Tress UE: Exercise Stress Testing System

STTS210
STRESSVUE
Exercise Stress Testing System
INSTALLATION AND GETTING STARTED GUIDE
STTS210
Notice European Directives

This product consists of hardware and
About This Edition software. The hardware carries the CE
PN 453564009661 mark based on the declarations provided
Edition 2 in the User’s Guide for the IT hardware.
Printed in USA
The StressVue software and the Philips
Edition History thermal printer are class IIa medical
devices under the Medical Device
Edition 2, October 2004
Directive 93/42/EEC and carry the
Edition 1, August, 2004
0123 mark accordingly.
Philips Medical Systems shall not be
Authorized EU Representative:
liable for errors contained herein or for
incidental or consequential damages in Philips Medizinsysteme
connection with the furnishing, Böblingen GmbH
performance, or use of this material. Hewlett Packard Str. 2
71034 Böblingen
Copyright Germany
Copyright © 2004
Koninklijke Philips Electronics N.V. All WARNING
rights are reserved. As with all electronic equipment, Radio
Andover, MA 01810-1099 USA Frequency (RF) interference between the
(978) 687-1501 StressVue system and any existing RF
transmitting or receiving equipment at the
Permission is granted to copy and
installation site, including electrosurgical
distribute this document for educational
equipment, should be evaluated carefully
purposes.
and any limitations noted before the
Warranty equipment is placed in service.
Philips Medical Systems makes no Radio frequency generation from
warranty of any kind with regard to this electrosurgical equipment and close
material, including, but not limited to, the proximity transmitters may seriously
implied warranties or merchantability and degrade performance.
fitness for a particular purpose. Philips Medical Systems assumes no
liability for failure resulting from RF
Responsibility of Manufacturer
interference between Philips Medical
Philips Medical Systems only considers Systems medical electronics and any radio
itself responsible for any effects on safety, frequency generating equipment at levels
reliability and performance of the exceeding those established by applicable
StressVue system if: standards.
– assembly operations, extensions, read-
CAUTION
justments, modifications or repairs are
done by persons authorized by Philips Use of accessories other than those
Medical Systems, and recommended by Philips Medical
Systems may compromise product
– the electrical installation of the rele- performance.
vant room or vehicle complies with the
IEC or national requirements, and IN THE U.S., FEDERAL LAW
RESTRICTS THIS PRODUCT TO SALE
– the instrument is used according to the ON OR BY THE ORDER OF A
instructions for use presented in this PHYSICIAN.
manual.
THIS PRODUCT IS NOT INTENDED
FOR HOME USE.
STTS210
Contents
Safety Summary
Conventions Used in the Instructions for Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Safety Symbols Marked on the StressVue System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Safety Symbols Marked on the StressVue Packaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Important Patient and Safety Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x
Safety Information for the StressVue Exercise Stress Testing Systems . . . . . . . . . . . . . . . x
Safety Information for the Medical Isolation Transformer . . . . . . . . . . . . . . . . . . . . . . . xiv
Safety Information for the Ambulatory X-12 Transmitter . . . . . . . . . . . . . . . . . . . . . . . . xv
The StressVue Exercise Stress Testing System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviii
Intended Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviii
Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviii
Chapter 1. Installing and Configuring StressVue

Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Required Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Checking the Box Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Software Installation Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Configuring the Operating System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Installing Windows XP Service Pack 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Finalizing the Windows XP Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Configuring Windows XP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Configuring the Start Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Configuring the Display Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Configuring 24-hour Format Time Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Setting the Startup and Recovery Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
Configuring Windows Explorer Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
Installing the PCMCIA Card Reader. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Installing the StressVue Software and Card Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Installing Adobe Acrobat Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
Chapter 2. Installing the PCMCIA Card Reader

Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Installing the PCMCIA Card Reader Driver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Installing the PCMCIA Card Reader Hardware . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
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Table of Contents
Chapter 3. Assembling the StressVue Utility Cart

Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Required Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Basic Cart and PC Assembly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Connecting the Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Attaching the Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
Connecting the Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12
Attaching the SunTech Tango Blood Pressure Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12
Fully Configured Cart Example. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
Chapter 4. Getting Started Using the StressVue Stress Exercise System

About the StressVue System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
System Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Patient Interface Module (PIM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
About the Direct Connect Patient Interface Module (PIM), Model M12A . . . . . . . 4-6
Connecting the Direct Connect PIM to the StressVue Computer . . . . . . . . . . . . . 4-6
About the Ambulatory X-12 Patient Interface Module . . . . . . . . . . . . . . . . . . . . . . 4-8
About the Medical Isolation Transformer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
About the Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
Loading the Thermal Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11
StressVue Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12
About Stress Testing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12
About Profiles and Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12
How StressVue Loads Profiles and Protocols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-13
What StressVue Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-14
About the StressVue Exercise Testing Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16
About Preparing the Patient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16
About the Pre-Exercise Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16
About the Exercise Phase. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-17
About the Recovery Phase. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-17
About the Report (End) Phase. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18
About the StressVue Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18
Powering On the Equipment and Running StressVue . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18
About the Application Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-19
About the StressVue Startup Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-19
About the StressVue Main Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-21
About the Data Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-23
Testing and Acquisition Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-25
About the Report Manager Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-25
Navigating the Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-28
About StressVue Documentation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-28
Available Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-28
Conventions Used in this Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-29
Getting Help Using StressVue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-29
Ordering Parts and Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-29
iv StressVue Installation and Getting Started Guide

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Table of Contents
Chapter 5. Troubleshooting and Contacting the Response Center

Troubleshooting StressVue Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Contacting Technical Support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Philips Response Center Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
North America. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
South America . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Asia Pacific . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Index
StressVue Installation and Getting Started Guide v

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Safety Summary
This chapter provides important safety information related to the use of the StressVue Stress
Exercise system.
US FEDERAL LAW RESTRICTS THIS DEVICE TO SALE BY OR ON THE ORDER OF
A PHYSICIAN.
Conventions Used in the Instructions for Use

The following contentions are used in the StressVue Installation and Getting Started Guide,
this guide.
WARNING Warning statements describe conditions or actions that may result in personal injury or
loss of life.
CAUTION Caution statements describe conditions or actions that may result in damage to equipment or
software.
NOTE Notes contain additional important information about a topic.

Refer to the manual(s) accompanying the StressVue Exercise Stress Testing System that
pertain to the system’s computer hardware for additional definitions of symbols that may be
present.
Safety Symbols Marked on the StressVue System
Symbol Description
Attention. See StressVue Instructions for Use and other product

documentation for information.
ECG physio isolation is type CF, defibrillator proof.
vii
STTS210
Safety Summary
Symbol Description
Indicates that the system is receiving alternating currents.
Fuse
Equipotential grounding post used for establishing common ground

between instruments.
The connector near this symbol receives an incoming signal.
CE mark.
The number next to this symbol is the serial number of the system.
The number next to this symbol is the product model number of the
system.
Green light illuminated when power is On.
Green light illuminated when the paper is out or an error condition

is detected.
Pushing this button advances the paper to the next perforation and
resets the paper error condition. Holding down this button for
approximately 7 seconds resets the unit.
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Safety Symbols Marked on the StressVue Packaging
Safety Symbols Marked on the StressVue Packaging
Symbol Description
Keep dry.
Keep out of direct sunlight.
Acceptable temperature range.
Move and store packaging this end up.
Fragile.
adrillew2 (11:33:13 AM): back
adrillew2 (11:33:42 AM): 4:2:3
adrillew2 (11:34:02 AM): 5:1:3
adrillew2 (11:34:57 AM): 6:1:4
adrillew2 (11:36:13 AM): 8:1:4 nice for
advertising
adrillew2 (11:36:16 AM): are you here?
Recycle the packaging materials after use.
StressVue Installation and Getting Started Guide ix

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Safety Summary
Important Patient and Safety Information

Patient and safety information is divided into several sections:
StressVue Exercise Stress Testing system (see below)
Medical isolation transformer (see page xiv)
X-12 wireless transmitter (see page xv)
Safety Information for the StressVue Exercise Stress

Testing Systems
Warning Statements for the StressVue System
WARNING Failure to follow these warnings could affect both patient and operator safety.
The device (stress test system) captures and presents data reflecting a patient’s
physiological condition that, when reviewed by a trained physician or clinician, can be
useful in determining a diagnosis. However, the data should not be used as a sole means
for determining a patient’s diagnosis.
Before running the StressVue system, Philips recommends that the operator perform
leakage current testing according to UL 2601-1 requirements.
The StressVue Exercise Stress Testing System is supplied with a power isolation
transformer that must be used to maintain designed operator and patient isolation from the
power source. The power isolation transformer must be plugged into a hospital grade
outlet.
The PC, Suntech Tango blood pressure monitor (if used), the thermal printer, and the
monitor should use the isolation transformer as the power source.
Do not touch accessible connector pins and the patient simultaneously.
The use of equipment that applies high frequency voltages to the patient (including
electrosurgical equipment and some respiration transducers) is not supported and may
produce undesired results. Disconnect the patient data cable from the cardiograph, or
detach the leads from the patient prior to performing any procedure that uses high
frequency surgical equipment.
When operating the StressVue system, ensure that the system and all other electrical
equipment connected to or near the patient are effectively grounded.
Connecting multiple medical electrical equipment to the same patient may pose a safety
hazard due to the summation of leakage currents. Any combination of instruments should
be evaluated by local safety personnel before being put into service.
The StressVue system has been safety tested with the recommended accessories,
peripherals, and leads, and no hazard was found when the system is operated with cardiac
pacemakers or other stimulators.
x StressVue Installation and Getting Started Guide

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To maintain designed operator and patient safety, peripheral equipment and accessories
used that can come in direct patient contact must be in compliance with UL 2601-1,
IEC 60601-1, and IEC 60601-2-25.
To maintain designed operator and patient safety, only use parts and accessories supplied
with the device and available through Philips Medical Systems.
To avoid the possibility of serious injury or death during patient defibrillation, do not
come into contact with the device or patient cables. Additionally, proper placement of
defibrillator paddles in relation to the electrodes is required to minimize harm to the
patient.
Periodically inspect the patient data cable, lead wires, cables, and power cords for any
worn or cracked insulation to ensure that no inner conductive material is exposed. Discard
worn accessories and replace them only with Philips Medical Systems accessories.
A possible explosion hazard exists; do not use the device in the presence of flammable
anesthetics.
Before attempting to use the device for clinical applications, the operator must read and
understand the contents of the manual and any documents accompanying the device.
Do not connect any equipment or accessories to the StressVue system that are not
approved by Philips Medical Systems or that are not IEC 60601-1 approved. The
operation or use of non-approved equipment or accessories with the system is not tested or
supported, and system operation and safety are not guaranteed.
When using additional peripheral equipment powered from an electrical source other than
the isolation transformer, the combination is considered to be a medical system. It is the
responsibility of the operator to comply with IEC 60601-1-1 and test the medical system
according to the requirements. For additional information, contact Philips Medical
Systems.
Only install Philips Medical Systems software on the stress test system. The installation or
use of software not approved by Philips Medical Systems is strictly prohibited and system
safety and performance are not guaranteed.
Only use patient electrodes that are approved by Philips Medical Systems. The use of non-
approved patient electrodes may degrade system performance.
The Philips Medical Systems warranty is applicable only if you use Philips Medical
Systems approved accessories and replacement parts. See the StressVue Instructions for
Use, Appendix E, “Ordering Options and Parts” for more information.
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Safety Summary
Caution Statements for the StressVue System
software.
Do not use the StressVue system as a method for loading or operating commercially
available software. Doing so might affect the performance of the StressVue application.
If using the patient data cable to connect the Patient Interface Module to the StressVue PC,
be sure to:
– Thread the cable through the strain relief clip on the underside of the keyboard area on
the cart (if used)
– Position the PC and cart (if used) in such a manner as to eliminate the possibility of
inadvertently tangling the cable or pulling it out of the PCMCIA receiver card in the
PC
To prevent possible damage to the to the device during transport and storage (while in
original packaging), the following environmental conditions must be adhered to:
Ambient Temperature Range:
-20°C to 65°C (-4°F to 149°F)
Relative Humidity Range:
25% to 90% (non-condensing)
Atmosphere Pressure:
700 hPa to 1060 hPa
Allow the device to stabilize within its intended operating environment for a minimum of
two hours prior to use. The allowable operating environment is as follows:
Ambient Temperature Range:
15°C to 35°C (59°F to 95°F)
Relative Humidity Range:
30% to 70% (non-condensing)
Atmosphere Pressure:
700 hPa to 1060 hPa
Do not attempt to clean the device or patient cables by submersing into a liquid,
autoclaving, or steam cleaning.
Wipe the exterior surface of the device and patient cables with a non-alcohol sterilizing
disinfectant, then dry with a clean cloth.
Conductive parts of the patient cable, electrodes and associated Type CF connections,
including the neutral conductor of the patient cable and electrode, should not come into
contact with other conductive parts, including earth ground.
Do not pull or stretch patient cables as this could result in mechanical and/or electrical
failures. Store patient cables after forming them into a loose loop.
Ensure that all components are securely positioned on the system cart before using the
StressVue system.
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Ensure that the patient data cable is tucked away from the system cart wheels when
moving the cart. Ensure that the patient data cable does not present a hazard when pushing
the cart.
If using the Philips StressVue system cart, always lock the wheel brake on the system cart
when the cart is not in use. Press down on the wheel brake to set or to release the wheel
brake.
Do not dispose of waste materials in trash. Follow local regulations for disposing of
materials as small chemical waste.
Important Notes about the StressVue System

Proper patient preparation is important to proper application of ECG electrodes and
operation of the device.
Patient cables should be checked for cracks or breakage in its exterior properties prior to
use.
The arrhythmia detection portion of the StressVue is provided for the convenience of
automatic documentation. The StressVue system offers no diagnostic opinion to the user;
instead, it provides a high-fidelity instrument recording ECG waveforms during exercise
for the purpose of providing the operator with a tool to expedite the documentation of a
test for which he/she renders his/her own medical opinion.
As defined by IEC 60601-1 and IEC 60601-2-25, the device is classified as follows:
– Class I equipment
– Type CF applied parts
– Ordinary equipment
– Not suitable for use in the presence of flammable anesthetics
– Continuous operation
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Safety Summary
Safety Information for the Medical Isolation Transformer

Warning Statements about the Medical Isolation Transformer
Possible explosion hazard. Do not use in the presence of flammable anesthetics.

Use of this transformer with equipment other than originally supplied, or surpassing the
ratings, may cause damage, fire, or injury.
Risk of electrical shock! Do not remove cover. Refer servicing to qualified service
personnel. Grounding reliability can only be achieved when the equipment is connected to
an equivalent receptacle marked “Hospital Grade.”
When using additional peripheral equipment powered from an electrical source other than
the isolation transformer, the combination is considered to be a medical system. It is the
responsibility of the operator to comply with IEC 60601-1-1 and test the medical system
according to the requirements. For additional information, contact Philips Medical
Systems.
Caution Statements about the Medical Isolation Transformer
software.
Before connecting your equipment to the isolation transformer, make sure the voltage
selector (located above the power cord) matches the line voltage.
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Safety Information for the Ambulatory X-12 Transmitter

Warnings about the Ambulatory X-12 Wireless Transmitter
Device (Ambulatory X-12 Transmitter) transmits data reflecting a patient’s physiological

condition to a properly equipped system and when reviewed by a trained physician or
clinician can be useful in determining a diagnosis. However, the data should not be used as
a sole means for determining a patient’s diagnosis.
Connecting multiple medical electrical equipment to the same patient may pose a safety
hazard due to the summation of leakage currents. Any combination of instruments should
be evaluated by local safety personnel before being put into service.
To maintain designed operator and patient safety, peripheral equipment and accessories
used that can come in direct patient contact, must be in compliance with UL 2601-1, IEC
60601-1 and IEC 60601-2-25.
To maintain designed operator and patient safety, only use parts and accessories supplied
with the device and available through Philips Medical Systems.
To avoid the possibility of serious injury or death during patient defibrillation, do not
come into contact with device or patient cables. Additionally, proper placement of
defibrillator paddles in relation to the electrodes is required to minimize harm to the
patient.
Ensure that the electrodes or lead wires do not come in contact with any other conductive
materials (including earth-grounded materials) especially when connecting or
disconnecting electrodes to or from a patient.
A possible explosion hazard exists, do not use the device in the presence of flammable
anesthetics.
Defibrillation protection is guaranteed only if the original patient cable is used.
Simultaneous connection to other equipment may increase leakage current.
Some stimulators may cause interference with the signal.
ECG electrodes could cause skin irritation and should be examined daily. Reposition and
change electrodes every 24 hours, though it may be necessary to do so sooner if signs of
irritation or inflammation occur.
Before attempting to use the device for clinical applications the operator must read and
understand the contents of the manual and any documents accompanying the device.
StressVue Installation and Getting Started Guide xv

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Safety Summary
In some countries the use of the Ambulatory X-12 Transmitter (2400 MHz version) has
been limited as follows:
E Spain: Use is limited to channels in the range 8B to E6 (inclusive).
F France: Use is limited to channels in the range 8E to A5 (inclusive).
The channel setting of the X-12, when used in the above listed countries, must be set
accordingly.
In the United States and Canada, use of the X-12 transmitter (600 MHz version) is
regulated by Federal Communications Commission (FCC) rules, Part 15.
– The X-12 must be used solely on the premises of health care facilities (see Part 15,
section 15.242a).
– A health care facility operating the X-12 must coordinate with the directors of existing
nearby TV stations and Radio Astronomy Observatories to ensure compatible use.
Minimum separation distances from such facilities may apply. It may be necessary to
obtain written authorization from such facilities prior to installation and use of the
X-12 (Part 15, section 15.242d,e).
Caution Statements for the Ambulatory X-12 Transmitter
software.
To prevent possible damage to the keypad, do not use sharp or hard objects to depress
keys, only use fingertips.
Do not attempt to clean the device or patient cables by submersing into a liquid,
autoclaving, or steam cleaning.
Wipe the exterior surface of the device and patient cables with a non-alcohol sterilizing
disinfectant, then dry with a clean cloth.
Conductive parts of the patient cable, electrodes and associated Type CF connections,
including the neutral conductor of the patient cable and electrode, should not come into
contact with other conductive parts, including earth ground.
The Ambulatory X-12 Transmitter and patient cable should be cleaned between each use.
Do not pull or stretch patient cables as this could result in mechanical and/or electrical
failures. Patient cables should be stored after forming them into a loose loop.
The Ambulatory X-12 Transmitter only works with systems that are equipped with the
appropriate option.
xvi StressVue Installation and Getting Started Guide

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software.
No user-serviceable parts are inside. Any modification of this device may alter
defibrillator protection. Any modification to any part of this device is to be performed by
qualified service personnel only.
The following equipment may cause interference with the RF channel: microwave ovens,
diathermy units with LANs (spread spectrum), amateur radios, and government radar.
Important Notes about the Ambulatory X-12 Transmitter

Proper patient preparation is important to proper application of ECG electrodes and
operation of the device.
Patient cables should be checked for cracks or breakage in its exterior properties prior to
use.
As defined by IEC 60601-1 and IEC 60601-2-25, the device is classified as follows:
– Internally powered
– Type CF applied parts
– Ordinary equipment
– Not suitable for use in the presence of flammable anesthetics
– Continuous operation
StressVue Installation and Getting Started Guide xvii

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Safety Summary
The StressVue Exercise Stress Testing System

Intended Use
The device is a PC-based diagnostic tool intended to acquire, process, and store ECG data of
patients undergoing stress exercise testing. The software records ECG, heart rate, and ST data,
creates summary tables, trends, and a final report regarding a variety of cardiac data indices.
The cardiac data provided by StressVue is reviewed, confirmed, and used by trained medical
personnel to assist in the diagnosis of the electrocardiographic data reflecting the patient’s
physiological condition during stress exercise testing.
Indications for Use

The device is indicated for use to acquire, process, record, archive, analyze, and output
electrocardiographic data obtained during physiologic stress exercise testing.
The device is indicated for use in a clinical setting, by a physician or by trained personnel who
are acting on the orders of a licensed physician. It is not intended as a sole means of diagnosis.
The device is indicated for use on adult populations, typically symptomatic.
The device is not intended to be used as a vital signs physiological monitor.
xviii StressVue Installation and Getting Started Guide

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1
Installing and Configuring StressVue
Chapter 1
This guide presents detailed instructions for installing and configuring the StressVue system.
The StressVue system comprises a PC, monitor, PCMCIA card reader, printer, isolation
transformer, software, optional system cart, optional automated blood pressure monitor, and
patient module.
NOTE If you ordered the A06 option, you do not need to perform the installation steps described in
Chapter 1 (this chapter) and Chapter 2, “Installing the PCMCIA Card Reader.”
The installation process comprises the following steps, in this order:
Installation Step See...
1 Configuring the operating system. Chapter 1 (this chapter)

2 Installing the PCMCIA card reader in the PC and Chapter 2, “Installing the
installing the driver. PCMCIA Card Reader”
3 Finalize configuring software on the PC, including Chapter 1 (this chapter)

installing the StressVue software.
4 Setting up the system cart (if purchased) and installing Chapter 3, “Assembling
components. the StressVue Utility Cart”
This chapter provides the following information:

Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Required Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Checking the Box Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Software Installation Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Configuring the Operating System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Installing Windows XP Service Pack 1 . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Finalizing the Windows XP Installation. . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Configuring Windows XP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Configuring the Start Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Configuring the Display Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Configuring 24-hour Format Time Display . . . . . . . . . . . . . . . . . . . 1-5
Setting the Startup and Recovery Modes . . . . . . . . . . . . . . . . . . . . . 1-6
Configuring Windows Explorer Properties . . . . . . . . . . . . . . . . . . . 1-6
Installing the PCMCIA Card Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Installing the StressVue Software and Card Drivers. . . . . . . . . . . . . . . . . . . 1-7
Installing Adobe Acrobat Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
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Before You Begin

You must have knowledge of PC-compatible computer systems using the Windows XP
operating system and of general principles of software installation and operation to perform
this process. You must also be familiar with Microsoft Windows XP user interface basic
interactions.
Also, be sure to read the Safety Summary for important information about the components of
the system.
Required Tools
Have available the following tools and components to complete the full system installation:
Medium head, short-handled Phillips-head screwdriver
Large flat-head screwdriver or large coin (to open the back of the cart)
StressVue software CD
Checking the Box Contents

Verify that your StressVue shipment has all the components you ordered. In general, the
StressVue system comprises:
HP Compaq D510 or D530 convertible mini-tower
HP L1702 17” flat panel monitor
StressVue thermal printer or HP 4200 Laser Jet printer
StressVue software and documentation CDs
StressVue
Other common options include:
System transport cart
For setup instructions, see Chapter 3, “Assembling the StressVue Utility Cart.”
Software Installation Overview

Software installation and configuration is a multi-step process. Follow the instructions in the
order presented; key software components must be installed before others can be.
The process proceeds as follows:
1 Finish installing the Windows XP operating system. The system arrives with the operating
system installed, but not fully configured for your locale, time zone, and so on.
2 Install the driver for the PCMCIA card reader.
3 Install the card reader hardware.
4 Install the driver for the StressVue Direct Connect PCMCIA card.
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Configuring the Operating System
5 Install the StressVue application software.

6 Install Adobe Acrobat Reader. This application is required to enable you to read the
StressVue documentation, which is provided in PDF.

The Windows XP operating system is factory pre-installed on your PC. However, you must
finalize installation and configuration with your time zone and other location-specific
information.
Installing Windows XP Service Pack 1

NOTE If you are already running Window XP SP 1, you can skip this step.
1 Put the StressVue Stress Exercise Testing System Software CD into the CD-ROM drive.
2 Locate the directory XP Service Pack 1, and double-click the executable file in this
directory.
3 Follow the instructions provided by the installation wizard.
4 When prompted to select file archiving, select Don’t archive files, and click Next.
5 When installation is complete, click Finish, then reboot the PC.
Finalizing the Windows XP Installation

To finalize Windows XP installation
1 Power up the computer and allow the operating system to start.
This should be the first time the computer has been powered on since being received from
Philips. Windows XP Professional begins the installation process automatically. The
Welcome screen appears.
2 On the Welcome screen, click Next.
3 Select the appropriate system settings and click Next.
4 Set the proper time zone for the system and click Next.
5 Accept the EULA licenses and click Next.
6 Set the computer name to StressVue, leave the Computer Description field blank, and click
Next.
7 In the Type of Internet Connection field, select LAN and click Next.
StressVue Installation and Getting Started Guide 1-3

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8 In the LAN Connection fields, specify the following settings:

Static IP Address 192.168.10.100
Subnet Mask 255.255.255.0
Default Gateway 192.168.10.1
9 Select the radio button for Use the following IP address and click Next.
NOTE This address is required for correct operation of the thermal printer.
10 When prompted to register online, click No, then click Next.
11 On the final screen, click Finish.

The system automatically reboots.
Proceed to configuring the operating system, as described next.
Configuring Windows XP
During the configuration process, you customize the Start menu, display settings, date format,
startup and recovery modes, and Windows Explorer properties. The following sections
provide details for each process.
Configuring the Start Menu

To configure the Start menu
1 Right-click the Task bar and select Properties.
2 Click on the Start Menu tab and select Classic Start menu.
3 Click Customize next to the Classic Start menu option.
4 In the Advanced Start menu options, enable only the following check boxes:
– Display Administrative Tools
– Display Run
– Expand Control Panel
– Enable Dragging and Dropping
– Expand Network Connections
– Expand Printers
5 Click OK, then Apply, and finally OK again.

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Configuring the Display Settings

To configure the display settings
1 Click Start > Settings > Control Panel > Display.
2 Click the Settings tab and set:
Color quality Highest (32 bit)
Screen resolution 1280 x 1024
3 Click the Appearance tab, then click Effects.

4 Clear all options except for the smoothing of the screen fonts, and click OK.
5 Click the Screen Saver tab, and set the Screen saver to none.
6 Click Power and set the Power scheme to Home/Office Desk.
7 Under the Home/Office Desk settings, set the following options:
Turn off monitor Never
Turn off hard disks Never
System standby Never
System hibernates Never
8 Click the Advanced tab and:

a Clear the Prompt for Password when Computer resumes from Standby check box.
b Set the Press power button option to Do nothing.
9 Click the Hibernate tab, and clear the Enable hibernation check box; then click OK.
10 Click OK to close the dialog box; when prompted, click Yes to accept the changes.
Configuring 24-hour Format Time Display

To configure 24-hour format time display
1 Click Start > Settings > Control Panel > Regional and Language Options.
2 Click Customize and select the Time tab.
3 Enter a Time format of HH:mm:ss to specify a 24-hour clock.
4 Click the Date tab, and set the Short date format as appropriate to require a 2-digit month
and day and a 4-digit year:
– US: MM/DD/YYYY
– Europe: DD/MM/YYYY
5 Click OK; when prompted, click OK to accept the changes.

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Setting the Startup and Recovery Modes

To set the startup and recovery modes
1 Click Start > Settings > Control Panel > System.
2 Click the Advanced tab, then click Settings next to Startup and Recovery. In the Settings
window:
a In the Time to display fields, type 10 seconds for each.
b Clear the Automatically restart check box.
c In the Write debugging information field, select Kernel memory dump
3 Click OK; when prompted, click OK to accept the changes.
Configuring Windows Explorer Properties

To configure Windows Explorer properties
1 Open a Windows Explorer window and choose View > Details.
2 Select Tools > Folder Options and select the Use Windows classic folders radio button.
3 Click the View tab and ensure that the following settings are in effect:
4 Click Apply, then click Apply to All Folders.

5 When prompted, click Yes to set all folders to match the current view, then click OK.
You are now ready to install the PCMCIA card reader driver and continue installing StressVue
software.

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Installing the PCMCIA Card Reader

For details on installing the card reader hardware and the associated drivers, see Chapter 2,
“Installing the PCMCIA Card Reader.” When finished, return to this chapter.
Installing the StressVue Software and Card Drivers

NOTE Before beginning this part of the installation, ensure that you have installed the PCMCIA card reader
as described in Chapter 2, “Installing the PCMCIA Card Reader.”
To install the StressVue software and drivers

1 On the PC, insert the direct connect PCMCIA card into the lower slot in the card reader
and wait for the Windows operating system to detect the new hardware.
The system prompts you to install the driver for the card and starts up the New Hardware
wizard.
2 Select the option, Install from a list …, and click Next.
3 Insert the StressVue Stress Exercise Testing System Software CD into the CD-ROM drive.
4 When prompted, do the following:
a Clear the Search removable media option.
b Select the Include this location option.
c Click Browse and navigate to the DrvWinXP directory on the software CD, then click
OK.
d Click Next.
The system installs the driver.
5 Click Finish to exit the driver installation.
6 Re-insert the StressVue Stress Exercise Testing System Software CD into the CD-ROM
drive.
The Setup program automatically starts.
7 Follow the on-screen installation instructions.
8 Restart the computer when prompted.
9 Double-click the StressVue icon on the desktop.
The StressVue software starts and display a message asking for permission to re-initialize
the exam list.
10 Click Yes.
The StressVue startup screen appears.
11 Exit the StressVue software.
12 Right-click any empty space on the desktop and select Properties.

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13 Click the Desktop tab and navigate to C:\Program files\Philips\StressVue, and select
SplashScreen.bmp.
14 Set the Position field to Stretch, then click OK.
You can now install the Adobe Acrobat Reader software.
Installing Adobe Acrobat Reader

To install Acrobat Reader
1 Insert the Quartec Communication Product Drivers and Manuals CD (from the card
reader kit) into the CD-ROM drive.
NOTE Acrobat Reader is also provided on the StressVue Documentation and Training CD.
2 Open Windows Explorer and locate the directory Acrobat 5; then double-click the file in
the directory, AcrobatReader51_enu_full.exe.
3 Follow the on-screen installation instructions.
The StressVue system software, as well as required additional software, is now installed.

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2
Chapter 1 Installing the PCMCIA Card Reader
This chapter presents step-by-step instructions on how to install the PCMCIA card reader into
your system.
NOTE If you purchased the A06 option, you do not need to perform the steps in this chapter.
Before You Begin

Ensure all of the required components are included in the card reader hardware package.
These components include:
Card reader
Bracket
PCI I/O board
Two ribbon cable pairs
The driver is included on the
Quartec Communication Product
Drivers and Manuals CD, included
in the kit
NOTE Before installing the card reader, ensure you have completed the Windows XP operating system
software as described in Chapter 1, “Installing and Configuring StressVue.”
Installing the PCMCIA Card Reader Driver

To install the card reader driver
1 Power on the PC and insert the StressVue Stress Exercise Testing System Software CD into
the CD-ROM.
2 In the Quatech Driver directory, run setup.exe to copy the drivers for the card reader.
3 Power off the PC and disconnect the AC power cord.
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Installing the PCMCIA Card Reader Hardware

NOTE Before you begin, ensure you have loaded the card reader driver as described in the previous section,
“Installing the PCMCIA Card Reader Driver” on page 2-1.
To install the card reader hardware
1 Open the PC case.
a Remove the right side panel, by pulling the latch at the rear of the panel and slide the
panel toward the back of the PC.
b Remove the front bezel on the PC.
2 Make sure the PC has an unused PCI slot and an available 3½” or 5¼” bay.
Available PCI slots

Empty bay
3 Place the card reader into the bracket.

Fit the front part of the reader into the bracket, then push the back down. Ensure the pins in
the bracket line up with the holes in the reader.
Pins
4 Attach screws holding the reader to the bracket.

5 Remove bracket screws from the front of the PC and place them in the sides of the card
reader assembly.
These screws guide the card reader assembly into the bay.

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Spare bracket screws
Insert screws in side of card reader
6 Place the card reader in the empty bay in the PC.

Push the bundle of cables through first and feed them carefully down the middle of the PC.
Then gently push the card reader assembly until it snaps into place.
Card reader in bay
Guiding screw
Cables

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7 Lay the PC on its side.
8 Connect the ribbon cables from the card reader to the PCI board as follows:
– The pair of cables marked Cable Pair 1 attach to the connectors marked Socket 1. This
pair of cables is longer than Pair 2.
– The pair of cables marked Cable Pair 2 attach to the connectors marked Socket 2.
NOTE Pay very close attention to how you connect the cables. The red line on the cable must point
toward the top of the PCI board (the connecting pins on the PCI board are on the bottom).
Red line faces up
9 Gently push the card reader’s I/O board into the PCI slot, and attach the retaining screw.
Retaining screw

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10 Reattach the PC front and side panels.
Return to “Installing the StressVue Software and Card Drivers” on page 1-7 to continue
installing the StressVue software.

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Assembling the StressVue Utility Cart

Chapter 1
This guide describes how to set up the utility cart for use with the Philips StressVue Stress
Exercise System.
Setting up the cart comprises the following tasks:
Removing the cart from the shipping box
Placing the isolation transformer in the cart
Placing the StressVue PC in the cart
Attaching the keyboard and mouse
Setting up and connecting the printer
Attaching the display arm and the monitor
Attaching the optional SunTech Tango blood pressure monitor
Connecting all of the components
Before You Begin

Before setting up the cart and the StressVue PC and monitor, install the PCMCIA Card Reader
in the PC. For details, see Appendix H, System Assembly, in the StressVue Instructions for
Use.
Required Tools
Make sure you have the following tools available:
Medium head, short-handled Phillips-head screwdriver
Large flat-head screwdriver or large coin (to open the back of the cart)
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Basic Cart and PC Assembly

1 Remove the loose box before you remove the cart from the box.
2 Slide the cart out of the box and lift it off the base packing material.
Lock the casters to help prevent the cart from moving during installation.
NOTE Although a single person can do this, we recommend that two people work together on this step.
3 Verify that the two accessory boxes are enclosed.
– Loose box: Holds the radial arm for the mounting display, including the required tools.
– Box inside cart: Holds the cart accessories, including the baskets, paper tray, and
mouse platform.
4 Open the rear door using a large coin.
5 Using the Phillips-head screwdriver, remove the screws that attach the transformer locking
bracket to the base of the cart. The bracket is located under the PC shelf.
Inner bracket
Locking bracket to
remove
6 Slide the isolation transformer into the cart as far as it will go. The rear rim of the
transformer will touch the inner locking bracket.
NOTE The transformer weighs approximately 22 lb. As you slide it into the cart, be careful not to pinch
your fingers on the side of the cart.

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7 Position the transformer such that the locking bracket can be reattached; reattach the
bracket in front of the transformer.
8 Install the keyboard in the keyboard well at the front top of the cart.
9 Feed the keyboard cable through the opening at the rear of the well and through the large
opening above the PC.

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10 Install the mouse platform on either side of the cart, whichever you prefer.
Mounting holes
for the mouse
platform
11 Slide the platform hinges into the vertical slots and rotate the platform into a vertical
position.
NOTE Ensure the platform is properly inserted; the flat part of the platform must face up.
Vertical position
12 When the hinges are inserted all the way, rotate the mouse platform into its horizontal
position. Tighten the captive thumb-screw under the platform.
13 Place the mouse on the mouse tray.
Feed the mouse cable through the slot in the keyboard well.

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14 Moving the cords out of the way, place the PC on the shelf above the transformer, with the
front side of the PC facing forward. Slide the PC toward the front of the cart as far as it
will go.
NOTE As you slide the PC into the cart, be careful not to pinch your hands or fingers on the side of the
cart.
15 Connect the keyboard and mouse cables to the PC.
Mouse
Keyboard

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16 Mount the two baskets for cart supplies and the paper tray.
– Mount the paper tray and one basket on the right side of the cart.
– Mount the other basket on the left side of the cart.
Paper tray
Basket
Set up the printer as described next.
Connecting the Printer

This section describes how to hook up the StressVue thermal printer.
If you are using an HP LaserJet printer, the procedure is essentially the same for the location of
the printer and connections to the PC. Refer to the LaserJet documentation for appropriate
connections on the printer, as well as for LAN settings you must configure on the PC.
To connect the thermal printer

1 Plug the power cord and LAN cable into the printer.
Power cord LAN cable

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Connecting the Printer
2 Place the printer gently on the top of the cart and feed the cables through the slot in the
side of the printer well, toward the back of the cart.
3 Place the thermal printer in the printer well such that the printer connectors face the rear of
the cart.
4 Connect the LAN cable to the PC.
Attach the monitor as described next.

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Attaching the Monitor

The base of the arm is already attached to the cart. The monitor arm kit includes the required
Allen wrenches.
To attach the monitor arm and 17” monitor

1 Mount the arm in the base.
Look for the black plastic washer on the base. If it is not there, locate it in the box.
Black washer (on top) and

monitor arm base

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2 Secure the arm by tightening the set screw into the base.
Set screw
3 From the plates provided, select the appropriate monitor mounting plate.
For the Philips 17” monitor, the appropriate plate measures 100 mm x 100 mm.
4 Secure the plate to the monitor swivel piece.
Swivel piece
Mounting plate
5 Line up the holes on the swivel/plate assembly with the holes on the back of the monitor
and secure it to the monitor using the four screws provided.

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6 Place the monitor/swivel combination onto the arm. Secure it with the washer and
Phillips-head screw.
Monitor/swivel assembly
Screw and washer located

under the arm
Screw and washer located

under the arm
The following figure shows the monitor mounted on the arm.

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Mounted display
Swivel
Mounting plate Display arm
7 Connect the power cord and the data cable to the display.
8 Route the cables through the two cable troughs and then through the opening at the top of
the rear door.
Cable troughs

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9 Adjust the tension in the monitor arm, using the Allen wrench shipped with the kit. This
lets the monitor stay in position when it is raised or lowered.
Arm tension adjustment screw
Arm base
Connect all the components as described next.
Connecting the Components

Connect all the power cords as follows:
1 Use the power cord provided with the PC as the power cord for the isolation transformer.
2 The StressVue kit includes four shroud-type power cords. Use these cords for the PC,
thermal printer, display, and the Tango BP monitor (if installed).
Connect these cords to the isolation transformer.
The isolation transformer provides power to the StressVue system and automated blood
pressure monitor, if in use. The transformer remains on between periods of routine system
use.
Attaching the SunTech Tango Blood Pressure Monitor

If you purchased the SunTech Tango blood pressure monitor, attach it to the utility cart as
described in this section.

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Attaching the SunTech Tango Blood Pressure Monitor
To attach the blood pressure monitor

1 Attach the bracket to the monitor using four Phillips head screws.
Blood pressure
monitor
Bracket
2 Attach the bracket/monitor assembly to the cart with two Phillips-head screws.
The following figure shows the monitor attached to the cart.

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Fully Configured Cart Example

Your configured setup should look similar to the following.

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4
Getting Started Using the StressVue
Chapter 1
Stress Exercise System

The StressVue system is a PC-based diagnostic tool for use in the exercise stress testing
laboratory. Electrocardiographic data obtained during stress testing is acquired, processed,
recorded, analyzed, output, and archived. The StressVue software creates summary tables,
identifies trends, and generates a final statistical report, which trained clinicians review to
assist in the diagnosis of the patient’s condition.
The StressVue system interfaces to and controls a compatible treadmill or ergometer and non-
invasive blood pressure monitor. The TTL output option allows selectable ECG signal to be
sent to an Echo system for further tests.
This chapter provides the following information:
About the StressVue System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
System Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Patient Interface Module (PIM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
About the Direct Connect Patient Interface Module (PIM),
Model M12A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
Connecting the Direct Connect PIM to the StressVue Computer . . 4-6
About the Ambulatory X-12 Patient Interface Module . . . . . . . . . . 4-8
About the Medical Isolation Transformer . . . . . . . . . . . . . . . . . . . . . . 4-10
About the Printer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
Loading the Thermal Printer Paper . . . . . . . . . . . . . . . . . . . . . . . . 4-11
StressVue Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12
About Stress Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12
About Profiles and Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-12
How StressVue Loads Profiles and Protocols . . . . . . . . . . . . . . . . 4-13
What StressVue Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-14
About the StressVue Exercise Testing Workflow . . . . . . . . . . . . . . . . . . . . 4-16
About Preparing the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16
About the Pre-Exercise Phase. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16
About the Exercise Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-17
About the Recovery Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-17
About the Report (End) Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18
About the StressVue Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-18
Powering On the Equipment and Running StressVue . . . . . . . . . . . . . 4-18
About the Application Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-19
About the StressVue Startup Window . . . . . . . . . . . . . . . . . . . . . . 4-19
About the StressVue Main Window. . . . . . . . . . . . . . . . . . . . . . . . 4-21
About the Data Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-23
4-1
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Getting Started Using the StressVue Stress Exercise System
Testing and Acquisition Settings . . . . . . . . . . . . . . . . . . . . . . . . . . 4-25

About the Report Manager Window . . . . . . . . . . . . . . . . . . . . . . . 4-25
Navigating the Application. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-28
About StressVue Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-28
Available Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-28
Conventions Used in this Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-29
Getting Help Using StressVue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-29
Ordering Parts and Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-29
About the StressVue System

StressVue is a high-performance, PC-based dedicated color stress testing system, which
provides automatic ST segment analysis and trending on all 12 leads. The diagnostic quality
screen offers color superimposition comparison of current and reference complexes on both a
4x QRS and updated 12 lead median complexes. The system offers customizable screen
formats and stores a high number of protocols and profiles. StressVue provides automatic
ventricular ectopic beat detection and storage of up to 100 events for post-test review.
NOTE The arrhythmia detection portion of the StressVue application is provided for the convenience of
automatic documentation. The StressVue system does not offer a diagnostic opinion; rather, it
provides a high-fidelity instrument recording ECG waveforms during exercise, for the purpose of
providing a tool to expedite the documentation of a test for which a clinician renders his/her own
medical opinion.
The StressVue application interfaces with a treadmill or ergometer, and captures four phases
of a patient exercise test:
Pre-exercise
Exercise
Recovery
Report
StressVue is also programmable, allowing you to customize the operational conditions to suit
your specific needs. You can customize:
Up to 100 different user profiles to meet the needs of individual physicians
Up to 100 different exercise protocols
Automatic 12-lead ECGs and prompts for blood pressure
Full disclosure capability.
Multiple final report formats with custom report sequence capabilities
StressVue runs on a PC with the Windows XP operating system. You control its functions
using the keyboard and mouse.

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System Components
The StressVue system includes the following components:
HP Compaq D510 or D530 convertible mini-tower
HP L1702 17” flat panel monitor
StressVue thermal printer or HP LaserJet 4200 Series with WinXP drivers
Isolation transformer, 115V or 230V, depending on the country
System cart (optional)
One of the following transmitter/receiver sets:
– Patient interface module (PIM) and direct connect PCMCIA card
– X-12 digital transmitter (2500 MHz) and telemetry receiver PCMCIA card (not
available in the US)
PCMCIA card reader (internal)
For details about assembling the system, see the StressVue Installation and Getting Started
Guide. For specifications for each component, see Appendix F, “Specifications and
Requirements” of the StressVue Instructions for Use.
WARNING All components attached to the StressVue PC, including the PC, printer, monitor, and
optional blood pressure monitor, must be plugged into a medical isolation transformer
to ensure the system is properly grounded.
The StressVue system can be used with the following exercise equipment:
TrackMaster TKM425 treadmill
Ergometers using the Ergoline protocol, including the Ergoline 800, er800S, and er900S,
as well as Lode Corival ergometers

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Figure 4-1 StressVue system and cart
C
A
D
L
E
G
H
H
I
A Display arm and monitor H Storage baskets

B StressVue application (see page 4-18) I StressVue PC
C SunTech Tango blood pressure monitor J Card reader for use with the direct connect or wire-
less PCMCIA card for the patient module
D Mouse K StressVue utility cart
E Keyboard L Trackmaster treadmill
F Printer M Lock on wheel (not visible in image)
G Paper tray CAUTION: Always lock the wheel brake when the
cart is not in use. Press down on the brake to set or
release it.

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Figure 4-2 Wheel brake on cart
Locked brake Unlocked brake
Patient Interface Module (PIM)

The Patient Interface Module (PIM) is a module connected to the LeadForm patient cable that
records ECG activity on the patient and transmits this data to the StressVue system. It is
attached to the patient with a belt or carrying case. The StressVue system offers both direct
connect and wireless patient interface modules.
The direct connect PIM ships with the standard system, and collects data from the patient
via a patient data cable that connects to the StressVue PCMCIA ECG Processor card in the
StressVue PC. For details, see “About the Direct Connect Patient Interface Module (PIM),
Model M12A,” below.
The wireless PIM is an option (A03, A04) available in some areas. The wireless PIM
includes a transmitter and a PCMCIA card that acts as a receiver. For details, see “About
the Ambulatory X-12 Patient Interface Module” on page 4-8.
For details about ordering components, including additional patient cables, see Appendix E,
“Ordering Options and Parts” of the StressVue Instructions for Use.

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About the Direct Connect Patient Interface Module (PIM), Model M12A
Figure 4-3 PIM (M12A) and associated PCMCIA card
ts
A
B
A Direct connect patient interface C StressVue PCMCIA ECG Processor card (insert
module into card reader in PC) (page 4-6)
B Direct connect cable
Connecting the Direct Connect PIM to the StressVue Computer

The direct connect PIM connects only to the connector on the associated StressVue PCMCIA
ECG Processor card.
To connect the direct connect PIM to the StressVue computer
1 Plug the PIM connector into the connector on the PCMCIA card.
2 Insert the PCMCIA card into the card reader slot on the front of the PC and gently push it
in.

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WARNING To ensure safety and prevent damage to the system, only connect the patient data cable
to the connector on the PCMCIA card.
Do not connect the patient data cable into any other connector or port on the StressVue
computer.
3 To minimize stress on the connector to the PCMCIA card, secure the cable to the cart or
other configured location by a stress-relief device.
If you are using the StressVue system cart, the stress-relief device is located under the
keyboard tray.
To remove the PCMCIA card from the StressVue computer
NOTE Removing the card is not a routine operation; normally, the card remains in the card reader.
1 Push the PC card eject button to the right of the card slot.
2 Gently pull out the card.

To disconnect the direct connect PIM cable from the PCMCIA card
NOTE It is not necessary nor recommended to regularly disconnect the cable from the card.

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X Gently squeeze the two sides of the PIM cable and pull it out of the connector on the card.
About the Ambulatory X-12 Patient Interface Module

The wireless PIM is an option (A03, A04) available in some areas. The wireless PIM includes
a transmitter and a PCMCIA card that acts as a receiver. For details about the wireless PIM,
see the Mortara X-12 Operator’s Manual.
Figure 4-4 Ambulatory (wireless) PIM and card
A Ambulatory patient interface B StressVue PCMCIA ECG Processor card (insert

module into card reader in PC)

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To insert the wireless card into the PC

X Insert the PCMCIA card into the card reader slot on the front of the PC and gently push it
in.
To remove the PCMCIA card from the computer

NOTE Removing the card is not a routine operation; normally, the card remains in the card reader.
1 Push the card eject button to the right of the card slot.
2 Gently pull out the card.

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About the Medical Isolation Transformer

WARNING! Possible explosion hazard. Do not use in the presence of flammable anesthetics.
Use of this transformer with equipment other than originally supplied, or surpassing the ratings,
may cause damage, fire, or injury.
Risk of electrical shock! Do not remove cover. Refer servicing to qualified service personnel.
Grounding reliability can only be achieved when the equipment is connected to an equivalent
receptacle marked “Hospital Grade.”
The isolation transformer provides power to the StressVue system, including the PC, monitor,
and printer, as well as the automated blood pressure monitor, if in use. Two models are
available: 115V and 220V. For specifications, see Appendix F, “Specifications and
Requirements,” of the StressVue Instructions for Use.
Figure 4-5 Medical isolation transformer (115V pictured)
About the Printer

StressVue supports the use of the StressVue thermal printer. The computer-controlled thermal
printer uses an eight-dot per millimeter print head to print out ECG tracings and report data. It
also supports multiple print formats, controlled from within the application.
The printer operates on line power (connected to the isolation transformer) and is controlled
by a local area network (LAN) connection to the stress testing system.
For details about the printer, including setup and configuration, see Appendix D, “Configuring
and Using the Printer,” of the StressVue Instructions for Use.

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Figure 4-6 StressVue Thermal Printer
Loading the Thermal Printer Paper

To load the paper
1 Remove the outer packaging from the paper pack.
2 Facing the front of the unit, use the release latch on the left side and slide the paper tray
cover to the left.

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3 Place the pack of thermal paper into the paper tray such that the grid side of the paper is up
when it is pulled over the paper tray cover. The paper cue mark (a small black rectangle)
should be in the lower left corner.
4 Manually advance one page of paper beyond the closure point of the writer. Make sure the
paper lays on the black roller evenly within the channel of the paper door.
5 Slide the writer cover to the right until the cover latches in a locked position. You will hear
a sharp click when the door is properly latched.
6 Push the form-feed button to align the cue mark and prepare the paper for printing.
StressVue Basics
The following sections provides a general overview of StressVue:
“About Stress Testing” on page 4-12
Provides a brief overview of the purpose of stress testing, protocols, and the functionality
the StressVue application offers before, during, and after a test.
“About the StressVue Exercise Testing Workflow” on page 4-16
Provides a brief overview of the stress testing process using StressVue, by phase.
“About the StressVue Application” on page 4-18
Provides basic information about running StressVue, as well as an overview of the screens
and functions within the application, and how to navigate between them.
For detailed information about preparing a patient and conducting a test, see Chapter 2, “The
Patient Session,” of the StressVue Instructions for Use.
About Stress Testing

Exercise stress testing is a valuable non-invasive diagnostic tests in the clinical evaluation and
management of patients with suspected or known cardiovascular disease, particularly coronary
artery disease (CAD). The exercise stress test is also a very useful tool when used as a
screening procedure.
The treadmill and cycle ergometer are the most commonly used exercise testing devices.
Pharmacological studies can be used when the patient is unable to walk or cycle.
About Profiles and Protocols

Profiles allow individual clinicians to define preferred test settings, including screen
configuration, filters to use, and so on. A profile acts as a template for a given clinician or
facility; you can, however, override individual settings for a particular test. These overrides
apply only to the current session, however. The settings are reset to those specified in the
profile at the next patient session.

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Many different protocols are used for clinical exercise testing. All protocols include a warm-
up period, an uninterrupted exercise period with progressively increasing load, and a recovery
period.
StressVue ships with the following standard protocols: Bruce, Modified Bruce, Naughton,
Ellestad, Balke, Pharmacological, and Bicycle. For a snapshot of each protocol, see Appendix B,
“Protocol Reference,” of the StressVue Instructions for Use. You can modify these protocols,
or add new ones, as described in Chapter 5, “Configuring StressVue.”
How StressVue Loads Profiles and Protocols

When you define profiles, you can specify a profile as the Startup profile. The settings
specified in the startup profile are loaded automatically when you start StressVue.
StressVue loads profiles and associated protocols as follows:
When you start up StressVue, the application by default loads the profile defined as the
Startup profile in the Configuration settings.
In addition, StressVue loads the protocol that is associated with the profile defined as the
startup profile.
NOTE The startup profile is not necessarily named Default Profile; this name is used here for illustrative
purposes.
Figure 4-7 Startup profile and protocol
Startup
(default)
profile
Protocol
associated
with start-
up profile
After previously running a test, when you start a new patient session by clicking New
Exam, StressVue loads the profile and protocol used for the previous test.
You can change the profile and/or protocol to use for a given test. See “Starting a Patient
Session” in Chapter 2 of the StressVue Instructions for Use.
In addition, you can change which profile is selected as the startup profile, as well as which
protocol is associated with this startup profile. For details, see Chapter 5, “Configuration
StressVue,” of the StressVue Instructions for Use.

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What StressVue Displays

The StressVue application can be configured to display all or some of the following
information.
During the test, you can choose from four rhythm display screens:
3-lead display. Three channels consisting of 5 seconds of three user-defined leads.
6-lead display. Six channels consisting of 5 seconds of six user-defined leads.
6x2-lead display. Six split channels consisting of 2.5 seconds each of all 12 leads.
12-lead display. Twelve channels consisting of 5 seconds each of all 12 leads.
Additional parameters displayed during testing include:
Treadmill speed and grade Beats per minute (bpm)/ % of target heart
rate
ST level Blood pressure
Phase and stage Stage time
Patient name Total exercise time
One average complex for each of the Running trends of heart rate, ST level, and
displayed ECG leads superimposed METS
for comparing current data to
reference data
User defined expanded average complex superimposed for comparing current data to
reference data
At the end of the Recovery phase, the Report Manager displays a summary page that allows
you to define and create the final report. For details, see Chapter 3, “Working with Reports,”
of the StressVue Instructions for Use.

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The summary page includes a tabular data page, comprising a stage summary and a minute
summary for exercise and recovery. For details, see Chapter 3, “Working with Reports,” of the
StressVue Instructions for Use.
In addition, you can also print:

One average complex (at one-minute intervals or at stage intervals) from each of the 12
leads in the exercise and recovery phases
A trend of the ST level, ST slope, heart rate, blood pressure, double product, workload,
and estimated metabolic equivalents (METS)
Selected 12-lead ECGs

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About the StressVue Exercise Testing Workflow

Exercise testing should be performed by well-trained personnel familiar with normal and
abnormal responses during exercise to prevent life-threatening events. During exercise, a
cardiologist or specialized practitioner present, in addition to a nurse or medical technician to
prepare the patient and assist during the testing.
In general, the stress test goes through the following phases:
Pre-exercise
Exercise
Recovery
Report
The following sections provide a brief overview of each phase. For detailed information, see
Chapter 2, “The Patient Session,” of the StressVue Instructions for Use.
About Preparing the Patient

The technician prepares the patient, including:
Describing the test and what to expect, as well as getting consent form signed
Preparing the skin and applying electrodes/leads
Ensuring the electrodes are properly attached (via an impedance meter)
Demonstrating use of the equipment, if needed
For details, see “Preparing the Patient” in Chapter 2 of the StressVue Instructions for Use.
About the Pre-Exercise Phase

The Pre-exercise phase includes system preparation for the stress test and initial collection of
reference data:
Starting the StressVue application
Entering patient information
Calculating the maximal heart rate
Determining and setting the appropriate protocol for the patient according to the patient’s
clinical status
Determining and setting lead, gain, filter, and print settings for the test
Capturing a resting (baseline) ECG and BP; in some cases, also recording a standing and
hyperventilation ECGs
The Pre-Exercise “Supine” ECG includes 12-Lead ECG analysis and interpretation using
the Mortara Instrument ECG Analysis Program.
For details, see “Beginning the Pre-Exercise Phase” in Chapter 2 of the StressVue Instructions
for Use.

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About the StressVue Exercise Testing Workflow
About the Exercise Phase

The Exercise phase comprises the main portion of the test. During the Exercise phase:
ECGs are printed and BP is taken periodically, depending on preferences.
The pre-exercise clock is replaced by the total exercise clock and starts counting from
00:00.
The stage clock appears below the total exercise time clock and starts counting from
00:00. The stage number is also displayed.
If a treadmill or ergometer is turned on, the workload, as defined in the exercise protocol
or manual setting, appears in the upper right corner of the screen. The treadmill or
ergometer responds to the displayed settings.
Pre-exercise reference data is superimposed on the current data for each of the displayed
ECG leads and the expanded average Auto Compare complex. As the heart rate increases
and/or morphological changes occur, a separation of color occurs. Black represents
current data; blue, reference data.
For details, see “Conducting the Exercise Stress Test” in Chapter 2 of the StressVue
Instructions for Use.
About the Recovery Phase

During the Recovery phase:
The system automatically prints a 12-lead ECG labeled PEAK EXE. The 12-lead ECG is
printed at this stage transition regardless of system settings. The PEAK EXE 12-lead ECG
overrides any other ECG or rhythm strip print job in process.
The total exercise time clock freezes.
The recovery time clock replaces the stage clock. The recovery stage number is also
displayed.
The Phase button label changes to End.
StressVue advances the treadmill or ergometer to the recovery workloads specified in the
protocol.
The patient is monitored until physiological signs return to baseline (does not continue
exercising or cool down).
You can enter report notes describing why the patient ended the Exercise phase of the test,
the patient’s symptoms, and conclusions.
For details, see “Entering the Recovery Phase” in Chapter 2 of the StressVue Instructions for
Use.

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About the Report (End) Phase

During the Report phase:
StressVue freezes the recovery display while the test information is transferred to system
storage
StressVue loads the Report Manager, so you can review the test, and specify the
parameters and format of the final report.
For details, see Chapter 3, “Working with Reports,” of the StressVue Instructions for Use.
About the StressVue Application

The monitor, together with the keyboard and/or mouse, provide access to all StressVue
functions. Use the keyboard and/or the mouse to enter data, access StressVue functions, and
view results.
The following sections provide an overview of the main functions in the StressVue
application, and the functions available with each mode. For detailed information, see
Chapter 2, “The Patient Session,” of the StressVue Instructions for Use.
Powering On the Equipment and Running StressVue

CAUTIONS Before powering on the StressVue computer or attached components:
Read the “Safety Summary” chapter and the user safety information about StressVue and associated
components.
Ensure that the PC, printer, monitor, and if in use at your site, automatic blood pressure monitor,
are plugged into the medical isolation transformer.
Ensure that the medical isolation transformer is plugged into an approved Hospital Grade AC
outlet.
Do not run any other applications, including screensavers, on the StressVue PC.
For details on connecting the patient interface module (PIM) to the computer, see “PIM
(M12A) and associated PCMCIA card” on page 4-6.
To turn on the StressVue computer

1 If not already on, turn on the power on the isolation transformer.
The isolation transformer provides power to the StressVue system and automated blood
pressure monitor, if in use. The transformer remains on between periods of routine system
use.
2 Power on the computer by pressing the power button, located on the front of the PC.
The system boots up.
3 When prompted, log into the Windows system with your username and password.

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To run StressVue
CAUTION Do not run any other applications, including screen savers, when performing a stress test.
X Double-click the StressVue application icon on the StressVue computer desktop.

The StressVue Startup window appears. For details, see page 4-19.
The system is now ready for you to select the appropriate profile and protocol, and start a
patient session. All of these steps are covered in detail in Chapter 2, “The Patient Session,”
of the StressVue Instructions for Use.
About the Application Screens

StressVue presents information in the configurable Main window. You can customize the
appearance of the main window by specifying which panes to display and which leads to
include. For details, see “StressVue Display Options” in Chapter 2 of the StressVue
Buttons in the Main window (and Function keys on the keyboard) provide access to the
various functions and configuration settings of the application. For details, see “About the
StressVue Main Window” on page 4-21.
About the StressVue Startup Window

When you first startup the StressVue application, the Startup window appears. It is here that
you select the profile and protocol to use for the next patient session, as well as start the
Pre-exercise phase. You can also access stored reports, and configure system settings.
To access the Startup window

X Launch StressVue by double-clicking the StressVue icon.
Once you are in the application, return to the Startup window by clicking Main Menu at
the top of the screen.

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Figure 4-8 StressVue Startup window
Table 4-1 StressVue Startup window fields
Fields Description
User Profile Select the desired profile to use from the dropdown list. You
cannot change the selected profile after beginning a new
patient session. See “Selecting Profiles and Protocols” in
Chapter 2 of the StressVue Instructions for Use.
Exercise Protocol Select the desired protocol to use from the dropdown list. You
cannot change the selected protocol after beginning a new
patient session. See “Selecting Profiles and Protocols” in
New Exam button Click to begin a new patient session. Clicking New Exam
displays the Patient Demographics window and begins the Pre-
exercise phase of the test. See “Beginning the Pre-Exercise
Phase” in Chapter 2 of the StressVue Instructions for Use.
Archive button Click to search for and display stored reports. See Chapter 3,
“Working with Reports,” of the StressVue Instructions for Use.
Config button Click to display the Configuration window. This window has
multiple tabs, allowing you to define settings for individual
profiles. See Chapter 5, “Configuring StressVue,” of the
StressVue Instructions for Use.

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About the StressVue Main Window

The Main window displays all the exercise data and controls. It is configurable so you can see
just the data you are interested in, in the format that works best for the test at hand.
To access the Main window

X In the Startup window, click New Exam.
The Main window appears.
The Data panel on the right side of the window displays measurements, phase and stage
information, phase controls, and treadmill (or ergometer) speed and grade information.
The Command bar on the bottom of the window provides access to application settings
and exercise test controls.
Figure 4-9 StressVue window
A B C D
E J
K
L
P N
Q R S T
Table 4-2 StressVue application window components
A Patient name B Protocol name

Once selected and the test is started, you cannot
change the protocol for a test.

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Table 4-2 StressVue application window components (continued)
C Zoom ST Lead window D User profile

Once selected and the test is started, you cannot
change the profile for a test.
E Average complex display F Total exam (exercise) time (Data panel, page 4-23)
The average complex display shows one
average complex for each of the displayed
ECG leads, with ST level and slope, as well
as superimposition of current and reference
data.
G Current stage/stage timer H Treadmill or ergometer speed
(Data panel, page 4-23) (Data panel, page 4-23)
Displays the current workload settings of the
treadmill in miles per hour (mph) or ergometer in
watts.
I Treadmill grade (Data panel, page 4-23) J METS (Data panel, page 4-23)
Displays the estimated metabolic equivalents
(METS).
K Heart rate and % of target L Current ST level (Data panel, page 4-23)
(Data panel, page 4-23)
M Calculated ST/HR index value in micro-V/ N Last entered or acquired blood pressure reading
bpm or double product (Data panel, (Data panel, page 4-23)
page 4-23)
O Phase button and treadmill controls P Real-time ECG
(depending on phase) Displays the waveforms as they are acquired. The
This button displays four different labels display is configurable to show 3, 6, 12, or 6 x 2
during the course of an exercise test: Begin, leads.
Start Exe, Recovery, and End. Clicking the
button or pressing the F1 function key
advances the test to the next phase.
Treadmill controls allow you to turn the
treadmill on/off, as well as change speed and
grade.
Q Stress test controls (page 4-25) R Running trends
These buttons give you access to test Configurable display of trends.
functions, including recording blood
pressure, noting an event, and so on.
S Manual print controls T Current date and time

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About the Data Panel

The data panel shows status information about the test and the patient. The top of the panel
shows status information about the test and the equipment (Table 4-3). The bottom of the
panel shows information about the patient’s condition (Table 4-4).
Table 4-3 Test Status Data panel fields, top portion
Field Description
Total exam time Shows the total exercise time through all stages of the
test protocol. The timer starts at 0.00 in the
Pre-exercise phase, When you begin the Exercise
phase, the timer resets to 0.00. When the patient stops
exercising, the timer freezes until you begin a new
test.
Current stage and stage timer The current stage of the test protocol appears in the
upper right corner of the stage timer area. In this
example, the patient is in stage 1 of the test.
The stage timer shows the time elapsed in the current
stage of the exercise protocol. The stage timer resets
to 0.00 each time a new stage begins automatically or
if you change the workload manually. When the
recovery phase starts, the timer also resets to 0.00.
Treadmill speed or Shows the current workload of the treadmill in mph
Ergometer speed (miles per hour) or kph (kilometers per hour).
For an ergometer, shows the reading in Watts.
NOTE: When you print a report with the treadmill off,
dashes print in the speed and grade fields. Printing a
report with the treadmill on ensures the appropriate
values appear on the report.
You can click the up and down arrows to manually
control the treadmill. See “Controlling the Treadmill
or Ergometer” in Chapter 2 of the StressVue
Grade Shows the current elevation of the treadmill as a
percentage.
NOTE: When you print a report with the treadmill off,
dashes print in the speed and grade fields. Printing a
report with the treadmill on ensures the appropriate
values appear on the report.
See “Controlling the Treadmill or Ergometer” in
Mets Displays the estimated metabolic equivalent. One
METs value is provided per stage as soon as the stage
is entered.

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Table 4-4 Patient Status Data panel fields, bottom portion
Field Description
Heart rate (bpm) Calculates the patient’s heart rate, based on two
and% of target rhythm leads (II and V1), using a sliding average of
16 consecutive R to R intervals.
The target heart rate is the maximum predicted heart
rate, equal to 220 minus the patient’s age. The graph
and numeric percentage show how close the patient is
to reaching the target rate.
ST level (µV) Displays the measured ST value in microvolts or mm
for the on-screen average complexes.
Double product The display depends on whether the profile was
(bpm mmHg) or configured to show Double product or ST/HR index.
ST/HR index (µV/bpm) For Double product, StressVue waits for a manual
or automatic blood pressure reading, then
calculates and displays the value of BP x HR
(systolic blood pressure multiplied by the heart
rate).
For ST/HR index, StressVue calculates and
displays the value in micro-V/bpm. The index
value only appears if StressVue detects an
increase in heart rate of more than 10 beats and
any ST depression (below 0 mm). Otherwise,
dashes are displayed.
Blood pressure (mmHg) Shows the most recent blood pressure reading. When
the value is updated, the background turns yellow
and a beep sounds. The value remains on the screen
for 60 seconds (or 13 seconds into a new stage,
whichever comes first). Then the value is cleared and
replaced with dashes until a new value is entered.

STTS210
Testing and Acquisition Settings

During a patient session, you can modify several test settings, including acquiring or recording
blood pressure readings and events. The buttons in the Command bar at the bottom of the
StressVue window provide access to these settings.
For details about these functions, see “Conducting the Exercise Stress Test,” in Chapter 2 of
the StressVue Instructions for Use.
Figure 4-10 Command bar
Table 4-5 Command bar buttons
Button Description
BP Click or press F3 to enter a manual blood pressure reading.

Event Click or press F4 to display the Event dialog box to generate a 12-lead
ECG. StressVue documents the event name on the ECG, keeps the event
in memory, and reproduces it in the summary page and minute-by-minute
average QRS final reports.
RPE Click or press F5 to record the patient’s response when you ask the patient
to rate their perceived exertion (RPE)
Settings Click or press F6 to change the test settings, including gain, filter, display,
and print settings for this patient session.
ST Level Click or press F7 to set the Zoom ST Lead and trends display options, as
well as manipulating the QRS onset and offset, J-ST time interval,
reference average, and dominant complex.
Rhythm Click or press F8 to print a rhythm strip.
Stop Print Click or press F9 to stop the continuous ECG printout.
ECG Click or press F10 to generate a 12-lead ECG printout manually. The ECG
configuration is based on the settings for the profile you are using.
About the Report Manager Window

The Report Manager allows you to configure the final report.
To display the Report Manager

X Click End or press F1 to end the Recovery phase and enter the Report phase.

STTS210
Figure 4-11 Report Manager

A
B
H
E F G
Table 4-6 Report Manager fields
Description For more information, see the

following section of the
StressVue Instructions for Use
A Patient info button Chapter 2

Click to add or update patient data in the Patient
Info window.
B Summary “Summary Report” in Chapter 3
Displays basic information about the test.
C Max Values “Summary Report” in Chapter 3
Displays maximum values for heart rate, Mets,
double product, and blood pressure.
D Max ST “Summary Report” in Chapter 3
Displays ST Elevation and ST Depression times
and leads, amount of ST change, and ST/HR Index.

STTS210
Table 4-6 Report Manager fields (continued)
Description For more information, see the

following section of the
E Report copies “Printing the Final Report” in

Specify the contents of the final report printout Chapter 3
(after you save the report). Select:
– The number of copies of each individual report
to print, if any
– What printer to use
– Whether to print a grid
Click Print Report to print the final report.
F Quick print “Quick Printing” in Chapter 3
Click to print up one of four individual reports
(before or after you save the final report).
G Post-processing “Reviewing and Editing Test
Click to review or edit test data. You can: Data in Chapter 3
– Review rhythm events
– Review the test
– Modify the ST measurement point
H ST Snapshot “Reviewing ST Snapshots” in
Select a lead, then review the heart rate and ST Chapter 3
change graph. Below the graph, you can review the
start time and duration of any ST Change greater
than 100 µV.

STTS210
Navigating the Application

Use the mouse and keyboard to navigate the application screens.
Click the left mouse button to activate a command or option. Some commands display a dialog
box containing additional options. All dialog boxes time out if no selection is made within 7
seconds. You can also click Cancel to exit a dialog box without making changes.
The main commands are also available using the Function keys (F1 through F10) located at the
top of the keyboard. Each command in the application also shows the associated Function key.
For example, ECG / F10 in the application indicates that you can print a 12-lead ECG either by
clicking the ECG button or pressing the F10 key on the keyboard.
About StressVue Documentation

Philips Medical Systems provides detailed instructional and reference materials to help you
get the most out of your StressVue system.
Available Documentation
The following documentation is available with the StressVue system:
StressVue Installation and Getting Started Guide
This guide. Describes how to set up the StressVue hardware and software, and provides an
overview of StressVue components and operation.
A reference that provides detailed information about StressVue functionality, including
how to configure the system, as well as run the StressVue application. This guide also
includes troubleshooting and maintenance information.
Specifically, it is intended for stress exercise technicians, as well as system administrators
and anyone else authorized to use the system, such as trained clinicians.
StressVue Tutorial
Teaches you to configure and use StressVue.
StressVue Administrator Training
Explains how to set up, configure, and maintain the StressVue system.
Mortara X-12 Operator’s Guide
Provides information about how to set up and maintain the X-12 wireless transmitter
(PIM).

STTS210
Ordering Parts and Supplies
Conventions Used in this Guide

The documentation and training materials for StressVue use the following typographic
conventions.
Item How Displayed
Menu item Menu items and button names appear in a bold no-serif font.
Button name
Example: Click Settings.
Field names and list Field names and list items appear in a no-serif font.
items Example: Select the appropriate format from the Format dropdown
list.
WARNING Warning statements describe conditions or actions that may result in injury to the
patient.
software.
NOTE Notes provide additional important information about a topic.
Getting Help Using StressVue

For detailed troubleshooting information, as well as details about contacting the Philips
Response Center, see Chapter 5, “Troubleshooting and Contacting the Response Center.”
Ordering Parts and Supplies

For detailed information, see Appendix E, “Ordering Parts and Options” of the StressVue

STTS210
5
Chapter 1 Troubleshooting and Contacting the
Response Center
When you encounter a problem working with StressVue, address the issue in the following
order:
1 Review the Troubleshooting chapter to see if your issue is addressed.
2 Contact your StressVue administrator.
3 Contact the Philips Response Center.
The Philips Response Center can assist with product troubleshooting and provide technical
expertise to help with any issue with the StressVue system. For details, visit the following
URL on the Web:
www.medical.philips.com/main/services/response_center
Troubleshooting StressVue Issues

When you are using StressVue, you may encounter some problems with the system. The
following table describes some of the more common symptoms and provides information
regarding possible causes, and solutions to help you solve potential problems.
Table 5-1 Troubleshooting StressVue issues
Problem Cause Solution
Waveform Issues
Baseline drift Poor skin-to-electrode contact. Re-prep skin and replace faulty electrodes.
Square waves Lead failure caused by Correct the faulty lead identified on the
displayed on the real- inadequate skin-to-electrode upper-right corner of the screen.
time ECG display contact. Replace the patient cable.
Broken lead wire or patient Perform an RF scan to determine the
cable. presence of RF interference. Select the
RF interference (wireless optimal channel.
option only).
ECG artifact caused by Electrode placed over an area of Find a stable electrode site, re-prep the skin,
muscle interference muscle or fatty tissue. and apply a new electrode away from
muscular and fatty areas.
5-1
STTS210
Troubleshooting and Contacting the Response Center
Table 5-1 Troubleshooting StressVue issues (continued)
System Navigation Issues
No response to Disconnected keyboard Turn the system off. Check whether the
keyboard commands. cable. keyboard is connected to the Mouse
serial port.
See the StressVue Installation and
Transposed keyboard or Getting Started Guide for correct
mouse cable. component connection.
Cursor does not move Disconnected mouse cable. Turn the system off. Check whether the
mouse is connected to the proper port.
See the StressVue Installation and
Transposed keyboard or Getting Started Guide for correct
mouse cable. component connection.
Treadmill Issues
Treadmill does not Equipment was powered up Turn the treadmill Off through the
respond to the On in the wrong sequence. Treadmill dialog box in StressVue
command from (Chapter 2). Wait one minute and turn the
StressVue power On. Proceed with the test.
Check the treadmill-to-StressVue cable
The Treadmill power switch connection. Turn the Treadmill main
is in the Off position, or the power switch to the On position. The
treadmill cable is not properly switch is located at the base of the
attached. treadmill hood, on the left side.
Reset the Emergency Stop button by
turning it clockwise one quarter turn.
The Emergency Stop button

is engaged.
System Error Messages
Error message appears: An attempt to access a final report Click on the patient name to select it, then
No selected exam is made, but no patient is selected access the file.
from the list.
Error message appears: An attempt to exit from the Click Save Report, then exit the Report
Not reported exam final Report Manager is Manager.
made, but the report has not
been saved. A test is labeled Reported only after it is
An attempt to export a final saved.
report is made but the report
has not been saved as Click Save Report, then export the final
Reported. report.

STTS210
System Error Messages (continued)
A warning sign appears on the The measuring points (J point, Isoelectric

screen, next to the ST point or J + XX msec) have been modified by
measurements. the user during or after the stress test. The
warning sign indicates that a manual change
occurred and that the results are now based
on user decisions.
One or more leads have failed. Connect the electrodes. Once connected, the
warning message disappears.
Error message appears: In the protocol edit function, an Double-click on the stage to edit. The Edit
No stage selected attempt is made to edit a stage, window appears, allowing you to change the
but no stage has been selected. stage parameters.
The message appears: The StressVue PCMCIA ECG Reinstall the StressVue system software.
Unknown Device or
Processor card is not recognized See the StressVue Installation and Getting
Unknown Manufacturer
due to an incorrect installation or Started Guide .
lack of installation of the device
driver.
Error message appears: The PCMCIA ECG card is Remove the card from the PCMCIA slot
ECG front-end error - not correctly inserted. and reinsert it. The system emits a
Can’t proceed confirmation beep when the card is
installed properly.
Incorrect Power Savings Restart the PC. If this fixes the problem,
settings. it is likely that your system has incorrect
Power Saving settings configured.
Specify the settings as follows:
a Exit the StressVue application.
b Click Start > Settings > Control
Panel.
c Double-click Power Management.
d Set the Stand-By option to Never.
e Click OK and exit the Control Panel.
f Restart StressVue.

STTS210
Printer Issues
Thermal printer Paper jammed. Open writer cover and remove jammed
paper out light is No paper in tray. paper.
on Insert new pack of paper in tray.
Thermal writer is Open writer door. See if writer door is latched.
not printing
Uneven printing of Printer head needs cleaning. Refer to cleaning instructions in
ECGs or reports Chapter 4, “Maintaining the StressVue
System,” of the StressVue Instructions
for Use.
No printing LAN settings may be Check to see that the Local Area
incorrect. Network Connection Properties settings
on the PC are defined correctly
Network cable may be loose. Ensure that a crossover network cable is
used and check connections.
Power cord may be Check AC power cord connections and
disconnected. confirm that the Power On indicator is
illuminated.
Printer might not have paper Check to see that paper has been loaded.
loaded.
Printer error. Check to see that no error indicator lights
are illuminated.
Uneven printing Possible causes of uneven Have a technician:
printing: Check the platen for uneven wear.
Print head itself Verify that the print head shoulder screws
Platen are secure before replacing the print
Poor or damaged paper head.
Mechanical misalignment of The shoulder screws that secure the print
the print head head should be properly centered in their
holes, allowing the print head slight vertical
movement.
No motor drive Insufficient paper tension Check and replace as needed.
Faulty writer assembly
Faulty circuit board
Defective paper Thermal paper that is old or that Test printer using a fresh pack of properly
was improperly stored can cause stored paper.
light or uneven printing.
Exposure to heat or chemical
vapors can damage the paper.

STTS210
Printer Issues (continued)
Gaps in printing Shorts, damaged cable, or Have a technician:

damaged connectors Check the power head cable and the
signal cable for shorts, openings, or
damaged connectors.
These cables plug in between the circuit
board and the thermal print head.
Check the print head. Replace if needed.
Defective print head Check the circuit board. Replace if
needed.
Defective circuit board
Replace the paper.
Uneven or damaged paper
X-12 Ambulatory (Wireless) Patient Module Issues
Wireless option only. Signal on the screen shows Review any messages in the upper right
Packet errors/ signal artifact and/or square waves corner of the display. A lead failure message
drop intermittently. (X12 Battery Low) indicates the system is not
receiving ECG signals.
Check that no 2.4 GHz network units operate
in the proximity of the StressVue system.
Perform an RF Scan to locate the source of
the interference and to change to the optimal
channel for the X-12 transmitter.
Wireless option only. With the patient (or simulator) Check the StressVue Miscellaneous settings, as
No waveform signal on connected, no waveforms are well as the X-12 transmitter to ensure that the
the screen displayed; only the square two units are set to the same channel.
waveform and lead-fail indicator For details about setting the receiving
appear. channel settings, see Chapter 5, “Configuring
StressVue,” of the StressVue Instructions for
NOTE: If neither the signal nor the Use.
squared waveform is present, click
Abort and start a new exam from
For details about the wireless settings, see the
the Main window. Mortara X-12 Operator’s Manual for
instructions.

STTS210
Contacting Technical Support

Philips Response Center Contact Information
North America
Country Telephone Number
Canada (800) 323 2280

Mexico 52 55 5269 9000
Puerto Rico 1 787 730 2345
United States (800) 548 8833
Miami (Spanish speaking) 954 835 2650
South America
Argentina 54 11 4546 7686

Brazil 55 11 4689 6880
Chile 56 2 730 2500
Columbia 57 1 422 2600
Venezuela 58 21 2207 6800
Europe
United Kingdom 07 002 432 58 472 or

07 002 HEALTHRC
Austria 01 25125 333
Belgium 32 2 525 7102 (French)
32 2 525 7103 (Flemish)
Finland 010 855 2455
France 0803 35 34 33
Germany 0180 5 47 5000
Italy 0800 8256087

STTS210
Contacting Technical Support
Europe
Netherlands 31 4 027 87630

Spain 34 90 230 4050
Sweden 08 5064 8830
Switzerland 0800 80 10 23
Asia Pacific
Australia 1800 251 400

China 800 810 0038
Hong Kong 852 2876 7578
India
New Delhi 011 2695 9734
Mumbai 022 5691 2643/2431
Calcutta 2485 3718
Chennai 044 555 01000
Bangalore 080 5091 911
Hyderabad 040 5578 7974
Indonesia 021 794 7542
Japan 0120 381 557
Korea 080 372 7777 (toll free)
Seoul 02 3445 9010
Macau 0800 923
Malaysia 1800 886 188
New Zealand 0800 251 400
Philippines 02 845 7875
Singapore 1 800 Philips
Taiwan 0800 005 616
Thailand 02 614 3569

STTS210
Index
A D K
Adobe Acrobat Reader, installing 1-8 data panel 4-23 keyboard
Ambulatory X-12 patient interface date format, configuring 1-5 connecting 3-5
module. See X-12 wireless transmitter direct connect patient interface installing 3-3
assembling cart module 4-6
required tools 3-1 disconnecting patient cable from
steps 3-1 PCMCIA card 4-7
L
display settings, configuring 1-5 lead failure 5-3
B driver, installing the PCMCIA card loading paper in thermal printer 4-11
reader 2-1
baskets, mounting 3-6
bicycle. See ergometer
M
E
blood pressure monitor, connecting 3-12 M12 patient interface module 4-6
environmental conditions for StressVue Main window 4-21
use xii
C medical isolation transformer
error messages 5-2 about 4-10
cables, connecting 2-4 Exercise phase 4-17 installing in cart 3-2
card drivers, installing 1-7 monitor
cart assembly attaching monitor arm 3-8
H connecting 3-8
required tools 3-1
steps 3-1 installing 3-8
heart rate, target 4-24
mounting plate 3-9
command bar 4-25
mouse platform, installing 3-4
components
connecting 3-12 I
front view 4-4 P
installing
list 4-3
StressVue 1-2 Adobe Acrobat Reader 1-8
paper tray, mounting 3-6
baskets 3-6
configuring patient interface module (PIM)
blood pressure monitor 3-12
date format 1-5 about 4-5
card drivers 1-7
display settings 1-5 direct connect 4-6
keyboard 3-3
operating system 1-3 how to connect to StressVue 4-6
LaserJet printer 3-6
recovery mode 1-6 patient status on data panel 4-23
medical isolation transformer 3-2
screen display 4-14
monitor 3-8 PCMCIA card
Start Menu 1-4
monitor arm 3-8 disconnecting from patient cable 4-7
startup mode 1-6
monitor mounting plate 3-9 inserting wireless card into
time format 1-5
mouse platform 3-4 StressVue 4-9
Windows Explorer 1-6
paper tray 3-6 removing from computer 4-7
Windows XP 1-4
PC 3-5 removing wireless card from
connecting PCMCIA card reader driver 2-1 StressVue 4-9
blood pressure monitor 3-12 PCMCIA card reader hardware 2-2 PCMCIA card reader
components 3-12 StressVue software 1-7 installing driver 2-1
keyboard and mouse cables 3-5 thermal printer 3-6 installing hardware 2-2
patient interface module 4-6 Windows XP 1-3 power cords, connecting 3-12
power cords 3-12 isolation transformer. See medical
conventions used in this guide 4-29 power isolation transformer, safety xiv
isolation transformer
powering on StressVue 4-18
Pre-exercise phase 4-16
Index-1
STTS210
preparing the patient 4-16 T

printer
connecting 3-6 technical support, contacting 5-6
troubleshooting 5-4 test status on data panel 4-23
profiles, about 4-12 thermal printer
protocols, about 4-12 about 4-10
loading paper 4-11
time format, configuring 1-5
R tools
recovery mode, setting 1-6 for cart assembly 3-1
for installation 1-2
Recovery phase 4-17
troubleshooting
Report Manager 4-14, 4-25
lead failure 5-3
Report phase 4-18 printer 5-4
response center, contacting 5-6 waveform issues 5-1
ribbon cables, connecting 2-4 X-12 wireless transmitter 5-5
turning on computer 4-18
S
U
safety
about x unpacking carton 3-2
environmental conditions for utility cart. See cart
StressVue use xii
power isolation transformer xiv
X-12 wireless transmitter xv W
screen display 4-14
command bar 4-25 windows
data panel 4-23 Main 4-21
software installation Report Manager 4-25
operating system 1-3 Startup 4-19
overview 1-2 Windows Explorer, configuring 1-6
Start Menu, configuring 1-4 Windows XP
starting the StressVue application 4-19 configuring 1-4
startup mode, setting 1-6 installing 1-3
Service Pack 1 1-3
startup profile 4-12
workflow 4-16
Startup window 4-19
StressVue
components list 4-3 X
front view of components 4-4
powering on 4-18 X-12 wireless transmitter
starting the application 4-19 safety xv
turning on 4-18 troubleshooting 5-5
workflow 4-16
SunTech Tango Blood Pressure Monitor.
See blood pressure monitor
system messages 5-2
Index-2 StressVue Installation and Getting Started Guide

STTS210
Copyright © 2004
Koninklijke Philips Electronics N.V.
All rights are reserved. Permission is granted to copy
and distribute this document for educational purposes.
Printed in the U.S.A.
October 2004
Edition 2
453564009661
*453564009661*

Tress UE: Exercise Stress Testing System

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STTS210

Notice European Directives

Chapter 1. Installing and Configuring StressVue

Chapter 2. Installing the PCMCIA Card Reader

StressVue Installation and Getting Started Guide iii

Chapter 3. Assembling the StressVue Utility Cart

Chapter 4. Getting Started Using the StressVue Stress Exercise System

iv StressVue Installation and Getting Started Guide

Chapter 5. Troubleshooting and Contacting the Response Center

StressVue Installation and Getting Started Guide v

Conventions Used in the Instructions for Use

NOTE Notes contain additional important information about a topic.

Safety Symbols Marked on the StressVue System

Attention. See StressVue Instructions for Use and other product

ECG physio isolation is type CF, defibrillator proof.

Indicates that the system is receiving alternating currents.

Equipotential grounding post used for establishing common ground

The connector near this symbol receives an incoming signal.

Green light illuminated when the paper is out or an error condition

viii StressVue Installation and Getting Started Guide

Safety Symbols Marked on the StressVue Packaging

Keep out of direct sunlight.

Acceptable temperature range.

Move and store packaging this end up.

Recycle the packaging materials after use.

StressVue Installation and Getting Started Guide ix

Important Patient and Safety Information

Safety Information for the StressVue Exercise Stress

x StressVue Installation and Getting Started Guide

StressVue Installation and Getting Started Guide xi

Caution Statements for the StressVue System

xii StressVue Installation and Getting Started Guide

Important Notes about the StressVue System

StressVue Installation and Getting Started Guide xiii

Safety Information for the Medical Isolation Transformer

 Possible explosion hazard. Do not use in the presence of flammable anesthetics.

Caution Statements about the Medical Isolation Transformer

xiv StressVue Installation and Getting Started Guide

Safety Information for the Ambulatory X-12 Transmitter

 Device (Ambulatory X-12 Transmitter) transmits data reflecting a patient’s physiological

StressVue Installation and Getting Started Guide xv

E Spain: Use is limited to channels in the range 8B to E6 (inclusive).

F France: Use is limited to channels in the range 8E to A5 (inclusive).

Caution Statements for the Ambulatory X-12 Transmitter

xvi StressVue Installation and Getting Started Guide

Important Notes about the Ambulatory X-12 Transmitter

StressVue Installation and Getting Started Guide xvii

The StressVue Exercise Stress Testing System

Indications for Use

xviii StressVue Installation and Getting Started Guide

Installation Step See...

1 Configuring the operating system. Chapter 1 (this chapter)

3 Finalize configuring software on the PC, including Chapter 1 (this chapter)

This chapter provides the following information:

Before You Begin

Checking the Box Contents

Software Installation Overview

1-2 StressVue Installation and Getting Started Guide

5 Install the StressVue application software.

Configuring the Operating System

Installing Windows XP Service Pack 1

Finalizing the Windows XP Installation

StressVue Installation and Getting Started Guide 1-3

Possible explosion hazard. Do not use in the presence of flammable anesthetics.

Device (Ambulatory X-12 Transmitter) transmits data reflecting a patient’s physiological