Download ТЕМЕО - TEMEO

TELEMETRIC SYSTEM FOR
MONITORING AND CONTROL OF
CARDIAC ACTIVITY
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TEMEO – The Principle
TEMEO works in two modes – automatic mode and ECG mode
.
Automatic mode:
This is the basic mode in which TEMEO works.
1. Sensors on the chest send signal on every heart
contraction
2. A built-in accelerometer reports the physical activity
3. 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.
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TEMEO device
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TEMEO
TEMEO
Concept
Servers
Internet
TEMEO
GSM
Network
Medical Expert
TEMEO
TEMEO
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Medical Supervisors
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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.
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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.
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RR – Physical activity
For every 5-minute interval sent to the telemedicine 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)
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HRV analyses
A variety of tolls for HRV analysis and processing
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Report for a random period
There 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
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Normal day record - (Pulse rate and Physical activity)
Respiratory
Arrhythmia
Normal night record - (Pulse rate and Physical activity)
Ventricular
extrasystoles
Supraventricular
extrasystoles
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Absolute
Arrhythmia
With patients with atrial fibrilation of 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
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Physical
activity
Supraventricular
extrasystoles
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 infarction and 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
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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
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ECG
TEMEO provides tools for filtering, processing and analysis of ECG.
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Clinical research statistics:
Parameter
Holter ECG
Temeo Holter ECG
Monitoring time
72 778 min
61 389 min
Registered QRS complexes
83 505 ± 14806
78 912 ± 14 736
р = 0.8
Average frequency
73 ± 14 bpm
74 ± 16 bpm
(р = 0.16)
Maximal frequency
133 ± 33 bpm
121 ± 19 bpm
(р = 0.007)
Minimal frequency
54 ± 14 bpm
47 ± 12 bpm
(р < 0.001)
% Time in tachycardia
11.4 ± 18.3%
9 ± 15.1%
(р = 0.24)
Single premature ventricular
contractions
2897 ± 8388
363 ± 722
(р = 0.02)
Double premature ventricular
contractions
456 ± 708
75 ± 195
(р < 0.001)
Triple premature ventricular
contractions
0.3 ± 1
0
(р = 0.15)
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p value
ECG - Extrasystole
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EXTRACTS OF LIFE
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Ventricular extrasystole
episodes of bigeminy type
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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.
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Venticular exstrasystoles of trigeminy type
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Interpolated venticular extrasystole
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Venticular extrasystoles followed by a
venticular tachycardia
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Atrial flutter episode
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Significant horizontal depression of the
ST segment episode
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Atrial fibrilation episode
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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.
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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.
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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.
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On the forth day of the supervision an atrial fibrillation episode
was detected. The patient was prescribed anticoagulation
therapy for embolism prevention.
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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.
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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.
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Patient living and working in Blackburn, England, watched over
in the telemedicine center in Kazanlak, Bulgaria. The system
works flawlessly with patients, situated outside Bulgaria, the
quality of the ECG and the automatic analysis remaining with
excellent at 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.
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TEMEO - The FUTURE
Best wishes!!!
SSI together with ICD MHAT “Dr.H.S.” Kazanlak
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