Hospital Telemetry ECG Recording and Analysis

Steady accumulation of experience in ECG monitoring showed that patients for whom real time ECG monitoring is very useful, though not necessarily in all cases. In these cases, monitoring can take place outside the intensive care unit but in the subsidiary chambers using telemetric monitoring systems that provide movement freedom for patients.

These states include:

• uncomplicated myocardial infarction for more than 48 hours
• diagnostically vague pain in the chest, which requires further observation
• conditions after uncomplicated percutaneous coronary intervention and after a routine coronary angiography
• initial stages of antiarrhythmic drugs treatment or drugs treatment for the heart rate frequency control during atrial tachyarrhythmias
• conditions after the pacemaker implantation for patients independent from pacemaker
• conditions after uncomplicated percutaneous catheter ablation on the arrhythmias
• a vague nature of syncope study
• non-resuscitation terminal condition that goes with arrhythmias and requires treatment because of discomfort
• conditions with high risk of myocardial ischemia after surgery
• congenital or acquired condition of children that associated with the risk of ischemia or myocardial infarction
• initial stages of treatment with psychotropic or other medications that affect the duration of the interval QT, thereby determining the risk of torsades de pointes
• acute neurological conditions, including subarachnoid hemorrhage

System for telemetry ECG recording and analyzing "Astrocard® - Telemetry" is designed for wireless long-term real time electrocardiogram monitoring (not less than 24 hours). The system provides ECG monitoring on 2-3 or 12 leads, depending on the type of telemetry ECG recorders, "Alarm" signal on the major arrhythmias and conductions, the ST dynamics, recording ECG data of all patients into the database with following retrospective analysis using Holter monitoring programs. Clinical departments are equipped with the necessary number of radio sets for continuous ECG recording of patients who can freely move thought out the department.

Types of telemetry recorders

Several types of portable digital recorders with wireless digital ECG data transfer are currently available

• 2-3-leads for heart rhythm disturbances monitoring
• 12 leads for ischemic changes and QT interval monitoring

All of them provide ECG recording and transmission to the central station on a given number of channels, and have button for events marking and personnel call.

Telemetry Central Monitoring Station

Telemetry central station is similar in function to the central stations at stationary monitoring. It consists of one or more specialized computers and allows to:

• display continuously monitored patients ECG (64 patients) on the screen
• analyze received information with alarms on critical cardiac arrhythmias and conduction, ST dynamics
• print out ECG fragments of different patients
• save full records of all patients in the database for further detailed retrospective processing using Holter monitoring programs

Due to the use of digital transmission, signal processing and the original method of QRS-complexes selection as well as correction of isoline shift we achieve high and stable quality of ECG recording (with the exception of isoline shift and noise reduction), the exact definition of depression and elevation of ST-segment as well as for "Emergency" alarm.

For medical staff we have designed a portable central station, which is a portable device that duplicates the screen of the main central station and "alarm" signals with the ability to move freely throughout the department.

The recorded ECG can be analyzed at the central station as an ordinary daily (Holter) monitoring record with the following features:

• View of ECG on 2-3 or 12 leads
• Automatic classification of ventricular complexes by their form
• Automatic analysis of ventricular and supraventricular, including atrial fibrillation, rhythm disturbances after the doctor's review of QRS-complexes types.
• nalysis of the ST segment dynamics
• Calculation of the spectral and temporal variability rate per day / hour of recording, as well as per any 5-minute interval
• Calculating of the QT interval value by the pick and at the end of T wave (QTa and QTe)
• Analytical (regression equation) and graphical calculation of the QT interval values dependence from RR per the day
• Automatic selection of stimulus artifact signal and analysis of the pacemakers major types
• View of analysis results in graphs and tables
• Automatic calculation of HR, RR, ST trends (all channels)
• Manual correction of the computer analysis results
• Printing of all the analysis results, as well as of any part of the ECG with the equivalent speed of the paper - 2,5, 5, 10, 25, 50, 100, 200 and 400 mm / s and a scale of 1, 2, 5, 10, 20, 50, 100 and 200 mm / mV
• Printing of the entire 24-hour recording on any of the channels in a "compressed" scale 15min/str., 30min/str. and 60min/str.
• Frequency analysis of cardiac arrhythmias
• Analysis of the P wave , including the definition of PQ interval and analysis of events of type P on T type events (algorithm PTAFDEF®)
• Analysis of QRST alternation
• Analysis of HRT