EPS320 Quick Reference ver 3.19

The MicroPace Screen & Keyboard Title Bar will give you Current Set up, Version and Page

STIMULUS Menu allows setting of stimulus pulse and train parameters

PACE STATUS displays sense site and result of pacing

Protocol Menu, set Stim train Protocol, selectable with Hot Keys T,N,S etc.

Pace Site Menu, select Stim Channel selectable with Hot Keys A,V etc.

More Hotkeys Menu displays menu of extra Hot Keys

Stimulus Symbol Display Resulting sensed ECG Display Pacing Intervals

Pause, Length of time before pacing begins between stims

Summary of Activity

Status of SGU (Under PC Control)

STIMULUS MENU • CURRENT Hotkey C, Sets Current • Applicable keys: Numerals, +/-, Ctrl +/-, Ctrl-Ins, Ctrl-Del, Alt +/• Values: 0.1, 0.2, 0.3… 4.8, 5,6,7… 10,15…25 mA. • Ctrl-Ins forces current to 20 mA. • Ctrl-Del Restores current from 20 ma to previous values • DURATION Hotkey U, Sets duration on Stimulus pulse in ms. • Applicable keys: Numerals, +/• Values: 0.5, 1, 2, 3…10ms • TRAIN Hotkey I, Sets # of Stim or # of sensed beats • Applicable keys: Numerals, +/-, Del • Del key sets INF = Infinite train or continuous pacing • DECREMENT Hotkey D • Applicable keys: Numerals, +/-, Ins, Del, Alt-L, Alt-U • Del turns of decrementation • Ins turns on decrementation, Ins with Tbl will bring up the table • SYNC TO Hotkey Y • Applicable keys: Y toggles between P/R and Off • Off pacing commences asynchronously • P/R pacing start after next sensed P/QRS • ECTO pacing starts after next sensed premature P/QRS • PACE MODE No Hotkey • User must highlight parameter with the ‘Up Arrow’ and adjust using the +/- key • Asyn pacing correspond to AOO and VOO pacing • Inhb pacing correspond to AAI and VII pacing

PACE STATUS • SENSE SITE: Active ECG Sense site/source, yellow subscript indicates the ECG Gain, adjustable in QRS Detect Menu (Alt-Q). • PQRS Sense / RR-average: Beat to Beat PQRS Sense interval and Average PQRS Sense interval are displayed in msec. • Heart Rate: in bpm. • Time Paced: Timed paced in seconds. • Impedance: Pacing circuit impedance is measured with each pulse to aid the user in determining the integrity of the pacing circuit. • Pulses Snt: Number of stimulus sent. • During Pacing , the blue ECG display bar will display vertical Stim markers(short bars for S1, longer bars for S2-S7 and Channel 1 above Channel 2). The sensed ECG trace and QRS markers are displayed in the lower half.

PROTOCOLS • THRESHOLD: Hotkey T. Helps determine the pacing threshold by continuously decreasing or increasing the pacing current amplitude. • The user needs to stop pacing when capture fails, and accept or modify default current. • NODAL_ERP: Hotkey N. Provide up to 3 autodecremented extra-stimuli for AV Node refractory measurements. S2-S4 may be auto-decremented by 50 msec above a value set by Config Var-36 and by the Decrement Auto parameter below that. • SNRT: Hotkey S. Displays an elapsed-seconds alarm timer and automatically decrements S1 after stopping pacing according to a SNRT. Table accessed by pressing(Ins) with the screen focus on the AUTO_DECREMENT OR S1 parameters while in the SNRT protocol. Note SNRT value calculation may not function correctly with catheter-tip sensing; use external EcG sensing to obtain SNRT calculation by the EPS320 Stimulator • PACE: Hotkey P. Select the Pace protocol to pace at a fixed interval set by S1 into selected pacing site. • BURST_PACE: Hotkey B. Regular pacing at S1 interval for a number of pulses defined in Train Variable. • Intra-burst decremental S1 pacing may be set by setting Decrement parameter to a desired decrement value. S1 will be decremented by this amount every 400ms, to the value set in Config Var-2. • See Config Var-18 to set up Rate Adaptive. • WENCKEBACH: decrements S1.

Hotkey

W.

Continuously

• Decrementation may be paused by continuous press of the (Spacebar) or optionally terminated by manual adjustment of S1. • See more options in the help menu for this protocol. • Multi_SX: Hotkey Z. Provides up to 6 autodecremented extra-stimuli primarily for programmed ventricular stimulation. • Defibrillator warning can be turned off by Config Var-38 to 0. • Manual adjustment of last Sx suspends next auto-decrementation and BSP key undoes last auto-decrement. • Double tap on Sx will take the Sx back up 10 msec and then return to the last Sx. • RSYNCED_SX: Hotkey R. Produces a train of up to 3 extra-stimuli coupled to a train of sensed complexes.

• DELAYED_AV: Hotkey E. Provides AV sequential pacing where S1 is the basic pacing interval and the S2 interval sets the AV delay.

PROTOCOLS continued • ATP-AICD: Hotkey L. ATP may be delivered at a preset % of the sensed VT cycle length set by S2 or at a fixed starting cycle length in ms set by S1. • S1 and %(S2) can be adjusted by the user prior to pacing. • Train length set by I. Auto decrement set by D. • A minimum S1 specific to this algorithm and intra-train S1 decrementation may be set by Config Var-4 and Config Var-19(Hotkey K). • OD_BURST: Hotkey O. Regular pacing at S1 interval for a number of pulses defined in Train Variable. • Intra-burst decremental S1 pacing may be set by setting Decrement parameter to a desired decrement value. S1 will be decremented by this amount every 400ms, to the value set in Config Var-2.

Press ‘G’ to return to previous protocols and parameters.

• See Config Var-18 to set up Rate Adaptive. • X-RS2: Hotkey X. Produces a train of up to 3 extra-stimuli coupled to a train of sensed complexes.

PACE SITE • ATRIUM Ch1: Hotkey A. Ch1 output. For optimum stimulator automation, this channel is typically used to stimulate the HRA, or the more proximal pacing site in the conduction tree. • VENTRIC Ch2: Hotkey V. Ch2 output. For optimum stimulator automation, this channel is typically used to stimulate the Ventricle, or the more distal pacing site in the conduction tree. • STIM3 Ch3: Hotkey ‘. General purpose channel. It shares the current generating circuit with Ch1, so EPS320 can’t stimulate both simultaneously. • STIM4 Ch4: Hotkey /. General purpose channel. It shares the current generating circuit with Ch2, so EPS320 can’t stimulate both simultaneously. • JOINED 1+2: Hotkey J. Simultaneous Ch1 and Ch2 stimulation. • In protocols without extra-stimuli, stimulation is simultaneous only into Ch1 and Ch2. • In protocols with extra-stimuli, a Menu allows independent connections of S1 to S7 pulses into either one or both channels. • The default menu setup is for S1 to pace both Atrium and Ventricle and extra-stimuli to pace only ventricle. • JOINED 3+4: Hotkey ]. Simultaneous Ch3 and Ch4 stimulation.

SENSE SITE • OFF: Hotkey ALT F. Turns of sense site. • ATR-Ch1/3 tip: Hotkey ALT A. Senses from the Atr stimulus channel pacing electrodes, which in Four channel pacing may be connected to either output channels CH1 or Ch3. • Note that you cannot Pace Ch3 and sense from Ch1 or visa versa.

• VEN-Ch2/4 tip: Hotkey ALT V. Senses from the Ventr stimulus channel pacing electrodes, which in Four channel pacing may be connected to either output channels CH2 or Ch4. • Note that you cannot Pace Ch4 and sense from Ch2 or visa versa.

SENSE SITE continued • EXT_ECG-1(A): Hotkey ALT 1. Senses from ‘ECG-1 Input’ at the rear of the SGU. • This should be connected to a HRA IECG (RTO) channel for optimal EPS320 performance. • EXT_ECG-2(V): Hotkey ALT 2. Senses from ‘ECG-2 Input’ at the rear of the SGU. • This should be connected to a RVA IECG (RTO) channel for optimal EPS320 performance. • AUTO_EXT: Hotkey ALT X. Senses from Ext_ECG-1(A) when pacing Atrium-Ch1 and from Ext_ECG-2(V) when pacing Ventr-Ch2. • Sense site remains Ext_ECG-1(A) when pacing Ch3 or Ch4 or Joined Ch 1+2 or 3+4. • AUTO_TIP: Hotkey ALT I. Automatically senses from the paced catheter tip. • Sense site is left unaltered when pacing Joined Ch 1+2 or 3+4.

QRS DETECT MENU • QRS Detect Menu: Hotkey ALT Q. Graphically displays the sensed ECG, and the process of QRS detection> • User can interactively adjust QRS-detecting parameters • Red line is ECG, Green line is QRS threshold, White line is baseline. • To change parameters, use hotkey or place cursor over parameter and press ‘+’ or ‘-’ keys to adjust. • While in QRS Detect Menu enter H for help and description of parameters. HOTKEYS

SOFTWARE CONFIGURATION • CONFIG Menu: Hotkey K. Software configuration including various safety limits and options may be changed by the Config utility. Password ‘service’. • To modify values, place the cursor over the variable and enter the new value. • Obtain help on any variable by pressing Hotkey H, when the cursor is over the variable. • CAUTION: Changing configurations will affect all users. • Programming of default Protocol Parameters: Hotkey ALT S. Default protocol parameters are loaded from a user definable defaults setup. To save new defaults for any protocol, set up parameters in the protocol as desired and press ‘ALT S’ and [enter]. • Default values for other parameters such as SyncToQRS, Train, Decrement and so on may be programmed similarly. • Storing multiple Protocol Defaults: Hotkey ALT S. You may store up to 5 different sets of Protocol Parameter defaults. • Store parameters as above except after pressing ‘ALT S’, enter a memory number from 1 to 5. Highlight number you want and press insert to rename Setup. • Retrieve a protocol by the ‘ALT-R’ hotkey, followed by the number of the memory. The currently loaded Parameter setup is displayed in the top left hand part of the screen. • The setup memory loaded is ‘1’ by default. This default may be altered by Config Var-39 to any value between 1 and 5. • Restoring factory Presets: Restore Config variables to factory defaults by selecting Config Var-40. This resets all Config variables to factory presets. • Restore Protocol parameters to factory presets by recalling memory ‘0’ by pressing ‘ALT-R’ and entering ‘0’ and then [enter].

WARRANTY SERVICE AND REPAIR Equipment Hotline:

800-872-3527

• Please consult appropriate product labels and inserts for indications,

contraindications, hazards, warnings, cautions, and directions for use.