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TELEMETRIC SYSTEM FOR MONITORING AND CONTROL OF CARDIAC ACTIVITY. TEMEO – The Principle TEMEO works in two modes – automatic mode and ECG mode. Automatic mode: This is the basic mode in which TEMEO works. Sensors on the chest send signal on every heart contraction
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TELEMETRIC SYSTEM FOR MONITORING AND CONTROL OF CARDIAC ACTIVITY www.ssi-bg.com
TEMEO – ThePrincipleTEMEO works in two modes – automatic mode and ECG mode. Automatic mode: This is the basic mode in which TEMEO works. • Sensors on the chest send signal on every heart contraction • A built-in accelerometer reports the physical activity • An electronic device receives the signals from the sensor and the accelerometer and forwards the information to the Telemedicine Center on every 5 minutes together with an ECG, representing the last 10 sec of the current 5-minute interval. ECG mode: There is a possibility for the patient to send a 10 sec ECG record to the Telemedicine Center anytime they feel some discomfort or worry. This is done by swithing TEMEO from automatic to ECG mode. www.ssi-bg.com
TEMEO device www.ssi-bg.com
Internet GSMNetwork TEMEOConcept TEMEO TEMEO TEMEO TEMEO Servers Medical Expert Medical Supervisors www.ssi-bg.com
TEMEO - Telemedicine center At the telemedicine center are analyzed the pulse, variability of the heart rate, some heart rate and conduction disorders, physical activity of the patient, current cardiovascular risk. Also a call is generated from the telemedicine center to either the patient, their GP or an Emergency Center if there is such need. www.ssi-bg.com
What type of information does TEMEO provide us? Supraventricular extrasystoles Ventricular extrasystoles Supraventricular extrasystoles in bigeminiya Ventricular extrasystoles in bigeminiya Atrial fibrilation Conduction disorders Bradycardia Supraventricular Tachycardia Ventricular Tachycardia ECG detailed visualization The results were verified through clinical investigations at MHAT “Dr. Hristo Stambolski” –Kazanlak and the National Cardiology Hospital. www.ssi-bg.com
RR – Physical activity • For every 5-minute interval sent to thetelemedicine center the system provides the following records: • A record of the heart rate (in green) put together with the physical activity of the patient (in blue) • An ECG record of the last 10 sec of this 5-minute interval (in yellow) www.ssi-bg.com
HRV analysesA variety of tolls for HRV analysis and processing www.ssi-bg.com
Report for a random periodThere is a possibility for generating a report for a random period of time about the following parameters: • Heart rate • Heart rate variability • Heart rate disorders • Conduction disorders www.ssi-bg.com
Normal day record - (Pulse rate and Physical activity) Respiratory Arrhythmia Normal night record - (Pulse rate and Physical activity)
Ventricular extrasystoles Supraventricularextrasystoles www.ssi-bg.com
Absolute Arrhythmia With patients with atrial fibrilationof basic interest are the leading, maximum and minimum heart rate during the different parts of the day, in rest and during physical activity. For all the patients the therapy was changed for better control of the heart rate and the effect of the changed dosages and the newly added drugs was immediately accounted. The system gave opportunity for registering the moments of paroxysmal atrial fibrilation of the patient with paroxysmal atrial fibrilation, as well as the heart rate during these moments. Absolute Arrhythmia www.ssi-bg.com
Physical activity Supraventricularextrasystoles When working with patients with acute myocardial infarction during their early rehabilitation, it is essentially important to watch closely their heart rate, the heart rate dynamics during physical activity and the efficiency of their beta blocking.The results from the extended tracking of these factors were used for adapting the treatment of the patients concerned by titration of the dose of the beta blocker. With one of the patients with inferior myocardial infarctionand RCA stent implementation, the system accounted a tendency for bradicardia up to 40-42 beats per minute at night and normal heart rates at day and during dosed physical activities. The system accounts the existence of ventricular extrasystole and shows its connection to the physical activity. Ventricular extrasystoles Physical activity www.ssi-bg.com
In conclusion, the collected data together with our experience show a very good tolerance to the devices on the patients’ side, when the system is working absolutely autonomously. The system works fully in automatic mode, which is a precondition for a good compliance. The initial placement of the device, as well as the Internet based tracking, do not place any special requirements to the supervising doctors. The collected data was useful in specifying the status and adapting the therapy of the patients. The system can be used for seriously ill patients with cardiac diseases, at hospitals or at home. The system is also very useful for active cardiac patients because it gives opportunity for extended monitoring during physical activity. “EVENT “ ECG www.ssi-bg.com
ECG TEMEO provides tools for filtering, processing and analysis of ECG. www.ssi-bg.com
Clinical research statistics: www.ssi-bg.com
ECG - Extrasystole www.ssi-bg.com
EXTRACTS OF LIFE www.ssi-bg.com
Ventricular extrasystole episodes of bigeminy type www.ssi-bg.com
Electrocardiographically verified atrial fibrillation Patient: M. S. K., 72 years old Entered the hospital on: 24.09.2009 Discharged from hospital on: 25.09.2009 Diagnosis: coronary artery disease. Stable angina FC II-III. PCI with stent implantation in SVG-DCA and stenting of SVG-OM1. Post-myocardial infarction-1989. Condition after ACB x 3-1999 (SVG-Ladd, CAD-PA, OM1). Atrial fibrillation. Hypertension III degree dyslipidemia. www.ssi-bg.com
Venticular exstrasystoles of trigeminy type www.ssi-bg.com
Interpolated venticular extrasystole www.ssi-bg.com
Venticular extrasystoles followed by a venticular tachycardia www.ssi-bg.com
Atrial flutter episode www.ssi-bg.com
Significant horizontal depression of the ST segment episode www.ssi-bg.com
Atrial fibrilation episode www.ssi-bg.com
Patient: T. I. T., 61 years old Complaints: episodes of tachycardia, not registered with ECG by the moment. TEMEO is placed. Initial record – normal rhythm. www.ssi-bg.com
On the third day of the medical supervision, during physical activity atrial fibrilation episode was registered with high heart rate. A voice contact with the patient was created and an emergency team was sent to him. The patient was brought to the ICD of MHAT “Dr. Hristo Stambolski” – Kazanlak, for treatment. After and hour the normal heart rate was restored. www.ssi-bg.com
Patient S.D.M., 55 years old, hospitalized in Neurology Department, diagnosed with ischemic stroke. In connection with atrial fibrillation suspicion, the patient is put a TEMEO. At the beginning – sinus rhythm. www.ssi-bg.com
On the forth day of the supervision an atrial fibrillation episode was detected. The patient was prescribed anticoagulation therapy for embolism prevention. www.ssi-bg.com
Patient D.I.I. – 65 years old. When hospitalized the patient was diagnosed with acute myocardial infarction of the LV. A coronarography was made in emergency and a stent was placed in the proximal segment of LAD. Due to the existence of frequent ventricular extrasystoles an ECG was made to register VLP. 3 positive signs of VLP were revealed (according to Davis criteria ). At discharge of hospital the patient was put a TEMEO for prolonged telemedical supervision. At the beginning – sinus rhythm. www.ssi-bg.com
On the third day of the supervision a paroxysmal ventricular tachycardia episode was registered. The patient was sent an emergency team and taken in Cardiac Department, where the tachycardia was taken under control by electrical cardioversion. www.ssi-bg.com
Patient living and working in Blackburn, England, watched over in the telemedicine center in Kazanlak, Bulgaria. The system works flawlesslywith patients, situated outside Bulgaria, the quality of the ECG and the automatic analysis remaining with excellentat the same time.
TEMEO C5 – two-channel record; Channel 1 – modified II standard lead. On this channel arrhythmias are observed. Channel 2 – modified V5 lead. On this channel depression and elevation of the ST segment are observed.
The philosophy of TEMEO products consists in the idea that we want to know about the diseases and their complications right now, at present, not tomorrow when it will be late. We have arrived at this conclusion as a result of our experience. For less than a year in the telemedicine center at the town 1300 patients have been looked after. www.ssi-bg.com
TEMEO - The FUTURE Best wishes!!! SSI together with ICD MHAT “Dr.H.S.” Kazanlak www.ssi-bg.com