Welch Allyn HR100 Manual

Holter Recorders
HR100/300/1200
Directions for Use
HR100
Recorder
HR300 or HR1200
Recorder

ii Welch Allyn Holter Recorder
Copyright 2006 Welch Allyn. All rights are reserved. No one is permitted to reproduce or duplicate, in any
form, this manual or any part thereof without permission from Welch Allyn.
Welch Allyn assumes no responsibility for any injury to anyone, or for any illegal or improper use of the
product, that may result from failure to use this product in accordance with the instructions, cautions,
warnings, or statement of intended use published in this manual.
Welch Allyn, HR100, HR300, and HR1200 are trademarks of Welch Allyn.
SD is a trademark of Toshiba.
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Software in this product is Copyright 2006 Welch Allyn or its vendors. All rights are reserved. The software
is protected by United States of America copyright laws and international treaty provisions applicable
worldwide. Under such laws, the licensee is entitled to use the copy of the software incorporated with
this instrument as intended in the operation of the product in which it is embedded. The software may not
be copied, decompiled, reverse-engineered, disassembled, or otherwise reduced to human-perceivable
form. This is not a sale of the software or any copy of the software; all right, title, and ownership of the
software remain with Welch Allyn or its vendors.
For information about any Welch Allyn product, call Welch Allyn Technical Support:
Manual Material No. 704556
Global Instrumentation part number 004-700-0046 Ver. C
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www.welchallyn.com

iii
Contents
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Recorder Illustrations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Patient Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Holter Procedure Patient Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Preparing for Electrode Placement on Patient . . . . . . . . . . . . . . . . . . . . . . . 10
Service Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Cleaning the Recorder and Patient Cable. . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Inspecting the Recorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Testing the Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Storing the Recorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Discarding the Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Technical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Conformance to Regulatory Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Electromagnetic Emissions and Immunity Information . . . . . . . . . . . . . . . . 22
FCC information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Limited Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

iv Contents Welch Allyn Holter Recorder

Directions for Use 1
Directions for Use
Intended Use
The Welch Allyn Holter System is intended to be used as a Holter ambulatory
electrocardiograph system for the purpose of screening for ECG rhythm disturbances
over a minimum 24-hour period. The Welch Allyn Holter System is intended for use under
the supervision of a physician or those knowledgeable in all aspects of ECG morphology,
rhythm, and arrhythmia.
This procedure is known as a Holter procedure and captures infrequent or activity
provoked ECG rhythm abnormalities outside of the physician’s office.
The Welch Allyn Holter System is comprised of the Welch Allyn Holter Recorder and the
Welch Allyn Holter System Application.
As the patient wears the recorder component of the system, it records ambulatory
electrocardiograph data. The Welch Allyn Holter System Application analyzes the recorder
data. The Welch Allyn Holter System is not intended for infants weighing less than 10 Kg.
The Welch Allyn Holter System acquires ambulatory ECG waveforms from patients. The
recorder and associated accessories provide signal acquisition for up to three channels
(HR100 and HR300) or up to eight channels (HR1200) of patient ECG waveforms through
surface electrodes adhered to the body.
Caution US Federal law restricts this device to sale by or on the order of a
physician.

2Directions for Use Welch Allyn Holter Recorder
Indications for Use
The Welch Allyn Holter System is intended for acquiring ambulatory ECG signals from
patients. Patients are people with coronary problems or suspected coronary problems.
This ambulatory electrocardiograph, and associated analysis system, can be used on
patients without limitation on patient age or gender.
The Holter Recorder procedure is one of the many tools that clinicians use to capture
infrequent or activity provoked ECG rhythm abnormalities outside of the physician’s
office. Indications for conducting Holter recording are:
•Arrhythmias
•Chestpain
• Unexplained syncope
• Shortness of breath
• Palpitations
• Evaluation of a pacemaker
• Regulation of anti-arrhythmic drugs
• Evaluation of a patient after myocardial infarction
• Family history of heart disease

Directions for Use 3
Symbols
Warning. Read Carefully.
Caution / Notices. Read Carefully.
Attention: See instructions for use.
Patient Activated Event.
Meets or exceeds Council Directive 93/42/EEC, MDD, Class IIb
Type BF Medical Equipment.
Battery Polarity. Use AA (LR6) Alkaline batteries.
Single use. Use materials labeled with this symbol once only.
Secure Digital Memory Card Interface.
Blue Tooth Wireless Communication Technology
Recycling Symbol - Do not dispose of this product as unsorted municipal waste. Prepare this product for reuse or
separate collection as specified by Directive 2002/96/EC of the European Parliament and the Council of the European
Union on Waste Electronic and Electrical Equipment (WEEE). If this product is contaminated, this directive does not
apply. See www.welchallyn.com/weee.
SD

4Directions for Use Welch Allyn Holter Recorder
Temperature range. (see Technical Specifications)
Keep dry. (see Technical Specifications)
This end up.
Fragile, glass.
Serial Number.
Reference Number.
No Latex.
No PVC.
Keep from direct sunlight.
LED light.

Directions for Use 5
Warnings and Cautions
Familiarize yourself with these warnings. Specific warnings and cautions are also found
throughout this manual.
Warnings
A warning statement in this manual identifies a condition or practice which, if not
corrected or discontinued immediately, could lead to patient injury, illness, or death.
Cautions
A caution statement in this manual identifies a condition or practice which, if not
corrected or discontinued immediately, could lead to equipment failure, equipment
damage, or data loss.
WARNING Safety—For patients with a pacemaker, maintain a minimum of 6
inches between the recorder and pacemaker. Turn the recorder off immediately
and provide appropriate patient care if you suspect the recorder affected the
pacemaker.
WARNING Safety—Remove electrodes, patient lead wires, and recorder from
patient before defibrillation.
WARNING Safety—The conductive parts of electrodes and associated
connectors for type BF or CF applied parts, including neutral electrode, should not
contact other conductive parts including earth.
WARNING Safety— Inspect recorder and accessories before each use.
WARNING Safety—peripheral equipment and accessories that touch the patient
must comply with all appropriate safety, EMC, and regulatory requirements.
WARNING Safety— System is not designed for use with high-frequency (HF)
surgical equipment and does not protect against hazards to the patient.
WARNING Safety—Discard electrodes after one use.
WARNING Explosion hazard—Do not use in the presence of a flammable
anesthetic mixture with air or oxygen or nitrous oxide.
WARNING Fire hazard— Replace batteries using AA (LR6) alkaline batteries.
Note polarity.
Caution US Federal law restricts this device to sale by or on the order of a
physician.
Caution Do NOT use acetone, ether, freon, petroleum derivatives, or other
solvents to clean the recorder.
Caution Do NOT let soap or water come into contact with the battery contacts
or patient connector pins.
Caution DO NOT submerse, autoclave, or steam clean the recorder or the
patient cabling.

6Directions for Use Welch Allyn Holter Recorder
Introduction
This manual is written for clinical professionals familiar with monitoring cardiac patients.
You must read and understand this manual and all other information accompanying the
ambulatory electrocardiograph and related options or accessories before:
• using the Welch Allyn Holter Recorder for clinical applications
• setting up, configuring, troubleshooting, or servicing the recorder
Features
All models:
• Lightweight and small size provides comfort for the patient.
• Either of two patient-activated event buttons enables patients to mark times they feel
are significant. (Both event buttons have the same function.)
• System status feedback: LED (HR 100) or LCD window (HR 300 & HR 1200).
• Removable Secure Digital Memory Card for a minimum of 24-hours of ECG storage
and transferring ECG data.
• Holter Analysis system provides real-time ECG data via Bluetooth Wireless
Communication to verify patient electrode placement and electronic transfer of ECG
recordings.
• Operates on AA alkaline (LR6) batteries: one (HR 100) or two (HR 300 & HR 1200).
• Removable patient cable.
HR 300 & HR 1200:
• Navigational keypad — enter, cancel, up, down, right, and left keys.
• LCD window provides ECG waveform views to ensure proper electrode connection.
• Time of day display.

Directions for Use 7
Recorder Illustrations
Figure 1. HR 100 Holter Recorder
Figure 2. HR 300 & HR 1200 Holter Recorder
LED
Patient Cable
Battery
Compartment
Secure Digital
Card Interface
Patient-Activated Event Buttons
Secure Digital (SD)
Card Interface
LCD
Patient-Activated
Event Buttons
Patient Cable
Batteries

8Directions for Use Welch Allyn Holter Recorder
Operation
To Set the Time (HR 300 & HR 1200 only)
1. Remove the battery cover from the recorder (see Figure 2 on page 7).
2. Remove the Secure Digital Card from the Secure Digital port located at the rear of the
device (see Figure 2 on page 7).
3. Insert two new, AA alkaline (LR 6) batteries into the recorder battery compartment.
Note the polarity.
4. Slide and secure the battery cover onto the recorder. The LCD window shows the
time after the recorder self-diagnostics is complete (approximately 10 seconds).
Time is displayed in 24-hour time format and the hour digit is blinking.
5. Increase the hour shown with the up arrow key or decrease the hour shown with the
down arrow key. Use the right and left arrow keys to toggle between the hour and
minute display. Once the time displays, remove the batteries.
To Start a Test
Use this procedure for SD Card only. For wireless operation, refer to the Holter System
manual.
1. Prepare the patient according to “Patient Preparation” on page 10.
2. Initialize the Secure Digital Card. Refer to the Holter System Application Directions for
Use for the Secure Digital Card initialization procedure.
3. Remove the battery cover from the recorder (see “Recorder Illustrations” on page 7).
4. Insert the Secure Digital Card into the recorder’s Secure Digital port located at the
rear of the device (see figure 1).
5. Insert new AA alkaline (LR 6) battery or batteries. Note the polarity.
6. Slide and secure the battery cover onto the recorder.
• HR 100 — The LED flashes green in a sequence of two flashes, pause, three
flashes, pause, four flashes, pause, then flashes once approximately every three
seconds when operating. If the LED flashes yellow (any sequence) see
“Troubleshooting” on page 26.
• HR 300 & HR 1200 — The LCD window shows the time of day after the recorder
self-diagnostics are complete (approximately 10 seconds). The recorder is
collecting ECG data and functioning properly. After the self test, the recorder will
display ECG on the display for 5 minutes and then display the current time. If the
recorder does not display time or displays an error code, see “Troubleshooting”
on page 26.
7. Place the recorder into the carrying case. Secure the carrying case and recorder on
the patient.
WARNING Inspect patient cable, patient leads wires, LED or LCD window, and
enclosure for cracks or breaks before each use. See “Maintenance” on page 17
for more information.

Directions for Use 9
8. Write the start time, date, and patient data in the patient diary.
To Shut Down the Recorder (if the recorder does not stop automatically)
1. Press and hold both EVENT buttons and count the “beeps.” Release the buttons at
the start of the seventh beep. The HR300/HR1200 LCD will display a + sign indicating
successful shutdown. The HR100 green LED will stop flashing.
2. Press the EVENT button again. Did the recorder beep?
• If the recorder does not beep, the recorder was successfully shut down.
• If the recorder beeps, repeat the shutdown procedure.
• Remove the battery and SD card.
Data transfer to the Workstation
Refer to the Holter System Application operating instructions for transferring the Holter
procedure data to the Holter PC.
WARNING Discard electrodes after one use.

10 Directions for Use Welch Allyn Holter Recorder
Patient Preparation
Holter Procedure Patient Preparation
When making the appointment, tell the patient:
• Do not remove any electrodes or disconnect lead wires.
• Do not swim, bathe, or shower during the recording period.
• Do wear loose fitting, comfortable clothing to the appointment (shirt-and-pants or
blouse-and-skirt combinations are better than one-piece garments.)
Preparing for Electrode Placement on Patient
WARNING Safety—Leave 5 feet (1.5 meters) of open area around the patient
during recorder hookup and removal.
WARNING Safety—Do not connect external devices to the recorder. Connect
patient lead wires only to the patient electrodes.
WARNING Safety—Keep the recorder and patient cable clean, especially the
components that touch patients.
Caution Verify that dates on applicable accessories have not expired.
Table 1. Recommended accessories
Accessory Quantity
Electrodes 5 or 7
AA Alkaline Batteries (LR6) 1 for HR 100
2 for HR 300 & HR 1200
Disposable Safety Razor 1
Abrading pad 1
Alcohol Prep Pads 2
Pouch 1
Patient Diary 1

Directions for Use 11
To Prepare the Patient and Place Electrodes
Help the patient get comfortable. Patient preparation is important for a successful Holter
procedure.
1. Describe the procedure to the patient.
2. Prepare electrode locations. See Figure 4 on page 12 for 5-lead placement, Figure 5
on page 13 for 7-lead placement, Figure 8 on page 15 for 12-lead placement.
3. Shave the area for electrode placement, if necessary.
4. Clean electrode sites with alcohol.
5. Allow electrode site to dry.
6. Attach the electrodes to the lead wires before attaching to patient.
7. Secure each lead wire. Loop each lead wire into a 1- to 2-inch diameter loop, position
it approximately two inches from each sensor site, and tape it to the skin (see
Figure 3). This reduces movements that cause signal artifact.
Figure 3. Patient Lead Wire Stress Loop
Evaluating the Signal Quality from Each Lead
Refer to the Holter System Application Directions for Use.
Clinician tasks
Explain to the patient:
• the recording procedure
• how to record information in the patient diary
• how to use the Patient Event Button
• to avoid contact with water
Caution Always ensure that the appropriate electrode placement is employed
for the lead configuration selected.
Caution ECG electrodes can cause skin irritation. Examine the skin for signs of
irritation or inflammation and avoid placement of the electrode in those areas.

12 Directions for Use Welch Allyn Holter Recorder
Figure 4. 5-Lead Placement (HR100 only)
Table 2. 5-Lead Placement (HR100 only)
Lead AHA Color IEC Color Placement
Ch1+ Red Green 4th intercostal space at left border of sternum
Ch1- White Red Left clavicle, lateral of sternum border
Ch2+ Brown White 6th intercostal space at the anterior axillary's line
Ch2- Black Yellow Right clavicle, lateral to the mid-clavicle line
RL Green Black Lowest rib on right side of chest

Directions for Use 13
Figure 5. 7-Lead Placement (all models)
Table 3. 7-Lead Placement (all models)
Lead AHA Color IEC Color Placement
Ch1+ Red Green 4th intercostal space at left border of sternum
Ch1- White Red Left clavicle, lateral of sternum border
Ch2+ Brown White 6th intercostal space at the anterior axillary's line
Ch2- Black Yellow Right clavicle, lateral to the mid-clavicle line
Ch3+ Orange Orange 6th intercostal space on left midclavicular line
Ch3- Blue Blue Manubrium sternum
RL Green Black Lowest rib on right side of chest

14 Directions for Use Welch Allyn Holter Recorder
Figure 6. AHA lead cables
Figure 7. IEC lead cables

Directions for Use 15
Figure 8. 12-Lead Placement (HR1200 only)
Table 4. 12-Lead Placement (HR1200 only)
AHA
Lead
AHA
Color
IEC
Lead
IEC
Color Placement
RA White R Red Right clavicle, lateral of sternum border
LA Black L Yellow Left clavicle, lateral of sternum border
LL Red F Green Lowest rib on left side of chest
V1 Brown/Red C1 White/Red 4th intercostal space on right border of sternum
V2 Brown/Yellow C2 White/Yellow 4th intercostal space on left border of sternum
V3 Brown/Green C3 White/Green Midway between Lead V2 and Lead V4.
V4 Brown/Blue C4 White/Brown 5th intercostal space on left midclavicular line
V5 Brown/Orange C5 White/Black Left anterior auxiliary line at the horizontal level of V4
V6 Blue/Violet C6 White/Violet Left mid-auxiliary line at the horizontal level of V4
RL Green N Black Lowest rib on right side of chest
RA
LL
LA
RL
V6
V5
V4
V3
V2
V1

16 Directions for Use Welch Allyn Holter Recorder
Service Policy
All repairs on products under warranty must be performed or approved by Welch Allyn.
Unauthorized repairs void the warranty. In addition, whether or not covered under
warranty, any product repair shall exclusively be performed by Welch Allyn certified
service personnel.
If the product fails to function properly—or if you need assistance, service, or spare
parts—contact the nearest Welch Allyn Technical Support Center. For phone numbers,
see page ii.
Before contacting Welch Allyn, try to duplicate the problem, and check all accessories to
ensure that they are not causing the problem. When calling, please be prepared to
provide:
• Product name and model number and complete description of the problem.
• Serial number of your product (if applicable).
• Complete name, address and phone number of your facility.
• For out-of-warranty repairs or spare parts orders, a purchase order (or credit card)
number.
• For parts orders, the required spare or replacement part numbers.
If your product requires warranty, extended warranty, or non-warranty repair service,
please call first the nearest Welch Allyn Technical Support Center. A representative will
assist you troubleshooting the problem and will make every effort to solve it over the
phone, avoiding potential unnecessary returns.
In case a return cannot be avoided, the representative will record all necessary
information and will provide a Return Material Authorization (RMA) number, as well as the
appropriate return address. An RMA number must be obtained prior to any return.
If you have to return goods for service, follow these recommended packing instructions:
• Remove all cables, sensors, and ancillary products (as appropriate) before packing,
unless you suspect they are associated with the problem.
• Wherever possible use the original shipping carton and packing materials.
• Include a packing list and the Welch Allyn Return Material Authorization (RMA)
number.
It is recommended that all returned goods be insured. Claims for loss or damage to the
product must be initiated by the sender.