Progetti EPG 6 View Plus User manual

User’s manual
Edition III – Rev. March 2010

EPG 6 View Plus Electrocardiograph – User’s Manual
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Edition Date Changes Editor
02 08.02.09
Format changes
Added CE Declaration of Conformity
Improved functionality – added configuration option
of AUTO Examination printout
DM
03 27.07.09
Changes in functionality:
Import of Examinations from PENDRIVE
Preview of Examinations on main display
Additional adaptive filter
Additional printout formats
Different frequencies of isoline filter available
DM

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Contents
CONTENTS 2
INTRODUCTION 4
PRECAUTIONS AND SAFETY INSTRUCTIONS 4
DESCRIPTION 5
INSIDE THE BOX (SUPPLIED ACCESSORIES) 5
OVERVIEW 6
ELECTROCARDIOGRAPH UNIT 6
STEERING TOP PANEL -KEYBOARD 6
FUNCTION KEYS 7
LCD SCREEN 7
TECHNICAL SPECIFICATIONS 8
USING THE APPLIANCE 8
FUNCTIONAL ABILITIES 8
PRELIMINARIES 9
PAPER LOADING 10
SETTING UP RECORDING PARAMETERS 11
ARRANGEMENT OF ELECTRODES 12
ENTERING PERSONAL INFORMATION OF THE PATIENT 13
EXAMINATION IN AUTOMATIC MODE 13
EXAMINATION IN MANUAL MODE 14
MAKING THE COPY OF EXAMINATION 15
MANAGING THE MEMORY 15
CONFIGURATION 17
MENU NAVIGATION MAP 20
CLEANING,CONCURRENT DISINFECTION,MAINTENANCE 21
OPERATING AND TRANSPORT ENVIRONMENTAL CONDITIONS 21
MANUFACTURER’S DECLARATION OF CONFORMITY
FOR THE ELECTROMAGNETIC COMPATIBILITY 22

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Introduction
Electrocardiogram is the graphic presentation (ECG diagram) of electrical activity of the heart
over time. It allows to examine the mechanism and place where electrical impulses occur. It
also enables to check how it works in electrical system and heart muscle and allows to learn
its reactions.
Indirectly, it allows to examine and diagnose heart muscle behavior, its perfusion, oxidation
and tightness. Deviations in ECG record can help to recognize morbid conditions causing
invalid heart muscles work, or its reaction to electrical stimulus reducing perfusion and
oxidation of that muscle, what causes bad impulses to occur or their incorrect flow. Consider
emphasized that ECG is only one of the supplementary examinations which reveals its full
potential only with full clinical view of patient’s condition. Some exception can be the
myocardial infraction (not always) where the ECG record is evident and unequivocal what
enables to make right diagnosis – showing also the exact place in heart muscle area – without
seeing the patient. In the rest of heart illness cases ECG seems to be rare authoritative, but it is
a vital supplemental examination.
EPG 6 VIEW PLUS Electrocardiograph allows to record on thermal paper heart impulses in
full range of 12 standard channels. The device is compact. It has small dimensions and a built-
in battery. It allows to conduct examinations in all conditions. It is crucial for cardiologic
departments as much as for family doctor’s job.
Precautions and Safety Instructions
All the safety and operating instructions should be read before the appliance is
operated. It will help in correct using and servicing of the device making it long-time
life and safe tool.
It is vital to check periodically the correct work and quality of accessories and device
itself. In case of doubts, please contact qualified service personnel.
Most vital thing is to instantly pay attention to power cord which should be free from
any damage. It will eliminate a risk of electric shock to persons.
Using the device simultaneously with cardio stimulators or any other kind of electric
stimulators does not expose both patients and personnel to any danger.
It is very important not touch neither patient nor any device connected to him during
defibrillation.
Electrocardiograph can not be used simultaneously with any surgical devices
operating on high frequency.
To keep ECG record long-time archived, it is needed to make Xerox copy of printouts
or print them on outside printer operating on regular copy paper. Thermal paper which
is used to work with the device is fragile to environmental factors what can cause the
printouts unreadable after some time.
The device is not adjusted to work in places where inflammable fumes or
combustibles occur.
In case of simultaneous connecting the electrocardiograph with other devices to
patient, it is necessary to check the risk that may occur of summarizing of leakage
currents.
Electrocardiograph has CF safety protection type. It allows to do examinations directly
on patient’s heart.
Always connect electrodes with maximum caution avoiding connectors not touch any
metallic parts, including ground.

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Do not attempt to service the appliance yourself as opening or removing covers may
expose you to dangerous voltage or other hazards. Refer all servicing to qualified
service personnel.
Relocating the device between places with extremely different temperature may cause
moisture condensation inside. If condensation does occur, neither plug the appliance
to the power nor turn it on. Wait a few hours till the unit will have warmed up and any
condensation will have evaporated.
Description
EPG 6 VIEW PLUS electrocardiograph is a sophisticated and modern electronic device. It is
dedicated to record ECG impulses in full range of 12 standard channels. Printout is made on
thermal paper. The device is equipped with high resolution linear thermal printing unit and
color LCD. The built-in battery allows to use it quickly wherever it is necessary. Aesthetic
plastic cover together with membrane keyboard makes the device easy to keep clean.
Inside the box (supplied accessories)
Make sure you have the following accessories:
In Box Qty.
1. The device – EPG 6 VIEW PLUS
electrocardiograph 1 pc.
2. Clamp electrodes 4 pcs.
3. Sucker electrodes 6 pcs.
4. ECG cord 1 pc.
5. Power cord 1 pc.
6. ECG thermal paper 112mm wide 1 pc.
7. ECG gel 1 pc.
8. User’s manual 1 pc.
If some of above accessories are missing please contact your reseller or supplier.
MANUFACTURER/DEALER/ASSEMBLER:
PROGETTI S.R.L.
0197

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Overview
Electrocardiograph unit
Steering top panel - keyboard
paper feeder power socket USB connectors
electrodes connector
keyboard
LCD display
paper cover
release button

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Function keys
AUTO
Recording – automatic mode
START
Recording – manual mode
STOP
Stop recording
mm/mV
Setting recording sensitivity
mm/s
Setting recording speed
FILTR
Setting active filters
3/6/12
Setting the number of leads to be recorded
I,II..V6
Setting the group of leads to be recorded
MENU Configuration mode
Esc
Return one level up
LCD screen
recording
speed recording sensitivity active filters Current HR
battery charge
indicator
leads being
recorded
work mode

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Technical specifications
Dimensions (W x H x D) 260 W x 52 H x 220 D mm
Weight <1,8kg
Power Supply AC 90-240V, 50-60Hz
Built-in Battery Li-ion 7,2V, 2,2Ah
Can be replaced only by qualified servicing personnel
Power Consumption <30VA
ECG leads 12 Standard ECG leads:
Einthoven’s limb leads I, II, III
Goldberger’s limb leads aVR, aVL, aVF
Wilson’s precordial leads V1, V2, V3, V4, V5, V6
Sensitivity 2,5/5/10/20 mm/mV 5%
Recording Speed 5/10/25/50 mm/s 5%
Common Mode Rejection Ratio >100dB
Frequency Band 0,05-150Hz
Input Impedance >10MΩ
Control Range >300 mVpp
10 mVpp
Resolution 2,5μV
Sampling Frequency 1000Hz
Digital Filters 50Hz, 60Hz, 35Hz, 25Hz, antidrift
LCD Screen Color graphic display, 320x240
Safety Protection Type CF (EN60601-1) Class I
Class / Group Class A / Group 1 (CISPR-11)
Operating Environmental
Conditions Temperature +10 to +40˚C (+50 to +104˚F)
Relative Humidity 25 to 95% (non-condensing)
Input circuit is protected against defibrillation impulse. After such impulse, ECG waveform
will appear again up to next 10 seconds.
Using the appliance
Functional abilities
Electrocardiograph can record signals from 12-channel standard ECG leads. There are
following operating modes available:
Automatic recording mode
All 12 lead signals are being recorded in one 10 second time block. Afterwards device
automatically makes analysis including time and amplitude measurements of P-QRS-
T complex, determining the electrical axis of the heart and the rhythm analysis. Full
report printout includes the real ECG waveform, averaged P-QRS-T complex with
particular marked waves, conclusions of the measurements and calculations, text ECG
interpretation and the data of the patient.
Manual recording mode
This mode enables users to choose how many lead signals (3, 6 or 12) will be recorded
at the same real time. That mode allows to switch between lead groups, change
amount of recorded channels, sensitivity and the speed of the recording process during

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the examination. It is also available to activate or deactivate additional ECG signals
interferences filters.
Copy printout
It provides function to make an automatic examination copy printout stored in
appliance’s internal memory. The memory can store at least 100 ECG examinations.
The printout’s form is similar to the automatic recording mode’s one.
Outside printer printout
As connected to the electrocardiograph, the outside printer enables to make printouts
on regular paper or any media which the particular printer operates on. The only thing
required is that the outside printer uses USB port for connection and understands
PCL5 script language.
Saving examination’s copy to the external USB device (e.g. PenDrive)
The data is stored in accordance with the EN1064:2000 standard.
Reading copies of examinations from the external USB device (e.g. PenDrive)
Extending of ECG examinations’ database with an additional external memory makes
it possible to save practically unlimited amount of examinations.
Preview of examinations on main display
It is possible to preview any stored examinations – from internal or external memory –
on main display without printing it out.
Preliminaries
The appliance is equipped with a built-in battery. To indicate the device turned on press
on the keyboard. Before the first turning on or after the long period of not using the
device it is necessary to charge the battery. Plug the device in to a power and switch the
button on rear side to on position. Constant light of the LED on the keyboard indicates the
batteries are being loaded. Blinking of the LED informs that the battery is fully charged and
ready to use.

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Paper loading
The loading thermal paper in to the built-in printer is very easy. To do it open the paper cover
releasing it with button located at the end of papers exit hole (refer to the picture below). Put
the roll of the paper in its place in the printer and lead out the end of it outside of the cover.
Pay attention to the paper’s direction – head its active (squared) side up. Finish the whole
process closing the paper cover. Push it till it’s locked properly in the printing mechanism.
Paper cover release button

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Setting up recording parameters
Before starting the examination it is needed to set up the required recording parameters.
Turning the appliance on automatically recalls parameters last set in the setup menu. If
adjusting of some of them is needed it can be done by pressing one of the following keyboard
function buttons:
mm/mV
Setting recording sensitivity
Each single push changes the sensitivity value sequentially up:
2,5 → 5 → 10 → 20 mm/mV
mm/s
Setting recording speed
Each single push changes the speed value sequentially up:
5→ 10 → 25 → 50 mm/s
FILTR
Setting active filters
Each single push changes current active filters sequentially:
50 → 35 → 35/50 → 25 → 25/50 Hz → AUTO (Adaptive filter)
3/6/12
Setting the number of leads to be recorded
Each single push changes the number of leads to be recorded sequentially up:
3→ 6 → 12
I,II..V6
Setting the group of leads to be recorded
Number of
leads set to
be recorded
Available
number of
groups that
can be set
Available groups that can be set.
Each single push changes the group
sequentially
3 4
I – II – III
↓
aVR – aVL – aVF
↓
V1 – V2 – V3
↓
V4 – V5 – V6
6 2 I – II – III – aVR – aVL – aVF ↓
V1 – V2 – V3 – V4 – V5 – V6
12 1 12 Leads
Current settings are shown on the LCD screen.

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Arrangement of electrodes
The appliance is equipped with 10-electrode wire cable. The standard arrangement:
Lead type Lead Connection – body location
Red Right arm
Yellow Left arm
Green Left leg
Einthoven’s
bipolar limb leads
(4 electrodes) Black Right leg (reference point, ground)
aVR To Right arm electrode
aVL To Left arm electrode
Strengthened
Goldberger’s
unipolar limb leads aVF To Left leg electrode
V1 placed to the right of the sternum in the
fourth (IV) intercostal space
V2 placed to the left of the sternum in the fourth
(IV) intercostal space
V3 placed directly between leads V2 and V4
V4 placed to the left of the sternum in the fifth
intercostal (V) space in the midclavicular line
(even if the apex beat is displaced)
V5 placed to the left of the sternum in the fifth
(V) intercostal space, horizontally with V4 in
the anterior axillary line
Wilson’s
precordial leads
V6 placed to the left of the sternum in the fifth
(V) intercostal space, horizontally with V4
and V5 in the midaxillary line
The appliance constantly monitors the connection status of all the electrodes. In case the
electrode does not adhere the skin the diagram is shown in red color in the referring channel.
In order to get the proper signals from precordial leads it is vital the limb ones are connected
properly. That’s why it is recommended to connect limb leads as first.

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Entering personal information of the patient
The appliance allows to add the patient’s personal information to his examination data. To
add new information first press
MENU
then pick ‘PATIENT’. Confirm the selection with
Enter
. Continuing pick one of the following options:
NEW To add a new patient
CURRENT To edit the information about the current patient
STORED To recall patient’s data stored in electrocardiograph’s memory
Entering/Editing form screen
Use arrow buttons to navigate between the particular information to be edited. The chosen
field is enlighten. Confirm entered data with OK or CANCEL if you want to reject any
changes.
Examination in automatic mode
Automatic mode examination consists in the full 12-lead electrocardiogram recording. All 12
lead signals are being recorded in one 10 second time block. Afterwards device automatically
makes analysis including time and amplitude measurements of P-QRS-T complex,
determining the electrical axis of the heart and the rhythm analysis. Full report printout
includes the real ECG waveform, averaged P-QRS-T complex with particular marked waves,
conclusions of the measurements and calculations, text ECG interpretation and the data of the
patient. To get proper results in the interpretation it is neccessary to input sex and age of the
patient. Otherwise the analysis will set the patient as male 35 years old.
Each time the interpretation of ECG signals needs to be validated by a doctor.
The auto mode examination can be initialized by pressing
AUTO
. Before it, operator can
determine the printout format. After examination the data can be either printed out or stored in
electrocardiograph’s internal memory. The capacity of the memory is at least 100 of complete
ECG examinations.

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Schematic representation of normal ECG
Part of RR Action Duration
P wave Depolarization of atrial muscle 100ms
PQ segment Depolarization of atrioventricular node and atrioventricular
bundle 50ms
PQ interval Conducting depolarization from sinoatrial node to ventricles’
muscle 150ms
QRS Complex Depolarization of the ventricles’ muscle 90ms
ST segment Slow repolarization of the ventricles’ muscle 120ms
T wave Fast repolarization of the ventricles’ muscle 120ms
ST interval Slow and fast repolarization of the ventricles’ muscle 280ms
QT interval Action potential of ventricles’ muscle 370ms
U wave Visible in 50-75% of ECGs
RR interval One full heart’s electric cycle 800ms
The format of printout of automatic examination can be configured in the MENU: REPORT
sub-section of the SETTINGS section.
Examination in manual mode
This mode enables users to choose how many lead signals (3, 6 or 12) will be recorded at the
same real time. That mode allows to switch between lead groups, change amount of recorded
channels, sensitivity and the speed of the recording process during the examination. It is also
available to activate or deactivate additional ECG signals interferences filters. Every change is
indicated on the printout instantly.
The manual mode examination can be initialized by pressing
START
and runs till it is stopped
by pressing
STOP
.

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Making the copy of examination
It is possible to print the copy of automatic mode examination. It can be made by pressing
MENU
followed by picking ‘COPY’ option and confirming it with
Enter
. Afterwards there
are the following options to be chosen:
PRINT To print the last examination copy
MEMORY To recall patient’s data stored in electrocardiograph’s memory
PENDRIVE To save data on the external storage device
After MEMORY-READ option is taken please pick up the patient from the list and then
choose his particular examination. As confirmed, it will be followed by starting the printing.
Just before the printing it is necessary to pick the destination:
ROLL To print on the internal thermal printer
PRINTER To print on the external A4 USB printer
DISPLAY To view on the main screen
Before using the ‘PENDRIVE’ option please make sure if the proper device is connected to
the electrocardiograph’s USB socket. If so, use the function, then use EXPORT and then pick
the patient from the list, his particular examination and after confirming it provide the file
name under which it will be saved. In case the file with the same name already exists, it will
be overwritten by the new file. The data is stored in accordance with the EN1064:2000
standard.
To import an examination form external memory (PenDrive) follow the COPY→PEN
DRIVE→IMPORT options. Then pick the ECG file of your interest with an *.SCP extension
and press
Enter
. It makes the file checked in terms of the data is correct and then the
examination is copied to the internal memory of the ECG device. The data of the patient is
included in the file with the examination.
Managing the memory
Electrocardiograph is equipped with an internal memory. Its capacity is at least 100 of
complete ECG examinations. Storing to the memory is available on two cases – the patient’s
area or the ECG examination area.
Action How
Saving the patient’s data Press
MENU
then pick PATIENT → MEMORY → SAVE.
While saving the copy of an examination, the patient’s personal
information is being stored automatically.
Deleting the patient’s
data
Press
MENU
then pick PATIENT → MEMORY → DELETE.
Afterwards pick the particular patient from the list and confirm
the choice with
Enter
. With removing the patient from the
memory, all his stored examinations are being deleted too.

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Caution! – This operation cannot be undone!
Saving the examination
The copy of the examination can be saved after the automatic
mode recording is done. First press
MENU
then pick COPY →
MEMORY → SAVE. If there is no previous data of the current
patient stored in the memory, it will be stored now. Otherwise
the current record will be added to his existing, previously
stored data. The patient can be identified by his surname, name
and the ID assigned during the first data storing. The particular
stored examination can be determined by its date and time.
Deleting the examination
Press
MENU
then pick COPY → MEMORY → DELETE. The
screen should look like this:
With the arrow keys [←] [ ↑ ] [ ↓ ] [→] mark the particular
patient on the list and pick him pressing
Enter
. Afterwards,
the screen should look like this:
Now, chose from the appeared list the examination to be deleted
and confirm with
Enter
.

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Caution! – The chosen examination is permanently deleted and
cannot be undone!
Configuration
The settings of EPG 6 VIEW PLUS Electrocardiograph configuration are adjustable in wide
range. They can be set according the user’s actual needs. Turning the appliance on brings the
default initial settings and not adjustable – during the normal using – parameters (e.g. clock
time, date, language).
To enter the configuration setup press
MENU
and then pick SETTINGS option.
To configure the automatic examination’s report use REPORT option.
The REPORT configuration screen will look like this:
The following options available in the section
Option Description
TIME AUTO The duration of ECG examination in automatic mode
REPRESENTATIVE The most characteristic representative of P-QRS-T will be
shown
DIAGNOSTICS Text description of examination of electrocardiogram will
be shown
MEASUREMENT All time and amplitude measurements of the representative
will be shown
PRINT
Sets the printout target. Available are:
Roll – thermal paper
USB – external printer connected to the USB port
FORMAT
It allows to set the format of the ECG included in the report
of the examination. The RECORD option sets the actual
format set for manual mode. The rest of the options sets the
amount of channels and leads groups to be recorded. The
following are available: 3x4, 3x4+1, 3x4+2, 6x2, 6x2+1,
12x1.

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To configure the initial settings use INITIAL SETTINGS option. Initial settings can be easily
changed during normal using with the navigation keys. The set presets will always appear
after each turning on the device.
The INITIAL SETTINGS configuration screen should look like this:
Using the arrow keys [←] [ ↑ ] [ ↓ ] [→] mark the parameter to be changed and pick it
pressing
Enter
. The available values for it will be shown. Accept the choice with
Enter
.
When configuration is finished, confirm it with OK or reject any made changes with
CANCEL. The rest of the parameters can be set in CONFIGURATION.
The look of the suitable screen is like this:

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Managing the advanced settings is similar to the presets configuration.
The list of available options in the advanced settings section:
Option Description
MAINS Sets the frequency of the mains – 50Hz or 60Hz
ISOLINE
Activates or deactivates the antidrift filter. The following
frequencies are available: 0,125Hz, 0,25Hz, 0,5Hz and
1,5Hz. If the filter is activated, the producer suggest the
0,25Hz to be set as the most proper one.
TIME Sets the real time clock
DATE Sets the date
FORMAT
Sets the printout format. Available are:
Standard format
Cabrera format
QRS Sound indication of the QRS complex detection
LANGUAGE Sets the interface language
SURGERY Allows to put the name of the consultation’s office

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Menu navigation map
PATIENT COPY SETUP
MENU
NEW CURRENT MEMORY
PRINT MEMORY PENDRIVE
REPORT INITIAL SETTINGS CONFIGRUATION
SAVE READ DELETE
EDIT
EDIT
PATIENTS LIST
EXIT
EXIT
EXIT
EXIT
PATIENTS LIST
EXIT
EXAMINATIONS LIST
SAVE READ DELETE
EXIT
EXIT
EDIT
EDIT
EXIT
EXIT
EDIT
EXIT