust PC date and time
- send the monitoring plan to the device

II. Electrode settings

The tab enables you to:
- select color codes (European or American)
- select the mode of the ECG recording (bipolar or unipolar)
- select the number of channels (1, 2, 3 or 5)
- start real-time ECG to check whether the electrodes are placed properly to the patient

III. Storage
Here you can:
- select Diagnostic, Holter or Rhythm quality
- enable automatic ECG recording and set the lenght and the interval of the measurement
- enable manual ECG recording and set the pre-and post-event lenght of the measurement
If you check the 'Overwrite enabled' box, you can overwrite the measurements when the memory
of the device is full. If you put a tickmark next to ’PM detection enabled’, then the software will
recognise paced beats. Your settings will influence available free space on your memory card.
IV. Special settings
Here you can decide whether you want special accoustic effects during the push of the button,
electrode drop offs or errors. If you check the 'LED enabled' box, you will activate Satus and
Communication LEDs on the device.

V. Modem/Bluetooth
If you want to send your measurements to a PC via a Bluetooth-capable mobile phone, you need
to adjust your settings at the ’Modem/Bluetooth’ tab. In this case you should enable ’Dial
settings’ and fill in all the necessary entries. Your ’PIN’ code is the last four digits of the serial
number of your device. In case of CardioClip you need a cable modem for data transmission.
Downloading

To start reading data from CardioClip or CardioBlue, you have to connect the device to the PC
(CardioClip) or make the device Bluetooth-discoverable (CardioBlue), then select your device
from the drop-down list and click button. Further steps can be choosen in
’Tools/Options/Communication/Device reading’.

Evaluation

I. Step-by-step ECG evaluation

The order of the ECG evaluation frames can be set in ’Options/Start of evaluation’ menu. Select
your device and the frames that you want to see when you open an examination. Frames appear
in the selected order in the Evaluation screen where you can move by clicking button, which
is situated on the right side of the toolbar.

II. ECG annotation

After downloading of data, it is advisable to check ECG and select erroneous recordings
manually at first. Having done it, annotation can be created by clicking button in the
Evaluation screen. In the ECG annotation frame, it is possible to:
- create annotation groups by dragging a beat in the ECG detail frame and dropping it to one of
the beat-type buttons:
- merge annotation groups by drag and drop function or by right clicking on the annotation
group, selecting 'Merge groups', choosing a destination group then clicking 'OK'.
 Most important buttons for this frame:
'show selected types only' button
'beat-type' buttons for inserting individual beats

'run ECG' for the continuous fast review of the QRS of the selected group

'subgroups' for providing access to the subgroups of the selected annotation group
'ECG tablo' for the quick overview of the beats in the selected group
'beat distribution' button turns the beat distribution bar, which shows the ECG beat
occurrence during the monitoring period, on or off
'scroll bar' enables to go through the ECG beats step-by-step.

'baseline filter'
'channel on/off'
'RR interval' button shows RR distance between beats in ms.
'HR interval' button shows heart frequency in 1/min.

III. ECG statistics

The content of this frame is created automatically when the annotation is made. Chart
type or text style format can be choosen in the right-click menu.
IV. Spike chart
The spike chart is the event annotation of the examination. The events which you want to see
can be adjusted in the 'Options/'ECG setups'/Spike chart' menu. If you click on an event in the
Spike chart, the actual beat can be seen in the 'ECG detail' frame below.

V. List of data

Measured data can be seen here in chronological order.

There are 2 viewing formats in this frame:
’ECG event list’ shows recorded events during the
measurement period. This viewing format does not have
additional settings.
’ECG Spikes list’ contains the distribution of ECG
events. Related settings are available in ’Options/ECG
setups/Spike chart’ menu.

V. ECG 2 details
Full-disclosure ECG recording can be checked on each channel in this screen.
Report

At the end of each evaluation process a report can be made. The Report editor screen is a word
processor which can be edited and printed. Most important settings and default reports can be
found in ’Tools/Options/Standard reports’ menu.
'Add standard report to the report' button adds your preset report frames, which are
available in 'Options/Standard reports' menu, to the printable report.
'Add active frame to the report' adds selected frames from the 'Evaluation screen' to the
printable report.