To increase the speed of your Holter scans using Philips Zymed equipment, consider these four helpful tips. These reminders supplement the information provided in the user manual to optimize your workflow.
A) Auto Stops and Page Mode
Zymed offers four distinct methods for scanning Holter studies: Page Mode, Superimposition (S.I.), QuickScan, and Retrospective. Page Mode and Superimposition are considered prospective scanning modes, allowing you to observe heartbeats in real-time as the Holter algorithm analyzes them. In contrast, Retrospective scanning displays heartbeats only within their assigned Classes and Events after the system has completed the algorithmic analysis. QuickScan presents a hybrid approach, combining retrospective scanning with the capability for the Holter system to pause on all heartbeat types designated for Auto Stops.
Initiate your Holter studies in Page Mode with all Atrial, Ventricular New Classes, and Diary Auto Stops enabled. This allows for a rapid initial assessment of the Zymed system's beat classification accuracy. After documenting representative strips from each occurring Event, disable the Auto Stop for that specific Event. The system will then continue to count these events without requiring manual review of each instance.
Scanning styles can be dynamically adjusted mid-scan by clicking the white box adjacent to the 'GO' button in the upper left corner of the screen. After verifying the system's accurate beat classification, you can proceed with scanning in Page Mode, transition to QuickScan, or even switch to Retrospective mode for studies with minimal events.
B) Adjusting Display
A Holter algorithm comprises a set of mathematical formulas that classify heartbeats based on their unique shapes. The Zymed algorithm dynamically adjusts its analysis across all three channels, temporarily deactivating itself when an artifact is detected in any channel. Simultaneously, the algorithm attempts to assign a name to each heartbeat based on the available data. To optimize algorithm performance, adjust the Gain on any or all channels within the 'Display' menu in the upper-right corner (refer to Red Arrows) if waveforms appear excessively tall or short.
C) Learning Beats
While the Zymed algorithm boasts high accuracy in beat classification, occasional misclassifications or artifact identification may occur. In such instances:
- Utilize the 12-Lead capability to accurately diagnose the beat and determine its true nature.
- Employ the 'Learn' function to reclassify the beat as Normal, Ventricular, or Artifact. This feature can also be used to effectively classify Paced beats in situations where Pacemaker detection was inadvertently omitted during Holter recording or pre-scan.
D) The Call Function
The 'Call' Function, a significant enhancement in Zymed Software Revision 2.9, empowers users to override algorithmic classifications for individual or consecutive heartbeats. To utilize this feature:
- Activate the 'Call' function within the left toolbar.
- Select the desired beats by left-clicking and dragging the mouse across them.
- Upon releasing the mouse button, the 'Call Arrhythmia' window will appear.
- Choose the desired classification for the selected beats.
The system will automatically update the scan with the user-defined classification, indicated by italicized annotations above the affected beats. This user-defined classification will also be preserved when saving a Strip.