Braemar ER920W User manual

Braemar Inc.
Phone: [phone]
1285 Corporate Center Drive, Suite 150 Fax: [phone]
Eagan, MN 55121 USA E-Mail: [email protected]m
Copyright 2010, Braemar Inc. All rights reserved
Braemar, Inc.
ER920W Wireless
Arrhythmia Event Monitor

ER920W Wireless Event Monitor
30
Recommended Separation Distances
Refer to the following table for recommended separation distances
between the ER920W and portable and mobile RF communications
equipment.
The ER920W is intended for use in an electromagnetic environment in
which radiated RF disturbances are controlled. The user of the ER9xx
can help prevent electromagnetic interference by maintaining a minimum
distance between portable and mobile RF communications equipment
(transmitters) and the ER9xx as recommended below, according to the
maximum output power of the communications equipment.
Separation distance according to
frequency of transmitter
Rated maximum
output power of
transmitter
W
150 kHz
to 80 MHz
d= 1.2 √P
80 MHz
to 800 MHz
d= 1.2 √P
800 MHz
to 2,5 GHz
d= 2.3 √P
0,01 0,12 0,12 0,23
0,1 0,38 0,38 0,73
1 1,2 1,2 2,3
10 3,8 3,8 7,3
100 12 12 23
For transmitters rated at a maximum output power not listed above,
the recommended separation distance din meters (m) can be
estimated using the equation applicable to the frequency of the
transmitter, where Pis the maximum output power rating of the
transmitter in watts (W) according to the transmitter manufacturer.
NOTE 1: At 80 MHz and 800 MHz, the separation distance for the
higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations.
Electromagnetic propagation is affected by absorption and reflection
from structures, objects and people.
Braemar Limited Warranty
Braemar products are warranted to be free from manufacturing and
material defects for a period of one (1) year from the date of shipment
from Braemar to the original purchaser. This warranty does not apply
to any product which Braemar determines has been modified or
damaged by the customer.
Excluded from this warranty are expendable supply items including, but
not limited to, electrodes, lead wires, patient cables and batteries.
Except for the express warranties stated above, Braemar disclaims
all warranties including implied warranties of merchantability and
fitness. The stated express warranties are in lieu of all obligations
of liabilities on the part of Braemar for damages, including but not
limited to, special indirect or consequential, arising out of or in
connection with the use or performance of Braemar products.
Any action for breach of warranty shall be commenced within one (1)
year of said breach or be forever barred. Any repairs made to the
product, which are not covered by the warranty, shall be billed to the
customer.
Device is to be serviced by Factory Authorized Technicians only. Do
not attempt to repair, modify, or service the Braemar ER920W wireless
arrhythmia monitor.
Do not attempt to open or tamper with recorder case. Opening the
case will void recorder warranty.
Document Number: 600-0640-00
Revision: D
Date: November 2010

ER920W Wireless Event Monitor
29
NOTE:
This equipment has been tested and found to comply with the limits for a
Class B digital device, pursuant to Part 15 of the FCC Rules. These
limits are designed to provide reasonable protection against harmful
interference in a residential installation. This equipment generates, uses
and can radiate radio frequency energy and, if not installed and used in
accordance with the instructions, may cause harmful interference to radio
communications. However, there is no guarantee that interference will
not occur in a particular installation. If this equipment does cause
harmful interference to radio or television reception, which can be
determined by turning the equipment off and on, the user is encouraged
to try to correct the interference by one or more of the following
measures:
• Reorient or relocate the receiving antenna.
• Increase the separation between the equipment and
receiver.
• Connect the equipment into an outlet on a circuit
different from that to which the receiver is connected.
• Consult the dealer or an experienced radio/TV
technician for help.

ER920W Wireless Event Monitor
28
The internal wireless radio operates within guidelines found in radio
frequency safety standards and recommendations, which reflect the
consensus of the scientific community. Braemar Inc. therefore believes
the internal wireless radio is safe for use by consumers. The level of
energy emitted is far less than the electromagnetic energy emitted by
wireless devices such as mobile phones SAR value of 0.541W/kg max.
However, the use of wireless radios may be subject to governmental
and business restrictions, including but not limited to air travel and
hospital visitations. If you are unsure of restrictions, you are
encouraged to ask for authorization before turning on the wireless radio.
Radiofrequency radiation exposure Information
For body worn operation, this device has been tested and meets the FCC
RF exposure guidelines when used with the Braemar pouch and
accessories supplied or designated for this product. See Page 22 for a list
of accessories and part numbers.
Use of other accessories may not ensure compliance with FCC RF
exposure guidelines.
NOTICE: This device complies with part 15 of the FCC rules and with
RSS-210 of Industry Canada. Operation of this device is subject to the
following two conditions: (1) This device may not cause harmful
interference; (2) This device must accept interference received including
interference that may cause undesired operation.
Changes or modifications made to this equipment not expressly approved
by (manufacturer name) may void the FCC authorization to operate this
equipment.
ER920W Wireless Event Monitor
1
Table of Contents
Overview...................................................................................................2
Indications for Use....................................................................................2
Precautions...............................................................................................3
Monitor Components ................................................................................4
Setup Steps ..............................................................................................5
Electrode Application and Placement .......................................................5
1 and 2 Channel (4 Lead) Electrode Placement .......................................6
Monitor Preparation ..................................................................................7
Patient Operating Instructions ................................................................15
Troubleshooting (page 1 of 2).................................................................19
Event Markings.......................................................................................21
Service and Maintenance .......................................................................22
Service Items and Accessories...............................................................22
Equipment Symbols................................................................................23
Specifications .........................................................................................24
Electromagnetic Emissions.....................................................................25
Electromagnetic Immunity ......................................................................25
Recommended Separation Distances ....................................................30

ER920W Wireless Event Monitor
2
Overview
The ER920W Wireless Event Monitor is a battery operated, solid state,
looping event recorder designed to record symptomatic heart
arrhythmias. Event recording is activated by the patient or by automatic
event detection.
The ER920W (1 or 2 channel) event monitor provides up to 30 minutes
of total recording time and will operate as a simple looping event
recorder for a minimum of 30 days with the Lithium Thionyl battery
pack. It offers multiple programmed recording options allowing the
physician to determine their own parameters. Selectable parameters
include number of events, pre-event time, post-event time, audible
operation, pacemaker detection, and arrhythmia detection.
The ER920W event monitor is enhanced with Arrhythmia Detection
firmware which will capture and automatically record asymptomatic,
infrequent, or elusive heart arrhythmia events such as Bradycardia,
Tachycardia, Pause, and Atrial Fibrillation.
Once an event is recorded, the event ECG is automatically transferred via
a digital cellular link or can be manually transferred transtelephonically
(TTM) via a land line phone.
Indications for Use
The device is indicated for diagnostic evaluation of patients who
experience transient symptoms such as; dizziness, palpitations, syncope,
or chest pain. The device is intended to record cardiac activity associated
with these infrequent and transient symptoms. Once data is recorded,
patients transmit the recorded ECG data over the telephone or directly to
a host PC for review by a licensed physician.
ER920W Wireless Event Monitor
27

ER920W Wireless Event Monitor
26
ER920W Wireless Event Monitor
3
Precautions
A. Patient leads must be removed from electrodes before defibrillation.
B. Observe local laws for disposal of lithium batteries.
C. Do not leave the batteries in the Monitor when it is not in use.
Damage from corrosion could result.
D. Patient should be instructed to avoid close proximity to heavy
electrical equipment or other sources of electromagnetic
interference.
E. Device should be powered with Factory supplier battery packs only.
Do not use any other batteries, mix batteries, or use other power
supplies in the Braemar ER920W wireless arrhythmia monitor.
F. Do not use cellular phone to transmit patient data.
G. Monitor is not for infant use.
H. No automatic analysis algorithm can replace data review by a
qualified physician. Review and confirmation of analysis results is
required.
Additional equipment classification information as required in EN 60601-1
A. EQUIPMENT not suitable for use in the presence of a
FLAMMABLE ANAESTHETIC MIXTURE WITH AIR or WITH
OXYGEN OR NITROUS OXIDE
B. IPX0 Ordinary Equipment (enclosed equipment without protection
against ingress of water)
C. Internally Powered Equipment
D. Mode of Operation - Continuous Operation

ER920W Wireless Event Monitor
4
Monitor Components
Batteries ONLY use a 3.6V Lithium Thionyl battery pack.
Insert into battery compartment observing
polarity symbols.
Patient Cable To adjust, move plastic slip rings up or down to keep
leads together. To lengthen, pull leads apart.
Caution: Only use a Braemar supplied 3.6 V
Lithium Thionyl battery pack. Do not use any
other battery in the ER920W. Use of any other
battery pack or mixing batteries may cause
overheating and/or damage the device. Use
caution to observe correct polarity when
inserting battery pack in the device. Failure to
follow these instructions may cause damage to
the device and will void the Manufacturer’s
Warranty. Please dispose of exhausted battery
packs according to local laws.
U.S. Federal law restricts this device to sale by or on the order of a
physician.
ER920W Wireless Event Monitor
25
Electromagnetic Emissions
Emissions test
Compliance Electromagnetic
environment – guidance
RF emissions
CISPR 11
Group 1 The ER920W
uses RF energy only
for its internal function. Therefore,
its RF emissions are very low and
are not likely to cause any
interference in nearby electronic
equipment.
RF emissions
CISPR 11
Class B The ER920W is suitable for use in
all establishments, including
domestic establishments and those
directly connected to the public
low-
voltage power supply network
that supplies buildings used for
domestic purposes.
Electromagnetic Immunity
Immunity test IEC 60601
test level
Compliance
level
Electromagnetic
environment - guidance
Electrostatic
discharge (ESD)
IEC 61000-4-2
±6 kV contact
±8 kV air
±6 kV contact
±8 kV air
Floors should be wood,
concrete or ceramic tile. If
floors are covered with
synthetic material, the relative
humidity should be at least
30%.
Power frequency
(50/60 Hz)
magnetic field
IEC 61000-4-8
3 A/m 3 A/m Power frequency magnetic
fields should be at levels
characteristic of a typical
location in a typical
commercial or hospital
environment.

ER920W Wireless Event Monitor
24
Specifications
Functional
ER920W Wireless 1 or 2 channel
Max Number of events 30
Sample rate 256 samples per second
User interface LCD display and sound
Memory
Max event time
One channel 30 minutes
Two channel 30 minutes
Max total record time
One channel 30 minutes
Two channel 30 minutes
Type Flash
Data retention Non-volatile
Physical
Dimensions 2.82"x 4.33" (5.16” w/antenna) x .90"
(71.6mm x 109.9mm [131.06mm] x 22.86mm)
Weight with batteries 5 oz.
Enclosure Molded plastic
Operating position Any orientation
Electrical
Input impedance 2M min.
CMR ratio 60dB
AC signal range +/- 3mV
DC signal range +/- 300mV
Resolution 23uV (8bits)
Frequency response .05Hz to 40Hz
FCC ID HHMER920W-AF
IC ID 9158A-ER920WAF
Environmental
Operating temperature 0°C to +45°C
Non-operating temperature -20°C to +65°C
Operating humidity 10% to 95% (non-condensing)
Non-Operating humidity 5% to 95%
Transtelephonic Transmission
Transmit carrier 1900Hz
Carrier deviation 100Hz/mV
Battery
Type (1) 3.6V Lithium Thionyl Battery Pack
Life 300 transmissions, typically 30 days min.
Remove batteries during storage
Warranty 12 months from shipment
ER920W Wireless Event Monitor
5
Setup Steps
This manual is designed to allow a technician to follow the instructions
page by page to set up the ER920W. Here is the general layout:
1. Connect leads and electrodes to patient.
2. Prepare Monitor for recording.
A. Select program settings you want to use.
B. Erase all previous events.
3. Connect Patient Cable to Monitor.
Electrode Application and Placement
For each electrode lead wire:
1. Check the Patient Cable for any damage. Do not use damaged or
broken cables.
2. Snap the electrode onto the lead wire.
3. Remove the protective backing from the adhesive side of the
electrode.
4. Apply the electrode to the patient’s skin per Electrode Placement
diagram in this manual or as instructed by the physician.
NOTES:
A. The ER920W will support either a 1 Channel or 2 Channel
cable.
B. It is recommended that trained medical personnel instruct the
patient in the proper application of electrodes.
C. Use good quality long term electrodes. Braemar recommends
the use of low impedance Holter electrodes. Instruct patient to
apply fresh electrodes regularly. (Usually on a daily basis.)
D. Proper preparation of the patient's skin is absolutely essential
for obtaining a quality ECG recording. The skin surface where
the electrodes will be placed should be cleaned with alcohol,
allowed to dry, and abraded.
E. Any loose electrode needs to be replaced.

ER920W Wireless Event Monitor
6
1 and 2 Channel (4 Lead) Electrode Placement
This is a typical electrode placement. Refer to Analysis System software
and the physician for recommended positioning.
1 and 2 Channel Electrode Placement
Use only Channel 1 if you have a single channel cable.
Channel 1
= White and Red (V5 vector)
Channel 2
= Black and Brown (V1 vector)
ER920W Wireless Event Monitor
23
Equipment Symbols
Symbol Description
Type B Applied Part
Attention: Consult accompanying documents.
SN Serial Number
Date of Manufacture
Manufacturer name and address
Manufacturer:
Braemar, Inc.
1285 Corporate Center Drive, Suite 150
Eagan, MN 55121 USA
Phone: [phone]
651.286.8620
Fax: [phone]
E-mail: [email protected]
Web: http://www.braemarinc.com
Contact Braemar for further technical information.

ER920W Wireless Event Monitor
22
Service and Maintenance
Cleaning
Routine cleaning should be performed before each patient use. Remove
the batteries before cleaning the recorder. Clean the battery terminals
with a soft dry cloth. Dampen a soft cloth with mild detergent and water
to clean the recorder, lead wires, and belt clip.
Remove any adhesives from the patient lead wires with an adhesive tape
remover solution or swab. Use a mild disinfectant. Do not use alcohol
or acetone on the lead wires since they could stiffen and the insulating
plastic could crack.
Service
If there is a problem with the Monitor, refer to the Troubleshooting
section and review the symptoms and solutions. If additional assistance
is required contact customer support via phone, Fax or E-mail listed on
the next page. Call customer support before returning a Monitor to make
shipping arrangements.
A. Note there is not any preventative inspection or maintenance
that can be performed by the end user.
Service Items and Accessories
Description Part Number
Patient lead, 1 channel, Shielded 350-0173-09
Patient lead, 2 channel, Shielded 350-0173-10
Pouch 100-1894-001
Lanyard 350-0304-00
Operator manual 600-0640-00
3.6V Lithium Thionyl Battery Pack 350-0294-00
NOTES:
A. Only accessories listed above are meant for use with the Monitor.
B. Dispose of batteries in accordance with Federal, State, and Local
laws.
ER920W Wireless Event Monitor
7
Monitor Preparation
1. General setup:
Remove the Patient Cable if it is connected to the Monitor. Open the
battery compartment by sliding battery door downward. Install the
battery pack of AA Lithium Thionyl batteries. Observe proper battery
polarity. The Monitor will sound rising tones after completion of power
up. After a few seconds, the display will show the battery level and
number of events stored.
The battery level should read 100% for the battery pack and should
be near 100% with a fresh battery pack of AA Lithium Thionyl
batteries. The number of events stored does not matter at this point.
When the device detects the battery it is ready to monitor, record,
and send patient data files via wireless communication and the
following screen will be displayed:
Conditions which may cause the “ ” symbol (cellular
communication has been disabled) to be displayed:
•Low batteries
•Initialization with cell tower failed
•Wireless setting in program menu is set to “Off”

ER920W Wireless Event Monitor
8
2. Enter programming mode:
A. Push and hold both program buttons on the front of the Monitor
until an audible tone is heard.
B. The Monitor will then display an information screen. Press the
RECORD/SEND button to get to the programming mode
screen.
General Notes:
A. To leave the programming mode without saving your changes,
remove the batteries.
B. If you enter the programming mode, events stored in the
Monitor are always erased when the Monitor restarts and a
Patient Cable is connected.
NOTE:
•Be sure to send all stored events prior to entering
programming mode to avoid losing stored patient
files.
C. All previously stored events and settings are erased when you
select EXIT on the last programming screen.
D. The Monitor always highlights the DEFAULT option when
entering programming mode even if the CUSTOM option was
last used. Whatever option was used for a previous recording
will continue to be used.
E. Previously saved settings are displayed when viewing the
CUSTOM programming screen.
F. Factory default settings are indicated by a “ )( ” (asterisk) in
front of the setting.
G. Use the program buttons to view and select program settings
options; THEN press the RECORD/SEND button to confirm
the selected setting. Pressing RECORD/SEND also advances
the screen to the next program setting.
H. Lead loss detection is enabled all the time.
I. The number of channels a Patient Cable contains will determine
the number of channels the Monitor will record.
J. When a new monitoring period is started, a fresh pack of AA
Lithium Thionyl batteries should be used.
ER920W Wireless Event Monitor
21
Event Markings
The following shows typical event markings that are generated by the
Monitor and appear on the receiving station strip chart.

ER920W Wireless Event Monitor
20
Troubleshooting (page 2 of 2)
Batteries were pulled during programming.
Displays “Stopped” at top
of LCD At completion of TTM (sound) data transmission, unit is
“stopped”.
NOTE: Neither condition is a problem. Power cycle or
finish programming.
Mouthpiece of phone must be close to the Monitor speaker
hole.
Check telephone connection. Listen to phone line before
sending event(s) to ensure there is no noise.
Have patient call back and send ECG again.
Noise artifact on recorded
ECG at receiving center
Have patient try another phone.
Electrodes must be securely attached to patient.
Patient should remain still while recording.
Replace Patient Cable. Pulling on lead wires may damage
cable.
Verify the recording did not take place near a source of
electromagnetic interference (fluorescent lights, computer
monitors, or household appliances).
Noise artifact on recorded
ECG at patient location
Move electrodes slightly to the right or left of the original
location.
All or groups of timestamps
for recordings are the
same
If the inadvertent loss of power occurs, all the timestamps
in the FSK will reset to the time the unit powered back up.
Subsequent recordings will have time stamps relative to the
power up time.
Falling tone Transmission complete.
Rising tone Ready to record.
Low batteries. Not enough power to register cellular modem
with tower. Try new batteries.
Initialization with cell tower failed. Cycle battery power.
Ensure unit turns off completely. Re-insert batteries. If
condition continues with different batteries or additional
power cycles, contact customer service.
displayed (cellular
communication has been
disabled)
Wireless setting in program menu is set to OFF. Turn ON.
ER920W Wireless Event Monitor
9
Note about Arrhythmia and AFIB detection:
A. To change Arrhythmia and AFIB settings you must access the
CUSTOM program option.
B. The Arrhythmia and AFIB algorithms can be used
independently.
C. There is no guarantee arrhythmia detection algorithms will
detect all episodes of arrhythmia. For maximum efficacy, use
the most sensitive settings.
Notes about Sound:
A. Lead loss sound overrides the POST-EVENT SOUND setting.
B. If the Monitor detects lead loss during a recording, the Monitor
will produce an audible sound of the event until the recording is
complete. You can mute this sound by using the AUDIO setting
after the recording is complete.
C. The AUDIO setting can only be accessed before or after an
event is recorded. Trying to access the AUDIO setting during
a recording will cause the recording to stop.
D. The AUDIO setting controls many of the sounds produced
during the monitoring period. Audio may be turned ON or
OFF. The AUDIO screen can be accessed during normal
monitoring conditions (Patient Cable inserted) by pressing only
one of the programming buttons until an audible sound is heard.
The AUDIO screen will exit after 10 seconds of inactivity.
E. The AUDIO setting defaults to ON every time the Monitor is
powered up.
F. The AUDIO setting defaults to ON every time the Patient Cable
is removed. This is to enable the Monitor to send events to the
receiving center.

ER920W Wireless Event Monitor
10
3. Choose program:
Choose either the DEFAULT or CUSTOM option. The CUSTOM
option allows changes to all of the following settings.
NOTES:
A. Factory default settings in the Monitor are indicated by a “ )( ”
in front of the setting.
B. Choosing the DEFAULT option will program the monitor with
the factory default values, erase previous patient data, and
restart the monitor.
Programming settings:
Display Option Description
DISPLAY
CONTRAST
Default = NA
Set the contrast of the display. A
higher number will cause darker
text on the screen.
PRE-EVENT
TIME
Default = 30 sec
Seconds of ECG data stored
before event activation time. 300
seconds total can be split
between Pre and Post events.
(Programmable 5-295 sec in 5
second increments)
POST-EVENT
TIME
Default = 30 sec
Seconds of ECG data stored after
event activation time.
(Programmable 5—295 seconds
in 5 second increments)
POST-EVENT
SOUND
Default = OFF
ON = Sound on while recording
during the Post-Event time.
OFF = Sound off while recording
an event. See Notes about sound
for additional information.
ER920W Wireless Event Monitor
19
Troubleshooting (page 1 of 2)
Symptom Recommended Solution
No display Ensure batteries are inserted with correct polarity.
Cannot enter programming
mode
The Patient Cable must be removed and the batteries
installed. Then follow instruction in manual.
A good connection must be made from the Monitor to the
patient to be able to access the AUDIO setting.
While monitoring, press and hold only one of the
programming buttons until an audible sound is heard to
access the AUDIO setting.
Cannot access AUDIO
setting,
Patient wants to mute
Monitor.
AUDIO setting cannot be accessed during a recording.
Wait until end of recording, then access AUDIO screen.
No phone ring at end of
recording
AUDIO setting is turned OFF, which mutes most sounds.
Ensure patient electrodes/leads are connected to patient
properly. Is the Patient Cable damaged in some way?
Ensure Patient Cable is inserted completely.
No beep when inserting
Patient Cable
Patient Cable has more channels than Monitor can use.
Match the number channels for the cable and Monitor.
Memory full-Phone Ring. Follow instructions To Send and
Erase Events.
Ensure Patient Cable is inserted completely.
Will not record
Ensure RECORD/SEND button is held until an audible
sound is heard.
Monitor stops recording. Holding any button for two seconds while recording will
cause the Monitor to stop recording. This includes trying to
access the AUDIO setting.
Siren (alternating) tone
while recording
There is not a good connection. Check that electrodes/leads
have a good connection to patient and cable is plugged into
Monitor.
Monitor restarts and
erases stored events
Changing the Patient Cable to a different number of
channels tells the Monitor to restart and erase all events.
Phone ring sound every
hour
Memory has event(s) to be transmitted to the receiving
center.
Phone ring sound every
minute for 10 minutes
Memory is full; follow instructions To Send and Erase
Events.
Phone ring sound when
RECORD/SEND button is
pushed
Memory is full; follow instructions To Send and Erase
Events.
Phone ring sound once An event is already stored in memory at start up, also heard
at the end of a recorded event. Follow instructions To Send
and Erase Events.
Three beeps every five
minutes with cable inserted
Batteries are low. Replace batteries and/or clean battery
contacts.
Make sure mouthpiece of phone is directly over Monitor
speaker.
No information received by
receiving center
Ensure RECORD/SEND button is held for two seconds.

ER920W Wireless Event Monitor
18
4. Follow receiving center instructions.
A. When instructed, place the telephone mouthpiece over the
Monitor speaker hole.
B. Push the RECORD/SEND button until you hear audible sounds.
“SENDING” will be shown in the upper left hand corner of the
display while the recording is being sent.
•A falling tone will sound when the transmission is complete
and “STOPPED” or “MEMORY FULL” will be shown in
the upper left hand corner of the display.
•Pressing RECORD/SEND during transmission will abort
the transmission. Pressing RECORD/SEND again will re-
send the recording.
5. When instructed that the events have been sent successfully, it is OK
to erase events by reinserting the Patient Cable. (The Monitor will
restart and you will then hear a rising tone.)
Receiving a Text Message:
The ER920W monitor can receive text messages from the technician.
Messages up to 40 characters can be displayed on the LCD of the
recorder. This allows communications back to the patient.
NOTE:
A Text message received by a recorder will initiate a beeping sequence
alerting the patient of a new incoming message. The TEXT message and
beep sequence can only be disabled by the monitoring center or by
pressing one of the programming buttons (arrow button) until the sound
is muted.
Erase Events:
Events are automatically erased after a successful digital transmission.
There is not any patient interaction required for this erasure to occur.
Manually Erase Events:
1. Insert the Patient Cable. The Monitor will restart, erase the stored
events and emit a rising tone.
ER920W Wireless Event Monitor
11
Display Option Description
HOURLY
REMINDER
Default = ON
ON = Ring every hour when an
event is stored in memory.
OFF = Do not remind patient an
event is stored in memory.
PREVIEW TIME
Default = 30 sec
The number of seconds the ECG
signal is displayed for each
channel when the patient cable is
inserted.
TRANSMIT
SPEED
Default = 1X
File transmission speed for TTM
data transfer to Central Receiving
station.
PACEMAKER
DETECTION
Default = ON
Program Pacemaker detection
ON/OFF.
ARRHYTHMIA
DETECTION
Default = ON
Program Arrhythmia Detection
ON/OFF.
Select “ON” to program, Brady
Rate, Tachy Rate, and Pause
duration rate thresholds.
BRADY RATE
Default = 45 bpm
(Arrhythmia Detection must be
on to access this function)
TACHY RATE
Default = 160 bpm
(Arrhythmia Detection must be
on to access this function)
Continue on next page

ER920W Wireless Event Monitor
12
User Defined options continued
.
Display Option Description
PAUSE DURATION
THRESHOLD
Default = 3.0 sec
(Arrhythmia Detection must be
on to access this function)
AFIB
DETECTION
Default = ON
-AF devices only-
# OF EVENTS Total number of events the
monitor will store. The
maximum number allowed is
dependent on Pre and Post Event
times.
WIRELESS
MODEM
Default = ON
Select wireless modem ON/OFF.
“OFF” requires TTM file
transmissions.
EXIT OR
REVIEW
PROGRAM
See step about leaving
programming mode for
information.
4. Exit program mode and erase events:
Choose EXIT from the last programming mode screen and press the
RECORD/SEND button. The Monitor will restart.
NOTE:
A. Choosing EXIT will erase all stored events and save your
settings over the top of previous program settings. Choosing
REVIEW will allow you to changes program settings.
ER920W Wireless Event Monitor
17
Send Data via wireless transmission:
In most cases, events are automatically downloaded to the receiving
center via digital cellular link. There is no patient interaction required for
this transmission to occur. One event will be stored before it is sent to
the receiving center.
When the device is transmitting an event, a value (*3 for example) will
be displayed in the upper right hand corner of the LCD. This value
represents the quality of the signal strength which the modem has
detected when transmitting the event. This value has a range of *0 - *5,
*5 being the most robust signal possible.
Upon successful transmission of data, the device will connect to the
server according to the table below to check for any text messages.
Hours since
Last ECG: 1 2 3 4 5 6 7 8 9
10+
Reconnect
time: Once
every
15
min
30
min
60
min
60
min
60
min
60
min
60
min
60
min
60
min
24
hrs
If a text message is received in the first hour since the event was sent, the
device will reconnect to the server every 5 minutes to check for
additional commands or other text messages, otherwise the
communication protocol will follow the above table.
If an appropriate cellular signal is not present and the transmission of the
event was unsuccessful, the monitor will try an additional 3 times, once
every 5 minutes. If communication to the server fails three times the
device will output a phone ring alerting the patient of a stored event.
The patient can then send the event to the receiving center manually as
described below.
If the patient does not send the event manually and the event is still
stored, the device will retry to connect to the server after 60 minutes.
To Manually Send Events via TTM:
1. Remove the Patient Cable from the Monitor.
2. Set the Monitor on a flat surface with the speaker hole up.
3. Call the receiving center.
A. Cell phones and VOIP phones do not work for the transmission.

ER920W Wireless Event Monitor
16
To Record:
1. Press the RECORD/SEND button until an audible sound is heard,
then release.
NOTES:
A. To stop a recording, press the RECORD/SEND button again
until an audible sound is heard.
B. “RECORDING” will flash in the upper left hand corner of the
display.
2. Hold as still as possible during recording but continue breathing.
3. The recording is complete and ready to send when a phone ring is
heard from the Monitor.
NOTES:
A. The display will also show that an event is stored in the
Monitor. If the memory is full, follow instructions To Send and
Erase Events
B. You can mute many of the sounds from the Monitor by pressing
only one of the programming buttons until the speaker is
displayed. This screen allows you to select whether AUDIO for
the Monitor is turned ON or OFF, or will immediately mute the
device if it is displaying a message from your service.
C. The AUDIO setting defaults to ON every time the Monitor is
powered up.
D. The AUDIO setting defaults to ON every time the Patient Cable
is removed. This is to enable the Monitor to send events to the
receiving center.
Automatic Record:
If Arrhythmia Detection is ON and an event is detected, the Monitor will
beep at the start of the recording only if the wireless transmission option
is not active. When the recording is complete and ready to send a phone
ring will be heard from the Monitor if the patient must send the recording
manually via TTM. An event will show on the display under all
circumstances.
A. The last event location is always reserved for a manual
recording.
ER920W Wireless Event Monitor
13
Alternate method to erase events:
If you don’t want to enter the programming mode, you can also
erase events by the following sequence.
A. Remove the Patient Cable.
B. Hold the RECORD/SEND button until audible tone is heard.
You will hear the transmission of any events stored in the
Monitor. At the end of the transmission you will hear a falling
tone and the Monitor will display STOPPED in the upper left.
C. Inserting the Patient Cable at this time will erase all events and
restart the Monitor.
5. Connect the patient:
A. At this time, the patient leads should be connected to the
electrodes and the electrodes should be connected to the patient.
B. Insert the Patient Cable into the Monitor.
NOTE:
•If the patient is connected correctly, the Monitor will sound
one beep for a single channel cable or two beeps for a two
channel cable.
C. View the display just after the Patient Cable is connected. It
will show the signal from each channel of the cable.
NOTES:
•There will be an accompanying beep for the channel
number displayed.
•The Monitor will not respond to any button presses other
than Record Event during the preview time.
•Square wave will be displayed on
the LCD if a good patient
connection is not established. An
adequate connection with good
ECG signal must occur before the
ER920W wireless arrhythmia monitor initiates monitoring.

ER920W Wireless Event Monitor
14
6. The Monitor is ready to record events.
A. The general settings of the Monitor are displayed during
operation by the number of dots after the word
“MONITORING” shown on the display.
Display Setting
MONITORING No Arrhythmia or AFIB
MONITORING.Arrhythmia only
MONITORING.. Arrhythmia and AFIB
MONITORING…AFIB only
ER920W Wireless Event Monitor
15
Patient Operating Instructions
Display overview:
To Connect Monitor:
1. Snap lead wires onto electrodes first, and then apply electrodes
according to physician instructions.
2. Reapply fresh electrodes daily.
3. Insert the Patient Cable into the Monitor.
NOTES:
A. Depending on the cable, there should be a single or double beep
that indicates a good patient connection. If no beep is heard,
double check cable connections.
B. Viewing the display just after the Patient Cable is connected
will show the signals from each of the channels. There will also
be an accompanying beep for the channel number displayed.
C. The Monitor will not respond to any button presses other than
Record Event during the preview time.
D. Square wave will be displayed on the
LCD if a good patient connection is not
established. An adequate connection with
good ECG signal must occur before the
ER920W wireless arrhythmia monitor
initiates monitoring.
E. Monitor is now looping and ready to record.