Calipers and Measurements

Transcription

1 Calipers and Measurements OBJECTIVE: The objective of this exercise is for the clinical user to become familiar with the process of obtaining automatic baseline measurements and adding to and editing the measurements table. 1. Begin new study: Select from main menu. This will display the EP-WorkMate Opening Menu to enter patient information. It should be noted that both the Patient Name and ID Number are required to start a study. See Figure 1.1 for steps Figure 1.1 Item Rev A Page 1 of 11

2 2. Type in patient name in correct format (Last, First, MI) 3. Type in ID Number a. This is the patients unique medical records number 4. Select Begin New Study 5. Check Demonstration Signals option (at bottom right of screen) 6. Select Start at top right of screen 7. Enter the Setup screen by clicking on the Icon on the review screen or pressing Hot Key U. 8. Choose the DEMO CathMap. See Figure 1.2 for steps Choose the BASELINE Protocol. a. This protocol should display a few surface ECG s, an HRA, HIS, and RVA EGM recording. You may need to change pages with in the protocol to view these. If the DEMO CathMap does not include these signals please refer to the CathMap exercise to learn how to add them. At least one surface ECG, an HRA, HIS and RVA EGM are needed to perform auto measurements. 1. To change the page in the SETUP screen, click on the or buttons under the page header. See Figure If you have already exited out of you can click the same arrows on the bottom of the Real Time Screen to navigate through the pages in the selected protocol. See Figure Exit the Screen by clicking Close Setup Figure 1.2 Figure The page number is always displayed in the upper left corner of the Real Time Screen and Review Screen above the electrograms. See figure 1.4 Item Rev A Page 2 of 11

3 Figure Perform an function to capture a recording of the live signals. This will display them on the Review Monitor and create a log entry 12. Enter the LOG Window by clicking on on the Review screen or by pressing the Hot Key L. You should see a log entry labeled START RECORD-Baseline. See figure 1.5 for steps Double click on the entry to enable the Edit Annotation window 14. Rename your entry Basic Intervals 15. Exit the Edit Annotation window by pressing the Enter key on the keyboard or by pressing OK 16. Exit the window by either clicking on the X or pressing the Hot Key L Figure 1.5 In the next steps, the clinical user will obtain automatic baseline measurements. a. These measurements can only be taken with the Single Tick Mark Caliper b. The patient must be in sinus rhythm Item Rev A Page 3 of 11

4 c. The measurements must be obtained in a specific order and from specific ECG s or EGM s 17. Select the Single Tick Mark Caliper from the Review Screen tools a. On the Surface ECG place tick marks at the onset of the following signals across a single surface ECG. This is done by left clicking when the carrot is placed at the correct location on the electrogram. A tick mark will be placed where the carrot was when the operator performed a left click on the mouse. Use figure 1.6 for steps P Wave 19. QRS Complex 20. End of QRS Complex 21. End of T Wave 22. Next P Wave 23. On the HRA EGM, mark an A-A interval by placing a tick mark at the onset of two consecutive A signals 24. On the HIS Bundle Electrogram or HBE (typically HIS D works best because it usually has the most predominate HIS electrograms), mark the A-H and H-V intervals by placing a tick mark at the earliest rapid deflection of the A signal, onset of the H signal and the onset of the earliest V signal displayed on your screen. This can be tricky because, while the earliest onset can be anywhere; the carrot needs to drop the tick mark on the same HBE you marked the A-H interval. 25. On the RV EGM, mark the V-V interval by placing a tick mark at the onset of two consecutive V signals Figure 1.6 Item Rev A Page 4 of 11

5 26. Click on the SNAPSHOT icon. This icon is used to open the database and the measurements will auto populate in the appropriate interval cell. See figure 1.7 for steps Figure Select CLOSE. Refer to figure 1.8 for the following notes: a. Notice at the top of the Review Monitor there is an annotation of the measurements that were just taken. b. Open up the Log. Notice there is also a Log entry with the measurements that were just taken. In addition, these measurements were added to the Database under the MEAS tab and can now be added in to the physician s report. Item Rev A Page 5 of 11

6 Figure 1.8 In the next steps, the clinical user will learn to customize different measurement tables. Any measurements that you wish to add to the measurements table must be entered individually. This is done by taking a measurement with one of the calipers and left clicking on the numeric value of the measurement. This will open the measurements table. Simply click in the measurement cell you wish to enter data for and the number will drop in that cell. 28. Click on the once again to open the measurement table 29. Choose the EDIT icon. This will open a list of the measurement tables. See Figure 1.9 Item Rev A Page 6 of 11

7 28 29 Figure Choose the EDIT icon at the bottom of the TYPE header. This will open a window that allows you to edit the current list, delete an item or add a new item. See Figure Figure 1.10 Item Rev A Page 7 of 11

8 31. Choose the ADD ITEM icon. See figure 1.11 for steps In the SCREEN text box type TACH DATA. This is what will show up on EP-WorkMate in the log. 33. In the FORM text box type TACHYCARDIA DATA. This is what will show up on any report that is entered in to the patient s medical record. 34. Press the OK icon Figure 1.11 a. The new measurement table will be listed under the measurements header. 35. Select the icon 36. Select the TACH DATA measurement type. See figure 1.12 for steps a. Notice there is no measurement intervals selected for the TACH DATA measurement type. 37. Choose the measurement intervals you want included under the TACH DATA measurement type. 38. Select the OK icon Item Rev A Page 8 of 11

9 Figure Choose the TYPE icon in the measurements database. You should now see you TACH DATA measurement type. See figure Figure 1.13 Item Rev A Page 9 of 11

10 40. Select TACH DATA. See figure 1.14 for Steps Select Figure 1.14 a. The measurement interval selections are now listed in the Tach Data measurement type. See figure 1.15 for step Figure 1.15 Item Rev A Page 10 of 11

11 42. Click on the icon on the Save Measurements table to exit this window. This customization must be saved at the CathMap level if you want this measurement table to be available next time this CathMap is selected. 43. Enter the screen. See figure 1.16 for steps 43 and Click on once more Figure 1.16 Item Rev A Page 11 of 11