Medtronic POS12D19 Reference Guide

PACEART OPTIMA™ SYSTEM
POS12D Version 1.9
Paceart Optima System Software User Manual
Caution: Federal Law (USA) restricts this device to sale by or
on the order of a physician (or properly licensed practitioner).

Contents

Chapter 1: Introduction to the Paceart Optima™ System..............13
Paceart Optima System | Contents | 3
Explanation of symbols..........................................................................................................13
Indications..............................................................................................................................14
Precautions............................................................................................................................14
Contraindications....................................................................................................................15
Authorized users....................................................................................................................15
Technical Support...................................................................................................................15
Manuals supplied with your system........................................................................................16
Accessing the online Help......................................................................................................16
Navigating through the Paceart System without a mouse......................................................16
Explanation of dialog box fields and buttons..........................................................................17
Chapter 2: Paceart System Patient Records...................................19
Opening a patient record........................................................................................................19
Closing a patient record.........................................................................................................19
Switching between patient records.........................................................................................19
Adding a patient to the Paceart System database.................................................................21
Adding a new patient to the Paceart System database...............................................21
Deleting a patient record........................................................................................................24
Reassigning an encounter...........................................................................................24
Deleting devices from a patient record........................................................................25
Deleting appointments from a patient record...............................................................25
Deleting a patient record.............................................................................................25
Patient Record........................................................................................................................26
Copying information from the patent record tabs.........................................................26
Patient Information tab.................................................................................................26
Device Details tab........................................................................................................43
Encounters tab............................................................................................................49
Working with reports............................................................................................................129
Adding a subtitle to a report......................................................................................130
Previewing a report....................................................................................................130
Printing a report.........................................................................................................131
Emailing or faxing a report.........................................................................................131
Printing a report for a specific patient........................................................................131
Printing a report for multiple patients.........................................................................132
Report Graphing in the Paceart Optima System..................................................................132
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Chapter 3: Searching in the Paceart System.................................135
Sorting search results by columns.......................................................................................135
Patients search tab...............................................................................................................135
Searching for a patient..............................................................................................136
Devices search tab...............................................................................................................137
Searching for a device...............................................................................................138
Encounters search tab.........................................................................................................139
Searching for an encounter.......................................................................................140
Exporting an Encounter.............................................................................................141
Downloading remote encounters...............................................................................142
Appointments search tab......................................................................................................143
Searching for an appointment...................................................................................144
Downloading a remote appointment status update...................................................145
Advanced search..................................................................................................................146
Paceart System predefined advanced search queries..............................................147
User-created advanced search queries.....................................................................147
Creating an advanced search query..........................................................................149
Performing an advanced search................................................................................151
Editing a saved advanced search query....................................................................151
Copying an advanced search query..........................................................................152
Deleting an advanced search query..........................................................................152
Using operators and conditions in advanced searches.............................................152
Exporting search results to a spreadsheet...........................................................................155
Using an exported spreadsheet to create letters and mailings............................................155
Chapter 4: Home tab........................................................................157
Displaying today's appointments for a resource...................................................................157
Opening an appointment or patient record from a selected appointment............................157
Opening a task.....................................................................................................................158
Adding a user task................................................................................................................158
Field and button definitions for the Adding or Editing a Task dialog box....................158
Selecting an assignee...............................................................................................159
Chapter 5: Paceart System Encyclopedias...................................161
Searching for information in the encyclopedia.....................................................................162
Deleting an entry from an encyclopedia...............................................................................162
Exporting search results to a spreadsheet...........................................................................162
Using the Devices Encyclopedia..........................................................................................163
Searching for information in the encyclopedia...........................................................164
Adding or editing a device in the encyclopedia.........................................................164
ICD............................................................................................................................181
Pacemaker.................................................................................................................182
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ICM/ILR.....................................................................................................................183
Lead...........................................................................................................................183
Adapter......................................................................................................................184
Remote Monitor.........................................................................................................184
Event Recorder..........................................................................................................184
Other Device..............................................................................................................185
Device Alerts and Watches........................................................................................185
Aliases.......................................................................................................................189
Device Capabilities....................................................................................................191
Changing references of a device to a different device...............................................193
Making an entry unavailable for future association ...................................................194
Removing unused devices.........................................................................................194
Merging device manufacturers..................................................................................195
Merging devices........................................................................................................196
Using the Diagnoses Encyclopedia......................................................................................197
Adding or editing a diagnosis in the encyclopedia.....................................................197
Changing references of a patient's diagnosis to a different diagnosis.......................198
Making an entry unavailable for future association ...................................................199
Importing diagnoses from a spreadsheet..................................................................199
Using the Medications Encyclopedia....................................................................................200
Adding or editing a medication in the encyclopedia..................................................201
Changing references of a medication to a different medication.................................203
Using the Insurance Encyclopedia.......................................................................................203
Adding or editing insurance companies in the encyclopedia.....................................204
Changing references of an insurance company to a different insurance
company...............................................................................................................206
Using the Providers Encyclopedia........................................................................................207
Adding or editing a provider in the encyclopedia.......................................................207
Changing references of a provider to a different provider..........................................210
Making an entry unavailable for future association ...................................................211
Importing providers from a spreadsheet....................................................................211
Using the Charge Codes Encyclopedia................................................................................212
Adding or editing a charge code in the encyclopedia................................................213
Changing references of a charge code to a different charge code............................214
Using the Procedures Encyclopedia....................................................................................215
Adding or editing a procedure code in the encyclopedia...........................................216
Changing references of a procedure to a different procedure...................................217
Making an entry unavailable for future association ...................................................218
Importing procedures from a spreadsheet................................................................218
Using the Pager Services Encyclopedia..............................................................................219
Adding or editing a pager service in the encyclopedia..............................................220
Changing references of a pager service to a different pager service........................221
Chapter 6: Scheduling.....................................................................223
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Patient scheduling preferences............................................................................................224
Setting a patient's scheduling preferences................................................................224
Field definitions for Edit Preferences dialog box........................................................224
Scheduling appointments.....................................................................................................225
Adding an appointment from a patient's record.........................................................225
Adding or editing an appointment from the Schedule tab..........................................225
Adding an appointment from an encounter...............................................................227
Editing an appointment..............................................................................................227
Searching for an appointment...................................................................................228
Canceling an appointment.........................................................................................231
Reinstating a canceled appointment.........................................................................232
Deleting an appointment............................................................................................232
Associating an encounter with an appointment.........................................................232
Disassociating an encounter with an appointment....................................................233
Remote Appointment Status................................................................................................233
Downloading a remote appointment status update...................................................234
Chapter 7: Tasks tab........................................................................235
Searching for tasks...............................................................................................................236
Searching for tasks....................................................................................................236
Working with tasks...............................................................................................................239
Workgroups...............................................................................................................239
User tasks..................................................................................................................239
Encounter tasks.........................................................................................................242
System tasks.............................................................................................................243
Routing a task............................................................................................................248
Accepting a task........................................................................................................248
Deleting a task...........................................................................................................249
Adding task comments..............................................................................................249
Chapter 8: Paceart Optima System Administration......................251
Using the Activity Log...........................................................................................................252
Activity Log Services.................................................................................................253
Searching for information in the Activity Log.............................................................264
Deleting Activity Log Entries......................................................................................267
Editing Activity Log Retention....................................................................................267
Using the Audit Log..............................................................................................................267
Searching for information in the Audit Log.................................................................268
Batch Deleting Patients........................................................................................................269
Configuring Billing Payment Methods...................................................................................269
Adding or editing a payment method.........................................................................270
Deleting a payment method.......................................................................................271
Configuring Connectivity......................................................................................................271
Paceart Optima System | Contents | 7
Editing Verify Patient Match Configuration Settings...................................................272
Editing Demographics Only Match Configuration Settings........................................273
Activating CareLink Scheduling Integration...............................................................274
Deleting Appointment Requests................................................................................275
Activating CareLink Remote Encounter Acquisition..................................................276
Deleting Remote Encounter Acquisition Requests....................................................277
Viewing the Encounter Import Queue........................................................................277
Saving encounter import request data to a file..........................................................277
Editing Encounter Request Retention.......................................................................277
Editing Encounter Export Request Retention............................................................278
Deleting XML Export Requests.................................................................................278
Configuring Demographics...................................................................................................279
Setting the default country for a location of care.......................................................280
Adding or editing a Location of Care.........................................................................281
Viewing a list of patients related to a Location of Care..............................................283
Adding or Editing a Patient ID Type...........................................................................283
Deleting a Patient ID Type.........................................................................................284
Editing a Patient Code Type.......................................................................................284
Deleting a Patient Code Type....................................................................................284
Configuring Encounter Export Settings................................................................................285
Editing XML Encounter Export..................................................................................286
Editing HL7 Encounter Export...................................................................................287
Editing Encounter Auto-Export..................................................................................289
Configuring the Paceart System Home Tab.........................................................................289
Editing Visible Tasks..................................................................................................290
Adding or Editing Links on the Home Tab..................................................................291
Deleting Links from the Home Tab.............................................................................292
Changing the Order of Links on the Home Tab.........................................................292
Managing the Paceart System Licenses..............................................................................293
Viewing user license usage.......................................................................................293
Applying a license key...............................................................................................293
Viewing license expiration notifications.....................................................................294
Configuring Server and Client Logging................................................................................294
Editing Server and Client Logging.............................................................................296
Configuring the Messaging Service.....................................................................................297
Editing fax settings....................................................................................................298
Editing email settings.................................................................................................299
Editing pager settings................................................................................................299
Clearing pending messages......................................................................................300
Configuring Reports.............................................................................................................300
Editing Default Encounter Report Settings................................................................301
Adding or Editing a report group...............................................................................302
Deleting a report group..............................................................................................304
Configuring the Schedule.....................................................................................................304
Schedule configuration for a location of care.............................................................305
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Configuring resources for a location of care..............................................................310
Configuring the closed hours for a location of care...................................................312
Configuring Security Options...............................................................................................315
Users and User Roles...............................................................................................317
External System Accounts........................................................................................326
Security Policies........................................................................................................331
Viewing system information..................................................................................................332
Configuring Task Management.............................................................................................333
Configuring Workgroups............................................................................................334
Configuring Encounter Tasks.....................................................................................336
Configuring System Tasks.........................................................................................338
Configuring User Preferences..............................................................................................340
Report Options tab....................................................................................................341
Opening Paceart tab..................................................................................................344
Display Options tab...................................................................................................345
Chapter 9: Repor ts list....................................................................347
Appointment Search Results report.....................................................................................349
Billing report.........................................................................................................................349
Brady Programming History report.......................................................................................349
Comprehensive Encounter Summary report........................................................................349
Device Search Results report...............................................................................................349
Doctor Letter.........................................................................................................................350
Doctor Letter (Brady)............................................................................................................350
Doctor Letter (Tachy)............................................................................................................350
Encounter Arrhythmia (150 x 20 mm) report .......................................................................350
Encounter Arrhythmia (150 x 40 mm) report .......................................................................350
Encounter Arrhythmia (175 x 10 mm) report........................................................................351
Encounter Arrhythmia Event Recorder report......................................................................351
Encounter Arrhythmia (Implantable) report..........................................................................351
Arrhythmia Summary (Implantable, Lifetime) report ............................................................351
Encounter Brady (2 Strips) report........................................................................................351
Encounter Brady (3 Strips) report........................................................................................352
Encounter Brady (Biventricular) report.................................................................................352
Encounter Brady (No strips) report......................................................................................352
Encounter ECG 12 Lead (3 x 4) report ...............................................................................352
Encounter ECG 12 Lead (6 x 2) report ...............................................................................352
Encounter ECG 6 Lead report..............................................................................................353
Encounter Episode Details report........................................................................................353
Encounter Episode List........................................................................................................353
Encounter Miscellaneous Chart repor t.................................................................................353
Encounter Miscellaneous Letter to Patient...........................................................................353
Encounter Miscellaneous Letter to Provider.........................................................................354
Encounter Phone Note report..............................................................................................354
Paceart Optima System | Contents | 9
Encounter Search Results report.........................................................................................354
Encounter Tachy (Biventricular) report.................................................................................354
Encounter Tachy (Detailed) report .......................................................................................354
Encounter Tachy (Simplified, 2 strips) report........................................................................355
Encounter Tachy (Simplified, no strips) report .....................................................................355
Encounter TTM (2 Strips) report...........................................................................................355
Encounter TTM (3 Strips) report...........................................................................................355
Missed Appointment Letter...................................................................................................355
Missed Appointment List report............................................................................................356
Missed Appointment Postcard..............................................................................................356
Patient Activity report...........................................................................................................356
Patient Device History report................................................................................................356
Patient Labels.......................................................................................................................356
Patient Listing (Device Information) report...........................................................................357
Patient Listing (Landscape) report.......................................................................................357
Patient Listing (Last and Next Encounter Dates) report.......................................................357
Patient Listing (Last Encounter Date) report .......................................................................357
Patient Listing (Portrait) repor t ............................................................................................358
Patient Medication Summary report.....................................................................................358
Patient Schedule Letter........................................................................................................358
Patient Search Results report..............................................................................................358
Patient Summary report.......................................................................................................358
Patient Summary (Encounter) report ..................................................................................359
Patients Tested report...........................................................................................................359
Provider Labels....................................................................................................................359
Reminder Letter....................................................................................................................359
Reminder Postcard...............................................................................................................359
Remote Monitoring Prescription Letter.................................................................................359
Schedule (Device Information) report...................................................................................360
Schedule report ...................................................................................................................360
Chapter 10: Paceart System Web Access......................................361
Paceart System Web Access security..................................................................................362
Monitoring services and limiting access to patient data............................................362
Account administration.........................................................................................................362
Adding or editing a Paceart System user account.....................................................363
Linking users to providers..........................................................................................363
Setting a user password............................................................................................364
Logging in to Paceart System Web Access..........................................................................365
Searching patient encounters...............................................................................................365
Chapter 11: Paceart Optima System Security and Privacy..........367
Paceart Optima System Security Configuration Overview...................................................367
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Password Complexity Enforcement...........................................................................368
Integration with Microsoft Active Directory Services..................................................368
External system accounts and roles..........................................................................371
Data filtering in the Paceart Optima System..............................................................371
SSL Certificates.........................................................................................................371
Database security for Application Server services....................................................372
ClickOnce digital signing certificate...........................................................................372
Local security policies................................................................................................372
Audit control...............................................................................................................372
HL7 Integration.....................................................................................................................373
BCP data export...................................................................................................................373
Data authentication..............................................................................................................374
HIPAA Overview...................................................................................................................374
Product use and technical features...........................................................................374
Potential security exposures......................................................................................375
Paceart Optima System security features.................................................................376
Important notes.........................................................................................................378

Trademarks

The following list includes trademarks or registered trademarks of Medtronic in the United States and possibly in other countries. All other trademarks are the property of their respective owners.
Mainspring, Medtronic, Medtronic CareLink, Paceart Optima, Paceart
Chapter
1

Introduction to the Paceart Optima™ System

The Paceart Optima System is a clinic management tool that organizes patient, device, and programmer information. It also provides access to trend analysis, aiding a physician or clinician in their daily workflow and management of patient and cardiac data.The Paceart System supports cardiac rhythm devices from most manufacturers.
The Paceart System:
Stores programmed device parameters
Summarizes patient data into concise reports
Keeps a history of patient encounters
Creates correspondence documents
Schedules patient follow-up appointments
Assists with records processing
Assists in charge and billing management
Offers integration with a hospital's or clinic's HL7-compatible system
Provides task management to streamline clinic workflow
Provides automatic import of data from pacemakers, programmers, and other storage media

Explanation of symbols

Consult instructions for use
Conformité Européenne (European Conformity).This symbol means that the device fully complies with Regulation (EU) 2017/745 (EU-MDR).
Authorized Representative in the European Community
Manufacturer
Lot number
Re-order number
Date of Manufacture
14 | Paceart Optima System | Introduction to the Paceart Optima™ System
Do not dispose of this product in the unsorted municipal waste stream. Dispose of this product according to local regulations. See http://recycling.medtronic.com for instructions on proper disposal of this product.
Storage temperature limit
Transit temperature limit
Humidity Limitation
Software
Model number
Manufactured in
Medical device

Indications

The Paceart Optima System is intended for use as a database to follo w cardiac patients with or without cardiac implantable devices.

Precautions

Storage and installation
Ensure there is no condensed moisture on the Paceart System software USBs.
Paceart System software USBs must be stored within the following conditions:
Storage Environment
-20°C (-4°F) to +45°C (113°F)Temperature 20% to 90%Relative Humidity
System operation
Before system operation:
Ensure that the system is not being used with other instruments that may result in misdiagnosis or other problems.
Ensure there is no condensed moisture on the Paceart System software USBs.
The Paceart System software USBs must be operating in an environment within the following conditions:
Paceart Optima System | Introduction to the Paceart Optima™ System | 15
Operating Environment
0°C (32°F) to +35°C (95°F)Temperature 20% to 90%Relative Humidity
Additional precautions
Do not modify the original system in any way.This includes adding any software product.
Ensure that all patient records are updated and permanently stored before turning the PC power off.
Double-check the data before typing the data into the system.

Contraindications

No known contraindications.

Authorized users

Medtronic representatives provide the Paceart Optima System orientation and training materials at the time of the installation. All users should be f amiliar with the Paceart System documents, including the online Help, before using the P aceart Optima System.The designated system administrator should also read the Paceart System documentation for information on using the P aceart Optima System software user interface for function and control.
An authorized person, preferably a ph ysician, must v erify the implantable de vice and electrode specifications entered into the database or modified in the database. An authorized person, preferably a physician, must verify the test results that are automatically entered into the database by the instrument.The data obtained from this device must be interpreted in conjunction with other clinical data and the results of other independent tests.

Technical Support

For technical support contact your local Medtronic office. In the US and Canada, Paceart Technical Services can be contacted via phone or email.
Phone: 1-800-PACEART
Email: paceart.support@medtronic.com
Web:Visit the Paceart Community website at MedtronicAcademy.com/Paceart.
If you encounter a serious incident with the software, contact your Medtronic representativ e and the competent medical regulatory authority for your region or country.
16 | Paceart Optima System | Introduction to the Paceart Optima™ System

Manuals supplied with your system

Electronic versions of Paceart Optima System manuals are supplied on the documentation USB supplied with your software.You can also download or request printed copies of these manuals from www.medtronic.com/manuals.
There are two manuals installed for use with the P aceart Optima System software, the Paceart Optima System Software Installation and Configuration Instructions and the Paceart Optima System Software User Manual. The Paceart Optima System Software Installation and Configuration Instructions provide you with the information you need to install and configure your Paceart Optima System software.This includes optional configurations and optional software components.The Paceart Optima System Software User Manual provides you with information on how to use your Paceart Optima System software. Contact Medtronic if you find any errors in these manuals.
All patient and clinical data displayed in Paceart Optima System software documentation are fictitious and for demonstration purposes only.

Accessing the online Help

The online Help provides additional information about the features and functionality of the Paceart Optima System.
There are 5 ways to access the online Help.
Clicking Help > Help from the menu bar opens the appropriate help topic for where you are in the application.
Clicking the Help button in a dialog box opens the appropriate help topic for the dialog box.
In any add or edit dialog box, clicking the "?" and selecting an active field opens the field level Help for that field.
Pressing the F1 key while a field is selected opens the field level Help for that field.
Pressing the F1 key while no fields are selected opens the appropriate help topic for where y ou are in the application.
If your version of the Paceart System has been customized, you can view your customer build number by clicking Help > About.

Navigating through the Paceart System without a mouse

On some windows in the Paceart System, it is possible to navigate b y using the keyboard instead of a mouse . These keyboard commands are composed of the ALT key followed by one or more keyboard symbols.
1. From within a Paceart System window, press the ALT key. If the window supports AL T ke y functionality, the File menu item is selected and buttons, tabs, or file menu items are underlined.
2. Press the letter on the keyboard that corresponds to the desired action.
3. Press the TAB key, SHIFT+TAB, and the ARROW keys to access additional options in a list.
4. Press ENTER to make a selection.
Paceart Optima System | Introduction to the Paceart Optima™ System | 17

Explanation of dialog box fields and buttons

This table lists some of the common fields and buttons that appear in many of the dialog boxes within the Paceart Optima System. Additional fields and buttons for each dialog box are defined separately throughout the user manual and online help.
Field and button definitionsDialog box fields and buttons
Save
Save and Close
Select
Cancel
OK
Help
Saves all changes.
Saves and closes the dialog.
Shows the selected item in the main window.
Cancels and closes the dialog.
Saves the information and closes the dialog box.
Accesses the Help system.
Chapter
2

Paceart System Patient Records

A patient's record is an ongoing electronic compilation of encounters, appointments, test results, medical information, billing information, demographic information, and any other data that pertains specifically to a single patient. All of this information is stored in the Paceart System database and can be manipulated in a variety of useful ways.
The Paceart System lets you add information to a patient record in sev eral w a ys . For example, you can enter it manually, retrieve it from a previous entry, or download it from an external source.The process for adding information can vary depending on the type of data being added.

Opening a patient record

Opening a patient record gives you access to specific information about one patient.
1. Click the Search tab.
2. Click the Patients subtab.
3. Enter the patient name and any other relevant search criteria about the patient.
4. Click Search.
5. Select the patient record and click Open.
The patient record is displayed.

Closing a patient record

After you have finished working with a patient record you can save the changes and close the record.
1. If you are in add or edit mode make sure to save any changes you have made to the patient record.
2. Click the Close Patient link in the upper right corner of the patient record.
The patient record is closed.

Switching between patient records

You can switch between patient records and other parts of the Paceart System, such as tasks or the encyclopedia.
To switch from an open patient record to another part of the Paceart System, click on the tab you want to switch to. For example, you can click on the Tasks tab to view your assigned tasks.
20 | Paceart Optima System | Paceart System Patient Records
You can switch back to an open patient record by selecting the record from the open patient drop-down list in the upper right corner.
Paceart Optima System | Paceart System Patient Records | 21

Adding a patient to the Paceart System database

The Paceart System database is made up of patient records that contain information about the patient such as encounters, appointments, test results, medical inf ormation, billing information, and demographic information.
You can add a new patient to the Paceart System database from within the Paceart System from the Search > Patients subtab or from an external system such as an EMR or the Medtronic CareLink Network. Minimally you need to enter a patient's last name and location of care.

Adding a new patient to the Paceart System database

You can add new patients to the Paceart System database through an external system, or through the Paceart Optima System by entering, and then saving, their demographic information.
If you searched for the patient first, some of the search criteria that you entered on the Patients search tab will automatically transfer to the corresponding fields in the Add Patient dialog box.
First Name
Middle Initial
Last Name
Date of Birth
City
State/Province
Zip/Postal code
Country
Phone
1. On the Patients search tab, click Add. The Add Patient dialog box is displayed.
22 | Paceart Optima System | Paceart System Patient Records
2. In the Add Patient dialog box, enter the patient's demographic information.
3. Click Save.
Field and button definitions for the Add Patient dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Title:
*Last Name:
First Name:
MI:
Suffix:
The patient's title or salutation. The value must be one of the following values: Dr., Miss, Mr., Mrs, Ms., Prof.
The patient's surname (family name). Required field.
The patient's first given name (e.g. primary forename or primary personal name).
The first letter of the patient's second given name (secondary forename, secondary personal name, patronymic, or matronymic).
The suffix of the patient's name. For example, Sr. (senior).
Date of Birth:
The patient's date of birth.
Paceart Optima System | Paceart System Patient Records | 23
Field and button definitionsDialog box fields and buttons
Gender:
Status:
Marital Status:
Language:
Location of Care:
Email:
Remote Follow-up Service:
Transmitting Automatically
The patient's gender.The value must be one of the following values: Male, Female, Other.
A single character field used to represent the patient's current status.These values are defined by your clinic and your workflow, for example y ou could use "A" for active.
The patient's marital status.
The patient's preferred language.
The patient's primary location of care.This can be changed on specific appointments and encounters.
The patient's email address.
The patient's remote follow-up service.
Indicates that the device automatically transmits data using wireless telemetry.
Address:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone 1:
Type:
Phone 2:
The first line of the patient's street address.
The second line of the patient's street address.
The city associated with the patient's street address.
The state or province associated with the patient's street address.
The zip or postal code associated with the patient's street address.
The country associated with the patient's street address.
The patient's primary or preferred phone number.
The type of phone associated with Phone 1. Some examples are home, mobile, and pager.
The patient's secondary phone number.
Type:
The type of phone associated with Phone 2. Some examples are home, mobile, and pager.
24 | Paceart Optima System | Paceart System Patient Records
Field and button definitionsDialog box fields and buttons
Default:
Paceart:
Referring Providers
Diagnoses
Codes
Deceased:
Date of Death:
The patient's ID number from a previous version of Paceart or from an external system such as an electronic medical record (EMR).
The automatically generated Paceart ID number .This is created when a new patient is added to Paceart and is not editable.
The patient's referring providers. Click the [...] button to select a provider from the encyclopedia.
The patient's diagnoses. Click the [...] button to select a diagnosis from the encyclopedia.
The patient's code(s) as defined by your clinic. A patient can have multiple codes. Codes can be used for classifying or grouping patients.
Indicates whether or not the patient is deceased.
If the patient is deceased, the date of the patient's death.
Cause of Death:
If the patient is deceased, the cause of the patient's death.

Deleting a patient record

Deleting a patient record also deletes that patient from the Paceart System database. If you ha v e permission to delete a patient, you can delete patients that have no devices, no encounters, and no appointments.
The following topics describe the steps to delete a patient record.

Reassigning an encounter

If you have permission to edit encounters, you can reassign an encounter from one patient to another.This is used to resolve duplicate patients or situations where an encounter was added to the wrong patient record. The encounter cannot be reassigned if it has already been signed or locked. Signed or locked encounters must be amended before reassigning.
1. Search for and open the patient record.
2. Click the Encounters tab.
3. Select the encounter you want to reassign from the list.
4. Click File > Reassign Encounter. The Reassign Encounter dialog box is displayed.
5. Enter the name of the patient to whom you are reassigning the encounter or search for the patient by
clicking the [...] button.The patient you are reassigning the encounter to must have an implanted device. The Select Patient dialog box is displayed.
Paceart Optima System | Paceart System Patient Records | 25
6. Select the patient device from the drop-down list.This is not a required field.
7. Select the instrument from the drop-down list.This is not a required field.
8. Click Save.
9. In the confirmation dialog box click Yes.
The encounter is reassigned to the other patient. All encounters must be reassigned or deleted before deleting a patient record.

Deleting devices from a patient record

You can add, edit, and delete devices from a patient record in the Device Details tab. All encounters associated to a device must be reassigned or deleted before deleting the device.
1. Search for and open the patient record.
2. Click the Device Details tab.
3. Select All Devices.
4. Select the device to be deleted.
5. Click Delete.
6. To confirm that you want to delete the device, click Yes.
The device is deleted. All devices, both activ e and inactive, must be deleted from the patient record bef ore the patient can be deleted.

Deleting appointments from a patient record

If you have permissions to edit appointments, you can delete appointments from a patient's schedule.
1. Search for and open the patient record.
2. Click the Patient Information tab.
3. Click the Schedule tab.
4. In the Show drop-down menu, select (Select All).
5. Select the appointment to be deleted.
6. Click Delete.
7. To confirm that you want to delete the appointment, click Yes.
The appointment is deleted. All appointments, regardless of status, must be deleted before deleting a patient record.

Deleting a patient record

Deleting a patient record also deletes that patient from the Paceart System database. If you ha v e permission to delete a patient, you can delete patients that have no devices, no encounters, and no appointments.
This process only allows you to delete one patient record at a time.To delete multiple patient records at one time go to Administration > Batch Delete.
1. Click the Search tab.
2. Click the Patients tab.
3. Click Search.
The initial search results are sorted in ascending order by patient last name, patient first name, and then patient middle initial.You can change the sort criteria and order by clicking on any of the column headings .
4. In the Results window, click the patient you want to delete.
5. Click File > Delete Patient.
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6. Click Yes to confirm the deletion.
The patient record is deleted.

Patient Record

The patient record is divided into three tabs, the Patient Information tab, the Device Details tab, and Encounters tab.
The Patient Information tab is used to document patient specific inf ormation such as patient demographics, medication information, and scheduling preferences.The Device Details tab is used to document information about the patient's device or devices , such as device details, implant date , and serial number.The Encounters tab provides a list of patient encounters.

Copying information from the patent record tabs

You can copy information from any of the fields on the Patient Inf ormation, De vice Details, or Encounter s tabs in the patient record. After cop ying the inf ormation, you can then paste it when adding or editing records to speed data entry and reduce errors.
1. Locate the information that you want to copy from one of the fields on the Patient Information, Device Details, or Encounters tabs in the patient record.
2. Right-click the field, then select Copy from the menu that opens.
3. To paste the copied value into a field, right-click the field and select Paste from the menu that opens, or
place the cursor into the field and press Ctrl+V.

Patient Information tab

You can add, edit, and delete patient demographic information from the Patient Information tab.This tab is broken up into subtabs.You must be in add or edit mode and have sufficient privileges to view and modify information on the subtabs.
The Patient Information tab gives an overview of patient information including the patient ID number, the date of birth, and a list of diagnoses. If the patient has multiple ID numbers , then only the primary ID number is displayed.The primary ID is configured in Administration.
Patient Information Subtabs
Description of informationSubtab
Patient Overview
Demographics
Diagnoses
This tab contains a read-only overview of a patient's demographic information, patient IDs, codes, providers, diagnoses , medications, active de vices, and patient comments.
This tab contains personal information about the patient.Y ou can edit information on this tab.
This tab contains a list of all the patient's diagnoses.Y ou can add, edit, or delete information on this tab.
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Description of informationSubtab
Providers
Medications
Insurance
Schedule
This tab contains a list of all the patient's providers.You can add, edit, or delete providers.
This list also includes providers referenced as Implant, Abandoned, Partially Explanted, and Explanted providers in the Device Details section, providers referenced as Prescribing providers in the Medications subtab, and providers referenced as Billing providers in encounters.
This tab contains a list of all the patient's medications.You can add, edit, or delete medications.
This tab contains a list of all the patient's insurers.You can add, edit, or delete insurers.
This tab contains all scheduled, canceled, completed, or missed appointments. You add, edit, or delete appointments and view and edit patient scheduling preferences.
This tab contains a list of allergy, pharmacy, and CardioVoice information.Miscellaneous
Editing a patient's demographic information
You can edit an existing patient's demographic information, IDs, codes and comments.
1. In the patient record, click the Patient Information tab.
2. Click the Demographics subtab.
3. Click Edit.
4. In the Edit Patient dialog box, make changes to the patient's demographic data.You cannot change the
system-generated Paceart System patient ID.
5. Click Save.
Field and button definitions for the Edit Patient dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Title:
*Last Name:
First Name:
MI:
Suffix:
The patient's title or salutation. The value must be one of the following values: Dr., Miss, Mr., Mrs, Ms., Prof.
The patient's surname (family name). Required field.
The patient's first given name (e.g. primary forename or primary personal name).
The first letter of the patient's second given name (secondary forename, secondary personal name, patronymic, or matronymic).
The suffix of the patient's name. For example, Sr. (senior).
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Field and button definitionsDialog box fields and buttons
Date of Birth:
Gender:
Status:
Marital Status:
Language:
Location of Care:
Email:
Remote Follow-up Service:
Transmitting Automatically
The patient's date of birth.
The patient's gender.The value must be one of the following values: Male, Female, Other.
A single character field used to represent the patient's current status.These values are defined by your clinic and your workflow, for example y ou could use "A" for active.
The patient's marital status.
The patient's preferred language.
The patient's primary location of care.This can be changed on specific appointments and encounters.
The patient's email address.
The patient's remote follow-up service.
Indicates that the device automatically transmits data using wireless telemetry.
Address:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone 1:
Type:
Phone 2:
The first line of the patient's street address.
The second line of the patient's street address.
The city associated with the patient's street address.
The state or province associated with the patient's street address.
The zip or postal code associated with the patient's street address.
The country associated with the patient's street address.
The patient's primary or preferred phone number.
The type of phone associated with Phone 1. Some examples are home, mobile, and pager.
The patient's secondary phone number.
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Field and button definitionsDialog box fields and buttons
Type:
Default:
Paceart:
Patient Comments
Private Patient Comments
Codes
The type of phone associated with Phone 2. Some examples are home, mobile, and pager.
The patient's ID number from a previous version of Paceart or from an external system such as an electronic medical record (EMR).
The automatically generated Paceart ID number .This is created when a new patient is added to Paceart and is not editable.
Comments about the patient. Press F9 to look up a quick phrase.
Additional comments about the patient that can be viewed only within the Paceart System. These comments appear on the Edit Patient dialog bo x and read-only Patient Overview subtab , but are not printed on reports. Press F9 to look up a quick phrase.
The patient's code(s) as defined by your clinic. A patient can have multiple codes. Codes can be used for classifying or grouping patients.
Deceased:
Date of Death:
Cause of Death:
Indicates whether or not the patient is deceased.
If the patient is deceased, the date of the patient's death.
If the patient is deceased, the cause of the patient's death.
Adding or editing a patient's diagnosis
You can add or edit a patient's diagnosis to the patient's record on the Add Patient Diagnosis or Edit Patient Diagnosis dialog box. A patient can have up to twenty active diagnoses.
If the diagnosis is related to a device, or an implant diagnosis, y ou m ust edit the de vice details to change the diagnosis. Although it is listed on the Diagnoses tab, you cannot edit it there.
1. In the patient record, click the Patient Information tab.
2. Click the Diagnoses tab.
3. Determine which action to take.
To add a diagnosis, click Add.
To edit a diagnosis, select the diagnosis and click Edit. The Add Patient Diagnosis or the Edit Patient Diagnosis window is displayed.
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4. Enter or edit the diagnosis.To search for an existing diagnosis click the [...] button.
5. Select Active if it is an active diagnosis.
6. Enter or edit comments about the patient's diagnosis in the Comments field. Press the F9 key to enter a quick phrase in the Comments field.
7. The Display Order section shows you how the diagnoses will be listed on reports.To change the display order of the diagnoses, select the diagnosis and use Move Up and Move Down to move the diagnosis.
8. To save the information and add another diagnosis, click Save and Add Another. Otherwise, click Save
to save the information and close the dialog box.
The updated diagnosis information is displayed on the Diagnoses tab.
Field and button definitions for the Add or Edit patient's diagnosis
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
*Diagnosis:
Active:
Comments:
Display Order:
Move Up
Move Down
Save
The patient's diagnosis. Required field.Y ou ma y have up to twenty active diagnoses.
Shows if the diagnosis is active or inactive.
Miscellaneous comments.
Allows you to change the order the diagnoses will be listed in on reports.
Moves the selected item up in the list box.
Moves the selected item down in the list box.
Saves all changes.
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Field and button definitionsDialog box fields and buttons
Save and Add Another:
Saves the inf ormation that is displayed and redispla ys the window with unpopulated fields so you can add another.
Selecting a diagnosis
Use the [...] button by any Patient Diagnosis or Diagnosis field to search for and select a diagnosis.
1. Click the [...] button next to the Diagnosis or Patient Diagnosis field. The Select Diagnosis dialog box opens.
2. Type the search criteria in the Search String field.
3. Click Search. The items that match your search criteria are displayed in the Results list.
4. Select a diagnosis from the Results list.
5. Click Select.
The diagnosis you selected is displayed in the field.
Field and button definitions for the Select Diagnosis dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Search String:
Text box for entering whole or partial keywords.
Search
Code
Description
Coding System
Comments:
Invokes the search.
The code assigned to the diagnosis.
The description of the diagnosis.
The coding system of the diagnosis.
Comments about the diagnosis.
Adding or editing a patient's provider
You can add or edit a patient's provider on the Add Patient Provider or Add Patient Provider dialog box. If the provider is related to a device, such as an implanting pro vider, y ou must edit the device details to change
the provider. Although it is listed on the Providers tab you cannot edit it there.
1. In a patient record, click the Patient Information tab.
2. Click the Providers tab.
3. Determine which action to take.
To add a provider, click Add.
To edit a provider, select the provider and click Edit. The Add Patient Provider or the Edit Patient Provider window is displayed.
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4. In the Provider field enter or edit the provider's name .T o search f or the provider's name in the encyclopedia click the [...] button.
5. In the Provider Type drop-down box select the type of provider.
6. Enter any comments about the patient's provider in the Comments field.To enter standard comment text, click in the Comments field and press the F9 key.
7. Click Save.
The updated provider information is displayed on the Providers tab.
Field and button definitions for the Add or Edit a Patient Provider dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
*Provider:
*Provider Type:
Comments:
Patient's provider. Required field.T o select a provider from the list, click [...] button.
The provider type. Required field.
Miscellaneous comments.
Selecting a provider
You can search for and select a Provider, Patient Provider or Billing Provider.
1. Click the [...] button next to the Provider, Patient Provider, or Billing Provider field. The Select Provider dialog box opens.
2. Type the search criteria in the Search String field.
3. Click Search. The items that match your search criteria are displayed in the Results list.
4. Select a provider name from the Results list.
5. Click Select.
The provider you selected is displayed in the field.
Field and button definitions for the Select Provider dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Search String:
Search
Text box for entering whole or partial keywords.
Invokes the search.
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Field and button definitionsDialog box fields and buttons
Name:
Address:
Country:
Comments:
Phone
Provider ID:
Specialty:
Provider Code:
Full name of the provider.
The provider's street address.
The country of the provider's street address.
Miscellaneous comments.
The provider's phone number.
The provider's ID number.
The provider's medical specialty, for example, cardiology.
The provider code.
Adding, editing, or discontinuing a patient's medication
You can add or edit a patient's medication on the Add Patient Medication or Edit Patient Medication dialog box.
1. In the patient record, click the Patient Information tab.
2. Click the Medications tab.
3. Determine which action to take.
To add a medication, click Add.
To edit a medication, select the medication and click Edit. The Add Patient Medication or the Edit Patient Medication window is displayed.
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4. In the Medication Information section, enter or edit the medication.To search for an existing medication click the [...] button.
5. In the Prescription Information section, enter or edit the date dispensed and other relev ant prescription
information.
6. If you want to discontinue the medication select Discontinued and enter the relevant discontinuation information.
7. Click Save.
The updated medication information is displayed on the Medications tab.
Field and button definitions for the Add or Edit a Patient Medication dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Medication Information
*Medication:
Side Effects:
The patient's medication.T o select a medication from the list, click the [...] button. Required field.
The side effects of selected medication.This is a read-only view of the side effects from the medication encyclopedia for the selected medication.
Comments:
Prescription Information
Miscellaneous comments.
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Field and button definitionsDialog box fields and buttons
Provider:
Date Dispensed:
Tablets Dispensed:
Refills:
Dispense As Written:
Directions For Use:
Discontinuation Information
Discontinued:
Discontinued Date:
Discontinued Reason:
The provider who prescribed the patient's medication. To select a provider from the list, click the [...] button.
The date the prescription was dispensed.
The number of tablets dispensed in the prescription.
The number of refills in the prescription.
Indicates if the medication should be dispensed as written (DAS) and that no generic is allowed.
The directions for use for the prescription.
Indicates if the prescription is discontinued.
The date the prescription was discontinued.
The reason the prescription was discontinued.
Comments:
Miscellaneous comments.
Selecting a medication
You can search for and select a medication.
1. Click the [...] button next to the Medication field. The Select Medication dialog box opens.
2. Type the search criteria in the Search String field.
3. Click Search. The items that match your search criteria are displayed in the Results list.
4. Select a provider name from the Results list.
5. Click Select.
The provider you selected is displayed in the field.
Field and button definitions for the Select medication dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Search String:
Search
Text box for entering whole or partial keywords.
Invokes the search.
Description:
A description of the medication.
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Field and button definitionsDialog box fields and buttons
Side Effect 1:
Side Effect 2:
Side Effect 3:
Comments:
Side Effect 4:
Side Effect 5:
Side Effect 6:
Medication side effect.
Medication side effect.
Medication side effect.
Miscellaneous comments.
Medication side effect.
Medication side effect.
Medication side effect.
Adding or editing a patient's insurance
You can add or edit a patient's insurance company information in the Add Patient Insurance or Edit P atient Insurance dialog box.
1. In a patient record, click the Patient Information tab.
2. Click the Insurance tab.
3. Determine which action to take.
To add an insurance company, click Add.
To edit an insurance company, select the insurance company and click Edit. The Add Patient Insurance or the Edit Patient Insurance window is displayed.
4. In the Insurance Information section, enter or edit the Company Name.To search for an existing insurance company click the [...] button.
5. Select the Type of insurance from the drop-down list.
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6. In the Policy Holder Information section, enter or edit any relevant policy holder information.
7. Click Save.
The updated insurance information is displayed on the Insurance tab.
Field and button definitions for the Add or Edit a patient insurance dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Insurance Information
*Company Name:
*Type:
Active:
Policy Holder Information
Policy Holder Name:
Policy Holder Employer:
Policy Holder SSN:
Policy Number:
Certificate Number:
Effective Date:
The name of the patient's insurance company. To select an insurance company from the list, click the [...] button. Required field.
The insurance type (primary, secondary, or other). Required field.
Indicates if the insurance policy is active.
The name of the insurance policy holder.
The primary policy holder's employer.
The primary policy holder's social security number.
The policy number of the holder's insurance.
The insurance certificate number.
The date the insurance policy became effective for the patient.
Comments:
Miscellaneous comments.
Selecting an insurance company
You can search for and select an insurance company.
1. Click the [...] button next to the Company Name field. The Select Insurance dialog box opens.
2. Type the search criteria in the Search String field.
3. Click Search. The items that match your search criteria are displayed in the Results list.
4. Select an insurance company from the Results list.
5. Click Select.
The insurance company you selected is displayed in the field.
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Field and button definitions for the Select insurance company dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Search String:
Search
Company Name:
Address
Country:
Comments:
Code:
Phone:
Fax:
Text box for entering whole or partial keywords.
Shows the selected item in the main window.
The name of the Insurance company.
The insurance company's address.
The insurance company's country.
Miscellaneous comments.
Insurance company code.
The insurance company's phone number.
The insurance company's fax number.
Adding an appointment from a patient's record
You can add an appointment from a patient's record.
1. Open the patient's record.
2. Click the Patient Information tab.
3. Click the Schedule tab.
4. Click Add... to add a new appointment.
5. Enter the information for the appointment.
If needed, you can change the display interval for the hours shown on the Resource Schedule calendar using the right-click menu.You can divide the hours displayed on the calendar into 5, 6, 10, 15, 20, 30, or 60 minute intervals.
6. Click Save.
Field definitions for Add or Edit Appointment dialog boxes
This is a list of fields and buttons and their definitions.
Field definitionsDialog box fields
*Patient Name:
*Type:
The patient's name.To select a patient from the list, click the [...] button. Required field.
The type of appointment such as in-clinic, remote, TTM, implant, phone note, or miscellaneous. Required field.
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Field definitionsDialog box fields
*Location:
*Resource:
Start Time:
Duration:
Visit ID:
Comments:
In-Patient:
Cancel Appointment:
The location of care for the scheduled appointment. Required field.
The resource such as clinic staff or room that is assigned when creating an appointment. Required field.
The date and time for which the appointment is scheduled.
The amount of time assigned to the appointment.
Identifies all interactions with a patient related to a single encounter. Maximum length 75 characters.
Miscellaneous comments.
When selected, indicates the patient is hospitalized.
A check mark indicates that the appointment has been scheduled and then canceled.
Auto
Create Encounter
Save
Cancel
Delete
Automatically assigns the date and time for the appointment based on schedule preferences.
Creates an associated encounter for the appointment.
Saves all changes.
Cancels and closes the dialog.
Removes the item or items from the list.
Deleting an appointment
You can delete an appointment. Deleted appointments cannot be reinstated. There are multiple places from which you can open the appointment.Where you open it is determined by
your role and the workflow within your clinic. The following procedure shows you how to delete an appointment once you have selected it.
1. Click Edit. The Edit Appointment dialog box is displayed.
2. Click Delete.
3. Click Yes to confirm that you want to delete the appointment.
You cannot reinstate a deleted appointment.
4. Click Save.
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Setting a patient's scheduling preferences
You can set and edit the appointment frequency , the pref erred week day, and the preferred time for a patient. The Paceart System stores this information in the patient's record.
1. From within a patient record click the Patient Information tab.
2. Click the Schedule tab.
3. In the Preferences section, click Edit.
4. Enter patient preferences and, if desired, comments.
5. Click Save.
Field definitions for Edit Preferences dialog box
This is a list of fields and buttons and their definitions.
Field definitionsDialog box fields
Interval number
Interval label
Week
Day
Time
Comments:
The interval number. Click the up and down arrows or enter a number.
The interval label (day(s), week(s), or month(s)) that applies to the interval number.
Indicates if the patient has a week of the month preference for scheduling an appointment.
Indicates if the patient has a day of the week preference for scheduling an appointment.
Indicates if the patient has a time preference for scheduling an appointment.
Miscellaneous comments.
Editing a patient's allergy information
You can edit a patient's allergy information on the Edit Allergies dialog box.
1. In the patient record, click the Patient Information tab.
2. Click the Miscellaneous tab.
3. In the Allergy Information section, click Edit. The Edit Allergies dialog box is displayed.
4. Enter the patient's allergy information. Click the F9 key to select standardized text.
5. Click Save.
The allergy information is displayed in the Allergies section of the Miscellaneous tab.
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Field and button definitions for the Edit Allergies dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Allergy Information
The patient's allergies.
Editing a patient's pharmacy information
You can edit a patient's pharmacy information from the Miscellaneous tab.
1. In a patient record, click the Patient Information tab.
2. Click the Miscellaneous tab.
3. In the Pharmacy Information section, click Edit. The Edit Pharmacy dialog box is displayed.
4. Enter pharmacy information and click Save.
The pharmacy information is displayed in the Pharmacy Information section of the Miscellaneous tab.
Field and button definitions for the Edit Pharmacy dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Name:
Address:
The name of the patient's primary pharmacy.
The first line of the pharmacy's street address.
Address:
City:
State/Province:
Country:
Phone:
Fax:
The second line of the pharmacy's street address.
The city for the pharmacy's street address.
The state for the pharmacy's street address.
The country of the pharmacy's street address.
The pharmacy's phone number.
The pharmacy's fax number.
Editing a patient's CardioVoice information
You can edit a patient's CardioVoice settings from the Miscellaneous tab in the patient record.
1. In the patient record, click the Patient Information tab.
2. Click the Miscellaneous tab.
3. In the CardioVoice Information section, click Edit. The Edit CardioVoice Settings dialog box is displayed.
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4. Enter the patient's CardioVoice information and click Save.
The patient's CardioV oice settings are displayed in the Car dioV oice Inf ormation section of the Miscellaneous tab.
Field and button definitions for the Edit CardioVoice Settings dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
CardioVoice ID
Patient Name
The patient's CardioVoice ID. A CardioVoice ID must be between 4 and 10 digits.
Opens a dialog to record an audio file of the patient's name.The audio file will be used during CardioVoice calls.
Recording and playing a patient's spoken name
You can record a patient's spoken name from the Miscellaneous tab in the patient record.The spoken name audio file is played during CardioVoice calls.
NameButton
Record
Stop
Play
1. In the patient record, click the Patient Information tab.
2. Click the Miscellaneous tab.
3. In the CardioVoice Information section, click Edit. The Edit CardioVoice Settings dialog box is displayed.
4. Click Patient Name. The Patient Spoken Name dialog box is displayed.
5. To record the patient's name, click the record button.
6. To stop recording, click the stop button.
7. To play back the patient's name, click the play button.
8. When you have finished recording the patient's name click Close to close the Patient Spoken Name
dialog box.
9. In the Edit CardioVoice Settings dialog box, click Save.
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In the CardioVoice Information section the Patient Name field status changes to "Recorded".

Device Details tab

You can add, edit, and delete a device from a patient's record on the Device Details tab.You can also edit the information about the device and mitigate a device on alert.You must have sufficient privileges to view and modify information on this tab.
The Device Details tab gives you a quick overview of the patient's device details including the device manufacturer and model, the serial number, the implant/given dates, and any leads associated with the primary device. If the patient has multiple devices, only one device name will be displayed in the tab at a time. If Active Devices is selected, then only active devices are displayed on this tab. If All Devices is selected, the display order preference is giv en to active de vices.Then preference is giv en to both Pacemakers and ICDs, then ICM/ILRs, and then event recorders.Then preference is given to the most recent implant date.
If the patient has a device on alert or watch, the device name on the Device Details tab is displayed in red along with the alert or watch icon. If the device alert has been mitigated, the green check mark icon is displa yed next to the device name.
Adding or editing a patient's device
You can add or edit a patient's device in the Add Patient Device or Edit Patient Device dialog box.
1. In the patient record, click the Device Details tab.
2. Determine which action to take.
To add a device, click Add.
To edit a device, click Edit. The Add Patient Device or the Edit Patient Device dialog is displayed.
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3. In the Device Information section, enter the device or search for an existing device by clicking the [...]
button.
4. Enter or edit relevant device and implant information.
5. Click Save.
The device information is display ed on De vice Details tab . If you entered Abandoned, Partially Explanted, or Explanted information for the device you must select All Devices to view the device information.
Field and button definitions for the Add or Edit patient device dialog box
This is a list of fields and buttons and their definitions.
Device Information
Field and button definitionsDialog box fields and buttons
*Device:
Associated:
Serial Number:
Implant Diagnosis:
Complication:
Chamber:
Location
The patient's device.To select a device from the list, click the [...] button. Required field.
The leads or adapters that are associated with the device.
The serial number for the device .This field is required for matching incoming CareLink, SessionSync, and other transmissions to the correct patient.
The patient's implant diagnosis.T o select a diagnosis from the list, click the [...] button.
Any complication stemming from patient's implant procedure.
The heart chamber where the lead or adapter is implanted.
The location in the patient's body where the device is implanted.
Access:
Pacing:
Comments:
Implant
Date:
The entry site access for the lead.
Indicates if the lead is used for pacing.
Miscellaneous comments.
The date the device was implanted.This must be today's date or a date in the past for the Paceart System to consider it an active device.The device must be active to match CareLink, SessionSync, or Latitude transmissions. Also the device must be activ e to use the Retrieve from Programmer feature.
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Field and button definitionsDialog box fields and buttons
Provider 1:
Provider 2:
Facility:
Abandoned
Date:
Provider:
Partially Explanted
Date:
Provider:
Explanted
The primary medical provider for the implant .To select a provider from the list, click the [...] button.
The secondary medical provider for the implant.To select a provider from the list, click the [...] button.
The facility where the device was implanted.
The date the device was abandoned.
The medical provider for the abandoned device.To select a provider from the list, click the [...] button.
The date the device was partially explanted.
The medical provider for the partial explant.To select a provider from the list, click the [...] button.
Date:
Provider:
Buttons
Save
Save and Add Another:
The date the device was explanted.
The medical provider for the explant.To select a provider from the list, click the [...] button.
Saves all changes.
Saves the inf ormation that is displayed and redispla ys the window with unpopulated fields so you can add another.
Selecting a device
You can search for and select a device.
1. Click the [...] button next to the Device field. The Select Device dialog box opens.
2. Type the search criteria in the Search String field.
3. Click Search. The items that match your search criteria are displayed in the Results list.
4. Select a device from the Results list.
5. Click Select.
The device you selected is displayed in the field.
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Field and button definitions for the Select Device dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Device Type:
Search String:
Search
A drop-down list of available device types.
Text box for entering whole or partial keywords.
Invokes the search.
Pre-filling device information
If you are adding a new lead or adapter , you can use an e xisting device in the patient's record to pre-fill v alues for the new device.
1. From the Select Device dialog box, select a new device to add to the patient's record and click Select. The Paceart Optima System displays the Select Device - Pre-fill Information dialog box.
2. Select whether to use information from a patient's existing device to automatically update values for the new device.
To use values from an existing device, select Pre-fill information from the following device and
then select the device from the list.The Paceart System updates the new device's implant dates, provider names, diagnosis values , and implant facility with the e xisting de vice's data and automatically associates the new device with the existing one.
To leave the values in the new device blank for later updates, select Do not pre-fill any information
from another device.
3. Click OK.
The Paceart System returns you to the Add Patient Device dialog box. If you chose to pre-fill information, the Paceart System automatically updates the associated device, implant diagnosis, implant date , provider , and implant facility fields with information from the existing device you selected.
Field and button definitions for the Select Device - Prefill Information dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Pre-fill information from the following device:
Indicates that you want the system to pre-fill information from the selected device.
Paceart Optima System | Paceart System Patient Records | 47
Field and button definitionsDialog box fields and buttons
Device selection drop-down list
Do not pre-fill any information from another device
Select the device that you want to pre-fill information from.
Indicates that you do not want the system to automatically pre-fill information from another device.
Updating Device Associations
You can update the leads or adaptors associated with a patient's current ICD or pacemaker.
1. Add or edit a device on the Device Details tab. When you save your changes, the Paceart System identifies any lead or adaptor devices that either are
associated with an inactive device or are not associated with an y device. If an y exist, the Paceart System displays the Update Associations dialog box that lists current de vice associations and any unassociated devices from the patient's record.
The association tree at the top of the dialog box lists the patient's currently active ICD or pacemak er along with any leads or adapters associated with it.The Current Association section lists any leads or adapters associated with explanted, partially explanted, or abandoned devices.The Currently Unassociated section lists lead or adapter devices in the patient record that are not associated with an ICD or pacemaker .
2. Click Associate to associate the lead or adapter with the currently active device. The Paceart System updates the association and lists that lead or adapter in the association tree.You can click Remove to preserve the original device association, if needed.
3. Click Save. The Paceart System updates the list on the Device Details tab with any new associations.
Field and button definitions for the Update Associations dialog box
This is a list of fields and buttons and their definitions.
Field and button descriptionsDialog box fields and buttons
Associate
Associates the selected lead or adaptor with the patient's current ICD or pacemaker device.
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Field and button descriptionsDialog box fields and buttons
Remove
Removes the association between the selected lead or adaptor and the patient's current ICD or pacemaker and restores any original associations.
Device Alerts and Watches
Device alerts and watches allow you to flag de vices that require special management due to a manufacturer alert or recall.
Both device watches and device alerts are configured in the device encyclopedia.When a device is placed on watch or alert, that device is shown on the Device Alerts tab in the device encyclopedia and an alert or watch icon is always displayed next to the device name in the Paceart System and in reports.
Device alerts can be set for an entire device model type or for specific serial numbers. Device watches are set for an entire device model type.
If a patient has a device on alert or watch, the device name on the Device Details tab, in the patient record, is displayed in red along with the alert or watch icon. Also, the de vice alert or device on watch icon is display ed next to the device name in the device list. Any reports that list a device on alert or watch also display the icons.
DefinitionIcon
The device is on watch.
The device is on alert.
The device alert was mitigated.
Alerts can be mitigated at a patient level. Mitigating a device alert means that you hav e changed the condition that triggered the alert or that the alert is not relevant to the patient due to the specific details of the alert. F or example, you may have changed a device setting to mitigate the alert. When a device alert is mitigated, the alert icon changes to a green check mark.
A device watch can be escalated to a de vice alert, but a device alert cannot be downgraded to a device watch. Device alerts and watches can both be deleted in the device encyclopedia.
Viewing device alert or watch details from the patient record
You can view additional information about a device alert or watch from within a patient record.
1. In the patient record, click the Device Details tab.
2. Select the device from the device list.
3. Click the Show Device Alert Information in the lower-right corner of the window.
The Device Alert Information section is displayed.
Mitigating a device alert
A device alert may be mitigated by an action taken at the patient level, such as a change in device settings. From a patient record you can enter the device alert mitigation.You can continue to add to a mitigation until it is marked complete. After the mitigation is marked as complete , the device alert icon will change to a green checkmark in reports and searches, but no further changes can be made to the mitigation details.
Paceart Optima System | Paceart System Patient Records | 49
1. In the patient record, select the Device Details tab.
2. Select the device from the devices list.
3. Click Show Device Alert Information in the lower-right corner of the window.
The expanded device alert information is displayed.
4. Click Mitigate.
5. In the Mitigate Device Alert dialog enter information about how the device alert was mitigated for the
patient.
6. If no further mitigation is needed, check the Mitigation Complete check box.
7. Click Save.
When a mitigation is marked as complete, a green checkmark is displayed next to the device name on the Device Details tab and no further mitigation details can be added.The device name is still displayed in red to indicate the overall device alert.

Encounters tab

You can view, add, edit, delete, sign (or lock), route, and amend patient encounters information from the Encounters tab.You must have sufficient privileges to view and modify information on the tab.
The Encounters tab shows the next scheduled future encounter and the most recent past encounter. Encounters can be manually entered, imported from remote follow-up services, imported from a programmer,
or retrieved from a previous encounter and then manually updated. A patient record can have up to 5,000 encounters.
From the Encounters tab, you can view all of the encounters for that patient.The encounters are organized into the encounter tree.You can sort the encounter tree by encounter type or by encounter date.
The tabs that you see within an encounter are dependent on the type of encounter you have selected and on the patient's device capabilities and modes.
Encounter types
Remote
In-clinic
TTM
Implant
Programming
Phone Note
A remote encounter documents an interaction with a patient with an implanted device via a remote follo w-up service, such as the Medtronic CareLink Network.The data for a remote encounter directly corresponds to the data for a clinical follow-up.
An in-clinic encounter documents the interaction with a patient that happens in person at the location of care.
A TTM encounter documents an interaction with a patient that happens over the phone.
An implant encounter documents an interaction with a patient at the time of implant of a device.
A programming encounter documents programming changes to an implanted device.
A phone note encounter documents the interaction with a patient that occurred over the phone.
Miscellaneous
A miscellaneous encounter documents an interaction with a patient that is not covered by any other encounter type.
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Encounter tree
The Encounters tab includes a list of the encounters that can be sorted by either date or type. The default order is by date starting with the most recent.T o change the sort order , select either the By Date
or By Type radio button. If you have an encounter that has been signed or locked, and then that encounter is amended, the amended encounter is shown as the parent of the locked encounter.
Figure 1: Encounter tree sorted by date
When the encounter tree is sorted by date the 15 most recent encounters are displayed in the list, or approximately three years of encounters for a typical patient. Any other encounters go into the Older Encounters folder.
Paceart Optima System | Paceart System Patient Records | 51
Figure 2: Encounter tree sorted by encounter type
Patient Record Icons
The patient record contains icons for device types, lead chamber, and encounter types.
Device type icons
DefinitionIcon
ICD
Pacemaker
ICM/ILR
Event Recorder
Remote Monitor
Adapter
Other Device
Encounter not associated to a device
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Lead placement icons
Encounter type icons
DefinitionIcon
Lead placed in left atrium
Lead placed in right atrium
Lead placed in left ventricle
Lead placed in right ventricle
Lead without chamber specified
DefinitionIcon
Implant
In-clinic
Remote
TTM
Programming
Phone Note
Miscellaneous
Adding an encounter
Interactions, or encounters, with the patient can be entered in the patient's record.
1. From the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
Paceart Optima System | Paceart System Patient Records | 53
2. Select the device from the drop-down bo x. If you don't want to associate the encounter to a patient's device then clear the drop-down box.
3. Select the instrument, such as an event recorder or home monitor, if one is being used in the encounter. If you don't want to associate an encounter to an instrument then clear the drop-down box.
4. Select an encounter type.This a required field.
5. Click OK.
The Add Encounter dialog box will displa y with one or more tabs.The tabs that are displayed are related to the device capabilities selected in the device encyclopedia.
6. Depending on the tab, enter or download the encounter information.
7. Click Save.
The new encounter is displayed in the encounter tree.
Field and button definitions for the Choose Encounter Type dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Device:
Instrument:
Encounter Type:
Remote
In-clinic
TTM
The device to which you are adding an encounter.
The remote monitor, event recorder or other non-implantable device used during the encounter.
List of available encounter types.
Documents the interaction with a patient with an implanted device via a remote follo w-up service such as the Medtronic CareLink Network.
Documents the interaction with a patient with an implanted device that happens in person with a provider.
Documents the interaction with a patient with data that is obtained over the phone.
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Field and button definitionsDialog box fields and buttons
Implant
Programming
Phone Note
Miscellaneous
Documents the interaction with a patient at the time of implant of an implantable device.
Documents programming changes to an implanted device.
Documents the interaction with a patient that is captured in a phone call.
Documents the interaction with a patient not covered by any other encounter type. It can contain description and commentary.
Programmer Data Transfer Methods
Programmers are used in the clinical environment to test patients with medical devices.The programmer uses telemetered RF (radio frequency) communication with the implanted medical device to determine the current programmed values, change the current prog rammed values, and collect diagnostic inf ormation stored in the device.
For some device manufacturers you can automatically import device data from the programmer into the Paceart System.You can manually enter device data if automatic methods do not exist.
You can import device data from a programmer into an in-clinic encounter, a remote encounter, an implant encounter, or a programming encounter in the Paceart Optima System.
There are several ways to import device data into the Paceart System. Not all import options are available for all manufacturers' programmers.
Save the device data on removable media (such as floppy disks and USB flash drives), and then insert the media into the Paceart Optima System workstation and copy the data.
Save device data to a local hard drive folder or network path.
Save de vice data using SessionSync.This method is for Medtronic CareLink 2090 or Encore programmers only.
The automatic data transfer is intended to be a timesaving convenience feature. It is not a substitute for careful examination of the entire follow-up form prior to saving the test and printing a report.
Configuring the device data import options
You can configure the import file location.The Paceart System will automatically retrieve files from the location you configure.You can override the default location for a single session when necessary.
This icon is used in this topic.
DescriptionIcon
Open folder
1. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
2. Select the device.
3. Select the encounter type (in-clinic, implant, or programming).
4. Click OK.
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The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device, the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
5. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
6. Click Configuration. The Programmer Import Configuration dialog box is displayed. It contains a Configuration tab and a tab for each of the manufacturers that the Paceart Optima System supports.
7. On the Configuration tab, select the check box if you want the default answer to be "Yes" when a file is imported that doesn't match the device serial number or the encounter date in the Paceart System.
8. Click the programmer manufacturer-specific tab.
9. Click the open folder icon, navigate to the file location, and select the folder.
10. Click OK.
The Paceart System enters the file location in the text box on the manufacturer's tab.
11. Click Save.
12. The Programmer Import dialog box is displayed showing a list of available files at that location. If you
are importing Boston Scientific files, multiple files may be displayed for the same session. If there are multiple files, the most recent file sav ed as part of the session is marked with an asterisk in the Date/Time column.
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The Paceart System will default to this file location every time you click Retrieve from Programmer. Go through the configuration process whenever you want change the default location of the device data files. You can also configure a temporary file location for a single session by overriding the default location.
Field and button definitions for the Programmer Import Configuration dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Data
Browse
If the encounter date from the programer differs from the encounter date in the database, selecting this checkbox will set the def ault answer to "Yes" to update information in the database.
Opens a browse dialog and allows you to select a file.
Overriding the device data location for a single session
You can temporarily override the configured location for device data for a single session.This allows you to select a different location for the device data file containing the programmer device data.
This icon is used in this topic.
DescriptionIcon
Open folder
1. In the Programmer Import dialog box, click the Open folder icon.
2. Navigate to the folder containing the data and select the folder.
3. Click OK.
The temporary file path is displayed in the Temporary Import Source field in the Programmer Import dialog box.
4. Select the data file.
5. Click Import.
Biotronik Programmer
The Paceart Optima System supports data import from the Biotronik ICS3000 for select Biotronik pacemakers and ICDs.You can import device data into the Paceart System using a USB flash drive.
Performing a USB flash drive import from a Biotronik Programmer
You can import device data from a programmer for a specific manufacturer and model for in-clinic, implant, and programming encounters. Import the data by copying it from the programmer onto a USB flash drive, and then copying the data from the flash drive into the P aceart System.You may need to configure the location of the data files and how you want to resolve mismatched dates and serial numbers.
If you require assistance performing this operation on your progr ammer, consult y our programmer user manual or your Biotronik representative.
These icons are used in this topic.
DescriptionIcon
Open folder
Refresh
1. Insert the USB flash drive into the programmer and copy the device data to it.
2. Insert the same USB flash drive into the Paceart Optima System computer.
Paceart Optima System | Paceart System Patient Records | 57
3. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
4. Select the device.
5. Select the encounter type (in-clinic, implant, or programming).
6. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
7. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
8. Select the file that you want to import and click Import. If the data that is retrieved from the programmer is diff erent from the data stored in the database , then the
Programmer Import dialog box is displayed.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer
device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
ELA Programmer
The Paceart Optima System supports data import from the ELA Medical Corporation Orchestra programmer for select ELA Medical devices.You can import device data into the Paceart System by saving the device data to a floppy disk.
Performing a floppy disk import from an ELA Programmer
You can import device data from a programmer for a specific manufacturer and model for in-clinic, implant, and programming encounters. Import the data by copying it from the programmer onto a floppy disk, and then copying the data from the floppy disk into the Paceart System.You may need to configure the location of the data files and how you want mismatched dates handled.
If you require assistance performing this operation on your progr ammer, consult y our programmer user manual or your ELA representative.
These icons are used in this topic.
DescriptionIcon
Open folder
Refresh
1. Insert the disk into the programmer and copy the device data to it.
2. Insert the same floppy disk into the Paceart Optima System computer.
3. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
4. Select the device.
5. Select the encounter type (in-clinic, implant, or programming).
6. Click OK.
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The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
7. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
8. Select the file that you want to import and click Import. If there is data retrieved from the programmer is different from the data stored in the database the
Programmer Import dialog box is displayed listing the data that is different.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer
device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
Boston Scientific Programmer
The Paceart Optima System supports data import from the Guidant 2901 and 2920/ZOOM programmers for select Guidant devices.You can import device data into the Paceart System by saving the device data to a floppy disk or to a USB flash drive.
Performing a floppy disk import from a Boston Scientific Programmer
You can import device data from a programmer for a specific manufacturer and model for in-clinic, implant, and programming encounters. Import the data by copying it from the programmer onto a floppy disk, and then copying the data from the floppy disk into the Paceart System.You may need to configure the location of the data files and how you want mismatched dates handled.
If you require assistance performing this operation on your progr ammer, consult y our programmer user manual or your Boston Scientific representative.
These icons are used in this topic.
DescriptionIcon
Open folder
Refresh
1. Insert the disk into the programmer and copy the device data to it.
2. Insert the same floppy disk into the Paceart Optima System computer.
3. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
4. Select the device.
5. Select the encounter type (in-clinic, implant, or programming).
6. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
7. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
Paceart Optima System | Paceart System Patient Records | 59
8. Select the file that you want to import and click Import. If there is data retrieved from the programmer is different from the data stored in the database the
Programmer Import dialog box is displayed listing the data that is different.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer
device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
Performing a USB flash drive import from a Boston Scientific Programmer
You can import device data from a progr ammer b y cop ying the data on the progr ammer to a USB flash drive , and then copying the data on the flash drive onto the Paceart Optima System computer.
1. Insert the USB flash drive into the programmer and copy the device data to it.
2. Insert the same USB flash drive into the Paceart Optima System computer.
3. Extract the encrypted files from the USB flash drive. Contact Boston Scientific for instructions on how to
extract the encrypted files from the USB flash drive.
4. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
5. Select the device.
6. Select the encounter type (in-clinic, implant, or programming).
7. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
8. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
Medtronic Programmer
The Paceart Optima System supports data import from the Medtronic 9790 programmer and the Medtronic CareLink 2090 or Encore programmer for select Medtronic devices.You can import device data into the Paceart System by saving the device data to a disk, to a USB flash drive, or by using SessionSync.
Performing a floppy disk import from a Medtronic Programmer
You can import device data from a programmer for a specific manufacturer and model for in-clinic, implant, and programming encounters. Import the data by copying it from the programmer onto a floppy disk, and then copying the data from the floppy disk into the Paceart System.You may need to configure the location of the data files and how you want to resolve mismatched dates and serial numbers.
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If you are using the Medtronic 9790 programmer or the Medtronic CareLink 2090 programmer you can save data using a floppy disk. If you require assistance performing this operation on your programmer, consult your programmer user manual or your Medtronic representative.
These icons are used in this topic.
DescriptionIcon
Open folder
Refresh
1. Insert the disk into the programmer and copy the device data to it.
2. Insert the same floppy disk into the Paceart Optima System computer.
3. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
4. Select the device.
5. Select the encounter type (in-clinic, implant, or programming).
6. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
7. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
8. Select the file that you want to import and click Import. If there is data retrieved from the programmer is different from the data stored in the database the
Programmer Import dialog box is displayed listing the data that is different.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer
device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
Performing a SessionSync import from a Medtronic Programmer
For an in-clinic encounter using the Medtronic CareLink 2090 or Encore programmer you can save device data from the programmer directly to the Paceart System using your clinic's network by using SessionSync. The information is sent from the programmer through the clinic's network to the Paceart System.The encounter data that is available for import is the same encounter data that is available for flopp y disk or USB flash driv e import.
Downloaded patient data from a single encounter is automatically displayed in the encounter list. It can be opened, viewed, and edited like any other encounter. A SessionSync encounter shows the date and time of the device session, not the date and time the encounter is created in the Paceart System. For example, you performed an in-clinic device interrogation at 10:30 AM. If SessionSync with the programmer occurred at 10:45 AM and created a Paceart System in-clinic encounter then this encounter would have a time of 10:30 AM.
If a SessionSync transmission is received and an encounter was already created on that date f or the patient, one of two things will occur.
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If the patient record is open, the Paceart System will ask you if you would like to add the SessionSync data to the already created encounter or create a new encounter.
If the patient record is closed, a new encounter is automatically created.This results in two encounters of the same type on the same date.To reconcile the two encounters you must save the SessionSync data to your computer using File > Save to Disk and then use Retrieve from Programmer feature to import the file into the original encounter.
For information on how to use SessionSync consult the SessionSync software documentation supplied with the software or contact Paceart Technical Services.
Performing a USB flash drive import from a Medtronic Programmer
You can import device data from a programmer for a specific manufacturer and model for in-clinic, implant, and programming encounters. Import the data by copying it from the programmer onto a USB flash drive, and then copying the data from the flash drive into the P aceart System.You may need to configure the location of the data files and how you want to resolve mismatched dates and serial numbers.
If you are using the Medtronic CareLink 2090 or Encore programmer you can save data using a USB flash drive. If y ou require assistance performing this operation on your prog rammer , consult y our programmer user manual or your Medtronic representative.
These icons are used in this topic.
DescriptionIcon
Open folder
Refresh
1. Insert the USB flash drive into the programmer and copy the device data to it.
2. Insert the same USB flash drive into the Paceart Optima System computer.
3. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
4. Select the device.
5. Select the encounter type (in-clinic, implant, or programming).
6. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
7. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
8. Select the file that you want to import and click Import. If the data that is retrieved from the programmer is diff erent from the data stored in the database , then the
Programmer Import dialog box is displayed.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer
device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
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St. Jude Medical Programmer
The Paceart Optima System supports data imported from the St. Jude Medical Model 3510 Prog rammer , the St. Jude Medical PR-3500 Programmer and the St. Jude Medical Model Merlin for select St. Jude Medical devices.You can import device data into the Paceart System by using a floppy disk (St. Jude Medical Model 3510 Programmer and St. Jude Medical PR-3500 Programmer) or a St. Jude Medical approved USB flash drive.
St. Jude devices can report therapy energy in volts rather than joules.The Paceart System displays therapy energy in volts when joules are not reported.
Performing a floppy disk import from a St. Jude Medical Programmer
You can import device data from a programmer for a specific manufacturer and model for in-clinic, implant, and programming encounters. Import the data by copying it from the programmer onto a floppy disk, and then copying the data from the floppy disk into the Paceart System.You may need to configure the location of the data files and how you want mismatched dates handled.
For more information on how to save device data to a floppy disk on St. Jude Medical programmers, consult your St. Jude Medical programmer user guide or your St. Jude Medical representative.
These icons are used in this topic.
DescriptionIcon
Open folder
Refresh
1. Insert the disk into the programmer and copy the device data to it.
2. Insert the same floppy disk into the Paceart Optima System computer.
3. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
4. Select the device.
5. Select the encounter type (in-clinic, implant, or programming).
6. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
7. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
8. Select the file that you want to import and click Import. If there is data retrieved from the programmer is different from the data stored in the database the
Programmer Import dialog box is displayed listing the data that is different.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer
device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
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Performing a USB flash drive import from a St. Jude Medical Programmer
You can import device data from a progr ammer by cop ying the data on the prog rammer to a St. Jude Medical approved USB flash drive, and then copying the data on the flash drive onto the Paceart Optima System computer.
If you require assistance performing this operation on your progr ammer, consult y our programmer user manual or your St. Jude Medical representative.
These icons are used in this topic.
DescriptionIcon
Open folder
Refresh
1. Insert the USB flash drive into the programmer and copy the device data to it.
2. Insert the same USB flash drive into the Paceart Optima System computer.
3. In the patient record, click Add Encounter. The Choose Encounter Type dialog box is displayed.
4. Select the device.
5. Select the encounter type (in-clinic, implant, or programming).
6. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from Programmer button. If you do not see this button then the patient does not have an active device,
the device you selected is not supported for that encounter type, or the encounter type does not support this functionality.
7. Click Retrieve from Programmer. The Programmer Import dialog box is displayed.
8. Select the file that you want to import and click Import. If the data that is retrieved from the programmer is diff erent from the data stored in the database , then the
Programmer Import dialog box is displayed.
9. Select the check box es of the properties that you would like to hav e updated with data from the programmer
device data.
10. Click Import. The patient's record is updated but has not been saved.
11. Click Save to save the encounter. You can view the imported device data by selecting the encounter, and then looking at the appropriate
subtabs on the Encounters tab.
12. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
Vitatron Programmer
The Paceart Optima System supports data import from the Medtronic 9790 programmer and the Medtronic CareLink 2090 or Encore programmer for select Vitatron devices. Refer to the Medtronic Programmer topic for additional information.
Field and button definitions for the Programmer Import dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Configuration
Opens the Programmer Import Configuration dialog box.
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Field and button definitionsDialog box fields and buttons
Browse
Refresh
Import
Opens a browse dialog and allows you to select a file.
Refreshes the data.
Imports the data.
Retrieving data from a previous encounter
For a new encounter , you can retrie ve programming, episode , and billing information from a previous encounter , and then update the fields that have changed.This is quicker than entering data manually, and can also decrease data-entry mistakes.
Make sure the patient record is open. Using the Retrieve from feature is the only way to import billing information from a previous encounter.
1. Click Add Encounter.
2. Select the device from the drop-down bo x. If you don't want to associate the encounter to a patient's device
then clear the drop-down box.
3. Select the instrument, such as a home monitor, if one is being used in the encounter. If you don't want to associate an encounter to an instrument then clear the drop-down box.
4. Select the encounter type.This is a required field.
5. Click OK. The Add Encounter dialog box is displa yed. It defaults to the Quick View tab, which contains the Retrieve from button. If you do not see this button then either the device you selected is not supported for that
encounter type, the encounter type does not support this functionality, or a previous encounter has not been added for the patient.
6. Click Retrieve from. The Retrieve from dialog box is displayed.
7. Select the encounter you want from the list. By default, the most recent encounter is highlighted.
8. Click OK.
The patient's record is updated but has not been saved.
9. Update and verify the encounter information.
10. Click Save to save the encounter.
You can view the imported device data by selecting the encounter, and then looking at the appropriate subtabs on the Encounters tab.
11. Select and examine each data entry tab and form prior to printing a report. Manually enter any data and comments that did not import.
Field and button definitions for the Retrieve from dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Current Encounter Device:
Serial Number:
The device associated with the current encounter.
The serial number of the device associated with the current encounter.
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Field and button definitionsDialog box fields and buttons
Encounter
Device
Serial Number
List of encounters in the patient record, showing the date, time, and type.
The device associated with the listed encounter.
The serial number of the device associated with the listed encounter.
Device Data Import Icons
Imported device data files may contain values or formatted data that the Paceart System doesn't expect. After an encounter is imported icons may be displayed to the left of the fields with these unexpected values. You can resolve these unexpected values in the encounter edit mode.
Device data import icons are displayed in the Paceart System, but they do not appear on generated reports.
ExplanationNameImport icon
Unexpected parameter
value
The value of this parameter is unexpected, it does not match expected type, or is out of range.
The device did not report a value during import of this parameter.Unreported
A processing error occurred during import of this parameter.Processing error
Unexpected parameter
This icon indicates the field has an unexpected value or f ormat. Some common errors in v olve an une xpected number of decimal places, an imported value that contains words instead of a numbers, and an imported value that does not match one of the values in a Paceart System drop-down list.
Sometimes the data imported is correct, even though it does not match the expected value or format. For example, a programmed n umeric setting, such as PVARP, might have a value of Auto. In this case, you can ignore the icon.T o remov e the icon, y ou m ust change the v alue to the e xpected f ormat. For more information on the expected value or format click on the "?" icon and then click in the field to display the online Help.
For example, a device import file may contain "OK" as the value for Battery Status. In the encounter edit mode, you can remove the icon by selecting an appropriate value from the drop-down list.
Unreported value
This icon indicates that the Paceart System expects a value from the device but a value was not imported. Importing files from older devices usually means you will have more of these icons.
To remove this icon, you must manually enter the data. For example, a device import file may not contain a value for Sensing Pathway.That value is expected. In
edit mode, you can remove the icon by selecting an appropriate pathway value.
Processing error
This icon indicates that a calculation done by the Paceart System resulted in an invalid output or that a parameter required for a calculation was missing. In edit mode, you can remove the icon by providing an appropriate value.
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Pertinence
Some fields in an encounter are not applicable to all devices, features, and modes. Fields with gray backgrounds are not pertinent to the device based on the selected features and modes.
If a field is gray ed out you can still enter a value . Non-pertinent fields that are grayed out in the P aceart System are also grayed out on reports.
What it meansField description
For this device and selected feature this field is not pertinent.A gray field without a
value A gray field with a
value
For example, although the Adaptive Status is "Disabled" the device reported values for Paced AV Delay and Sensed AV Delay.The values are displayed but the gray background indicates that the fields aren't pertinent because Adaptive Status is disabled.
If you change Adaptive Status to "Enabled" the shading is removed because the values are pertinent.
For this device and selected f eature this field is not pertinent but the device reported a value.
Modes
Some fields in an encounter are not applicable to all devices, features, and modes. Fields with gray backgrounds are not pertinent to the device based on the selected features and modes.
The following modes are available: AAI, AAIR, AAT, AATR, ADI, ADIR, AOO, AOOR, DAD, DDD, DDDR, DDI, DDIR, DDT, DDTR, DOO, DOOR, DVI, DVIR, DVTR, ODO, OOO, OOOR, OVO, VAT, VDD, VDDR, VDI, VDIR, VDT, VDTR, VOO, VOOR, VVI, VVIR, VVT, VVTR, AAI<=>DDD, AAIR<=>DDDR, AAIsafeR, SafeR, SafeR/DDIR, DDD-CLS, DDDR-CLS.
Each mode has different fields that are applicable and changing the mode will change which fields show up with a gray bac kground. Only the fields applicab le to a selected feature or mode , for e xample, atrial amplitude in the AAI mode, are shown without a gra y background.This is called pertinence. For AAI mode, which stands for Atrial chamber paced, Atrial Chamber sensed, and Inhibiting response to sensing, the following fields have gray backgrounds:
PVARP
PVAB
AV Delay fields
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Pacing and Sensing for RV and LV fields
Rate Response fields
Automatic Mode Switch fields
In this example, the ventricular fields are not pertinent for the atrial mode and are grayed out.
Quick Phrase
You can use quick phrase to create standardized text to use throughout the Paceart System application.You can designate a code to make your quick phrase easier to find.
Quick phrases are available in most comment fields in the Paceart System.To access quick phrases put your cursor in a text field and then press the F9 keyboard key.The Quick Phrase dialog box is displayed. You can either select a quick phrase or enter new quick phrase text.
For example, you could create a quick phrase with code "3 month remote" and a description of "Normal ICD function, next follow-up appointment in 3 months." When you select that quick phrase the description is inserted into the field.
Selecting a quick phrase
You can insert an existing quick phrase into most fields in the Paceart System.
1. Click in a text field. Most text fields in the Paceart System allow you to insert a quick phrase.
2. Press the F9 key. The Quick Phrase dialog box is displayed.
3. Select the quick phrase you want to insert into the field.
4. Click Select.
The quick phrase you selected is inserted into the field.
Field and button definitions for the Quick Phrase dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Search String:
Text box for entering whole or partial keywords.
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Field and button definitionsDialog box fields and buttons
Search
Add
Edit
Delete
Code
Description:
Invokes the search.
Adds information.
Allows you to edit existing information.
Removes the item or items from the list.
The code for the quick phrase.This code will be displayed in the list.
The description of the quick phrase.This is the actual text that will be inserted into the field.
Adding or editing a quick phrase
You can add a new quick phrase or edit an existing quick phrase.
1. Click in a text field. Most text fields in the Paceart System allow you to insert a quick phrase.
2. Press the F9 key. The Quick Phrase dialog box is displayed.
3. Determine which action to take.
To add a quick phrase, click Add.
To edit an existing quick phrase, select the quick phrase and click Edit.
4. In the Code field you can enter a code to make searching for the quick phrase easier.
5. In the Description field enter the actual text you want to be inserted for that quic k phrase.This is a required
field.
6. Select the Make above text available for all encounter types check box if the quick phrase applies to all encounter types. If you do not select this option the quick phrase will only apply to the encounter type you are in when you create it.
7. Click Save.
The new quick phrase is displayed in the search results section of the Quick Phrase dialog box.
Field and button definitions for the Add or Edit Quick Phrase dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Code
*Description
Make above text available for all encounter types.
The code for the quick phrase.This code will be displayed in the list.
The description of the quick phrase.This is the text that will be added to the reports. Required field.
Selecting this option makes this quick phrase a vailable for all encounter types. If y ou do not select this option the quick phrase is only available for the type of encounter you are in when you create it.
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Deleting a quick phrase
You can delete existing quick phrases.
1. Click in a text field. Most text fields in the Paceart System allow you to insert a quick phrase.
2. Press the F9 key. The Quick Phrase dialog box is displayed.
3. Select the quick phrase you want to delete and click Delete.
4. In the confirmation dialog box click Yes.
The quick phrase is deleted from the list.
Editing an encounter
You can edit all types of encounters.You cannot edit an encounter that has been signed or locked.
1. Open the patient record.
2. Click the Encounters tab.
3. Select an encounter from the encounter tree.
4. Click Edit. The Edit Encounter dialog box is displayed.
5. Edit the information on the tabs in the dialog box.
6. Click Save.
The edited encounter information is saved.
Locking an encounter
You can lock an encounter to prevent any future changes to the encounter. If desired, in Administration: Encounter Export, you can also configure the Paceart System to automatically export an encounter to the
clinic’s EMR when the encounter is loc ked. A clinic can either sign or lock an encounter which can be configured in Administration:Task Management. If an encounter is locked and you need to make changes, you will need to amend the encounter instead of edit.
1. Open the patient record.
2. Click the Encounters tab.
3. Select the encounter you want to lock from the list.
4. Click Lock.
5. In the confirmation dialog box, click OK to lock the encounter.
The encounter is locked and cannot be edited.The Lock button is no longer accessible for the encounter.
Signing an encounter
You can electronically sign an encounter from within the Paceart System.When an encounter is signed it is also locked (meaning changes can not be made to the encounter without an amendment).
Your clinic can either sign or lock an encounter which is configured in Administration:Task Management.
1. Open the patient record.
2. Click the Encounters tab.
3. Select the encounter you want to sign from the list.
4. Click Sign. The Sign Encounter dialog box is displayed.
5. Enter your password and click OK.
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The encounter is signed and locked.The Sign button is no longer accessible for the encounter.
Amending an encounter
You can modify encounter data for an encounter that was previously signed or locked. The signed/locked version of the encounter remains intact and no modifications will be allowed. An editable
version, or amendment, will be created and will continue to be editable until it is signed or locked.
1. Open then patient record.
2. Click the Encounters tab.
3. Select the locked encounter you want to amend from the list.
4. Click Amend.
5. Make the changes to the encounter and click Save.
The amended encounter is shown above the original locked encounter in the encounter tree.
Exporting an encounter
You can export an encounter to an external location or to an external system. XML Export and HL7 Export are optional features.You must have an appropriate license and have the f eature
configured in Administration: Encounter Export before you can export an encounter.
1. Open the patient record.
2. Click the Encounters tab.
3. Select the encounter you want to export from the list.
4. Click File > Export, or click the Export button on the Encounters tab.
The Export dialog box is displayed.The encounter date, time, and type are displayed in the dialog box title bar.
5. Select the export options for your system. These options are enabled or disabled by your Administration: Encounter Export configuration.
6. Click Export to export the encounter.
The encounter is exported to the configured external location or external system.
Field and button definitions for the Encounter export dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Export Type
Include PDF Report:
Select XML File or External System as the type of export.
Select whether to include a PDF report with the encounter export.The report that is included for each encounter and device type is controlled by the Def ault Encounter Report settings.
Available Reports
Address To Provider:
XML Version:
The list of available reports.
Select a provider to address letter reports to.
Allows you to choose which version of the Paceart XML schema to use for exporting encounters.
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Field and button definitionsDialog box fields and buttons
Include Attachments:
File Handling:
Sign By Provider:
Path:
Location:
External System
Export
Select whether to include attachments with the encounter export.
Select whether to embed or link to attachments for the encounter export.
Select a provider to sign the reports.
The file path for PDF reports and attachments to the encounter export.The export path is the physical file system path on the server.
The location of PDF reports and attachments to the encounter export.The location is the URL that is placed in the export file for attachments and linked Paceart System reports.
Selects the export destination of the file.
Exports the encounter to the specified location or external system.
Preview:
Shows a preview of the printed report.
Field and button definitions for the Select Provider dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Search String:
Search
Name:
Address:
Country:
Comments:
Phone
Text box for entering whole or partial keywords.
Invokes the search.
Full name of the provider.
The provider's street address.
The country of the provider's street address.
Miscellaneous comments.
The provider's phone number.
Provider ID:
Specialty:
The provider's ID number.
The provider's medical specialty, for example, cardiology.
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Field and button definitionsDialog box fields and buttons
Provider Code:
The provider code.
Routing an encounter task
You can route an encounter task to another Paceart System user or workgroup.
1. Open the patient record.
2. Click the Encounters tab.
3. Select the encounter from the list.
4. Click Route. The Select Assignee dialog is displayed.
5. Select the Assignee Type from the drop-down list or enter the user or workgroup name in the search
field.
6. Click Search.
7. Select the workgroup or user you want to route the encounter task to and click Select.
The encounter task is routed to the selected user or workgroup.
Saving data to disk
You can save imported data to a network, local disk drive, disk, or other location. Patient f ollow-up information that has been exported from a programmer and imported into the Paceart System
can be copied from the Paceart System and saved to a network, local disk drive, disk, or some other type of removable device such as a USB flash drive. Consult the manual for the originating instrument or system for information on whether it is possible to load and view the original data from that system.
1. Select the encounter.
2. Click File > Save to Disk. If the Save to Disk menu selection is disabled there is no downloaded data
available.
3. In the Browse for Folder window, navigate to the desired disk or USB flash drive, or a network or local disk drive folder, and then click OK.
4. Click OK to save the data.
Reassigning an encounter
If you have permission to edit encounters, you can reassign an encounter from one patient to another.This is used to resolve duplicate patients or situations where an encounter was added to the wrong patient record. The encounter cannot be reassigned if it has already been signed or locked. Signed or locked encounters must be amended before reassigning.
1. Search for and open the patient record.
2. Click the Encounters tab.
3. Select the encounter you want to reassign from the list.
4. Click File > Reassign Encounter. The Reassign Encounter dialog box is displayed.
5. Enter the name of the patient to whom you are reassigning the encounter or search for the patient by
clicking the [...] button.The patient you are reassigning the encounter to must have an implanted device. The Select Patient dialog box is displayed.
6. Select the patient device from the drop-down list.This is not a required field.
7. Select the instrument from the drop-down list.This is not a required field.
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8. Click Save.
9. In the confirmation dialog box click Yes.
The encounter is reassigned to the other patient. All encounters must be reassigned or deleted before deleting a patient record.
Field and button definitions for the Reassign Encounter dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Enter Patient Name:
Select Patient Device:
Select Instrument:
Click [...] to search for the patient.
Select the patient's device.
Select the patient's instrument.
Deleting an encounter
You can delete an encounter from a patient record.
1. Open the patient record you want to delete the encounter from.
2. Click the Encounters tab.
3. Select the encounter you want to delete from the list.
4. Click File > Delete Encounter.
5. In the confirmation dialog box, click Yes.
The encounter is deleted from the patient record.
Quick View
The Quick View tab gives you a way to quickly view summary information for the patient. You must be in add or edit mode to edit information on the Quick Vie w tab. Most of the inf ormation displa y ed
in the Quick Vie w tab is read-only, except for the Rhythm Assessment and Encounter Summary sections. Comments you enter in the Encounter Summary field will be displayed on reports. Click Expand or Collapse next to Encounter Summary to expand or collapse the comments in this section.
You can retrieve encounter data from the programmer by clicking Retrieve from Programmer. You can also retrieve from a previous encounter. Click Retrieve from to select the encounter you want to
retrieve inf ormation from.The latest encounter is at the top of the list. If the Retrieve fr om is gra y ed out there isn't a previous encounter to retrieve from or that encounter type doesn't allow for retrieve from a previous encounter.You cannot retrieve from a previous encounter for TTM encounters.
Field and button definitions for the Quick View tab
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Underlying Rhythm:
Dependency:
The status of the patient's underlying heart rhythm.
The patient's dependency on bradycardia pacing. Enter a value or select one from the drop-down box.
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Field and button definitionsDialog box fields and buttons
Encounter Summary
Retrieve from Programmer
Retrieve from...
A field to enter information you would like to record about the encounter. Comments you enter in the Encounter Summary field will be displayed on reports. Click Expand or Collapse to change the siz e of this field.
Click to begin importing encounter data from a programmer.
Click to retrieve information from a previous encounter.
ECGs
The ECGs tab displays previously recorded ECG data and associated measurements from ECG recordings . You must be in add or edit mode to modify any information.
Existing strips are listed in the drop-down box. Select a strip from the drop-down box to vie w specific information about that strip.
You can manually enter or edit values related to recorded strips in the Measurements and Assessment sections.
Click Launch ECG Viewer to launch the ECG viewer application.
Field and button definitions for the ECGs tab
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Launch Viewer
Selected Strip
Presenting:
AV Delay (ms):
Magnet:
AV Delay (ms):
Launches the ECG viewer.
A previously selected and saved strip. Select a strip to view more detailed information about it.
The externally measured cardiac rate and interval in beats per minute and milliseconds when the implantable device is in demand (presenting) mode.
The externally measured atrioventricular delay in milliseconds when the implantable device is operating in demand (presenting) mode.
The externally measured cardiac rate and interval in beats per minute and milliseconds when the implantable device is operating in magnet mode.
The externally measured atrioventricular delay in milliseconds when the implantable device is operating in magnet mode.
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Field and button definitionsDialog box fields and buttons
A. Duration:
V. Duration:
Rate
QRS width
PR interval
The externally measured duration in milliseconds of the right atrial pacing pulse.
The externally measured duration in milliseconds of the right ventricular pacing pulse.
The externally measured cardiac rate in beats per minute, measured from an area containing the minimum observed heart rate.Typically measured from an electrocardiogram.
The externally measured cardiac interval in milliseconds measuring the width of the QRS complex, measured from an area containing the minimum observed heart rate to the maximum observed heart rate.Typically measured from an electrocardiogram.
The externally measured cardiac interval in milliseconds measured from the beginning of the P wave to the beginning of the QRS comple x, measured from an area containing the minimum observed heart rate to the maximum observed heart rate.Typically measured from an electrocardiogram.
QT interval
Atrial Sensing
Ventricular Sensing
Atrial Capture
Ventricular Capture
The externally measured cardiac interval in milliseconds measured from the beginning of the QRS complex to the end of the T w a ve, measured from an area containing the minimum observed heart rate to the maximum observed heart rate.T ypically measured from an electrocardiogram.
The external observation of whether atrial sensing has been achieved.The value must be one of the following v alues:Yes, No, Dependent, Undetermined, N/A.
The external observation of whether ventricular sensing has been achieved.The value must be one of the following values:Yes, No, Dependent, Undetermined, N/A.
The external observation of whether atrial capture has been achieved.The value must be one of the following values:Yes, No, Undetermined, N/A.
The external observation of whether ventricular capture has been achieved.The value must be one of the following values:Yes, No, Undetermined, N/A.
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ECG Viewer
The Paceart System ECG viewer gives you the ability to measure and view previously recorded ECG data. ECG waveforms can be printed as part of a report.
Launching the ECG Viewer
You can launch the viewer from the ECGs tab in an encounter. Before you can launch the ECG viewer you must have an encounter selected.
1. With the patient record open, click the Encounters tab.
2. Select an existing encounter from the left side of the tab and then open it.
3. Click the ECGs tab.
4. Click Launch ECG Viewer. The ECG Viewer window is displayed.
Field and button definitions for the ECG Viewer window
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Gain
Speed
Filter
Invert
Display Pacer Intervals
Display Pacer Intervals and Pulse Width
The selected Gain setting in mm/mV. Gain is used to increase or decrease the amplitude of an ECG signal. Press F3 to decrease the gain and F4 to increase the gain.
The selected Speed setting in mm/sec.The strip speed indicates the horizontal scale of the ECG strip. Press F5 to decrease the speed and F6 to increase the speed.
The selected Filter setting in Hz. Filtering is used to eliminate "noise" on the ECG display. Press CTRL+ALT+F to change the setting.
When selected, inverts the polarity on an ECG strip. Press CTRL+ALT+I to toggle between the settings.
Displays previously detected pacing intervals and markers.
Displays previously detected pacing intervals and the pulse width markers.
Zoom
Calculate Measurements
Display Format
<
Click to measure the ECG or press CTRL+ALT+Z.
Calculates measurements from pacer intervals in the selected region of the ECG.
Allows you to change how y ou view the strip .Y ou can set a default display format in your user preferences.
Allows you to toggle between ECG strips.
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Field and button definitionsDialog box fields and buttons
>
Print
Symptoms
Location
Activity
Findings
History
Save
Save and Close
Allows you to toggle between ECG strips.
When selected, indicates that the strip should appear on reports.
The patient's arrhythmia or device-related symptoms .
The patient's location when they experienced the symptoms.
The patient's activity when they experienced the symptoms.
The findings of the arrhythmia evaluation.
Opens the Arrhythmia History dialog box, which displays the patient's past arrhythmia symptoms.
Saves all changes.
Saves all changes and closes the ECG viewer.
Close
Closes without saving your changes.
Shortcuts in the ECG Viewer
You can use shortcut combinations and function keys while in the ECG Viewer.
Shortcut key combinations
What it doesShortcut keys
Copies selected textCtrl+C (when the cursor is in a text field) Changes the filterCtrl+Alt+F Inverts the polarityCtrl+Alt+I Toggles the motion filter on/offCtrl+Alt+M Pastes copied textCtrl+V (when the cursor is in a text field) Cuts selected textCtrl+X (when the cursor is in a text field) Makes cardiac cycle interval measurementsCtrl+Alt+Z
Function keys
What it doesFunction key
Opens the online HelpF1 Decreases gainF3
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What it doesFunction key
Increases gainF4 Decreases speedF5 Increases speedF6 Makes pacer interval measurementsF8
F9
Key combinations in the ECG box
Left and Right arrows
Ctrl+Left arrow and Ctrl+Right arrow
Up and Down arrows
Home & End keys
Page Up & Page Down keys
Accesses Quick Phrases, in fields where Quick Phrases are enabled.
What it doesKey combinations
Moves the cursor within an ECG box with no highlighting
Moves the cursor left or right in larger increments within an ECG box with no highlighting
Moves the cursor within an ECG box between segments with no highlighting
Moves the cursor, within a selected row, to the beginning or end of the row
Moves the cursor a page f orw ard and a page bac k in a strip
Highlights the ECG with any movement of the cursorShift with any of the above Highlights 6 seconds on an ECG stripDouble-clicking
Adjusting ECG display settings
You can adjust display settings when viewing an Arrhythmia, ICD, or Pacemaker patient's ECG. These buttons are used in this topic.
DescriptionButtons
Invert
Display pacer intervals
Display pacer intervals and pulse width
You can adjust one or more of the following settings when necessary.
You can invert the ECG by clicking the Invert button.
You can display pacing markers and the paced heart rate by clicking the Display pacer intervals button.
You can display pacing markers, pacing rates, and pacing pulse widths by clicking the Display pacer
intervals and pulse width button.
Measuring pacer intervals in an ECG strip
The Paceart System can calculate measurements from pacer intervals and pulse widths found in a previously recorded ECG strip.To calculate these measurements, the strip must contain pacer markers.
These buttons are used in this topic.
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DescriptionButton
Calculate measurements
1. Open an existing strip.
2. Highlight an area of the strip.
3. Click the Calculate measurements button.You can also press F8 or click ECG > Measurements from
the menu bar.The Paceart System calculates measurements from the detection markers on the strip.
For a pacemaker de vice, the Paceart System will calculate and update the appropriate Presenting or
Magnet Rate measurements based on strip type.
For all other strip types, the Paceart System will calculate the measurements and display them at the
bottom of the viewer window but the system will not save them to the database.
Measuring cardiac cycle intervals in an ECG strip
You can use calipers to measure cardiac cycle intervals in Zoom mode, including R-R, PR, QRS, QT, and QTC intervals
You can launch the ECG viewer from the view, add, or edit encounter modes as long as the ECG window is not already open.
This button is used in this topic.
DescriptionButton
Zoom to make measurements
1. Click Launch ECG Viewer.
2. Select the strip that you want to measure from the drop-down list.
3. Click the Zoom to make measurements button or press CTRL+ALT+Z to magnify the waveform.
4. Adjust the vertical marking lines by clicking and dragging the P, Q, R, S, and T letters located above the
horizontal lines.
Move the blue R so that its associated vertical line is aligned with the peak of an R wave.
Move the gray R so that its associated vertical line is aligned with the peak of an adjacent R wave.
Move the P, Q, S, and T letters to align with their corresponding ECG waveform elements. As you make these adjustments, the Rate, RR, PR,QRS, QT, and QTC v alues at the bottom of the window
change automatically.
5. Click Save when the adjustments reflect accurate measurements.
6. Click Update Min or Update Max to save the measurements.These measurements are recorded on the Encounters tab ECGs subtab in the Measurements section.
Deleting an ECG strip
You can delete any ECG strip from a patient's ECG strip collection. You can launch the ECG viewer from the view, add, or edit encounter modes as long as the ECG window is
not already open.
1. Click Launch ECG Viewer.
2. From the drop-down list, select the ECG strip that you want to delete.
3. Click File > Delete ECG Strip.
4. Confirm your action.
The strip is deleted.
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Printing a waveform
You can print an ECG waveform in an encounter report such as the Encounter ECG 12 Lead (3 x 4) report.
1. In an encounter, select the ECGs tab. The ECG Viewer window is displayed.
2. Open the strip you want to print, and make sure the Print check box selected.
3. Print the report.
Episodes
The Episodes tab lists episodes, episode details and wav eform inf ormation.You must be in add or edit mode to modify any information.
The Episodes tab contains the last interrogation date and time, the episodes last reset date and time, and a list of all episodes that you can filter based on various criteria.You can view more detail about the selected episode by double-clicking the episode or by clicking View (in view-only mode) or Edit (in edit mode).
Use the filters at the top of the tab to list only the episodes that correspond to the selected criteria.
Select the check boxes to filter the episodes in the list by episode type.You can select multiple types.
Use the Select View and Durations lists to filter the episodes by treatment deliv ered and episode duration.
Use the encounter start list to view only the episodes that have occurred since the last encounter or to view all episodes for that device.
Use the Assessments list to filter the list by therapy assessment.
Field and button definitions for the Episode subtab
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Last Interrogation
Episodes Last Reset
VT/VF (VHR)
SVT
VT-NS
AT/AF/Mode Switch
The date and time of the last episode interrogation.
The date and time the episodes were last reset.
When checked, includes ventricular tach ycardias (VT), ventricular fibrillations (VF), and ventricular high rate (VHR) episodes in the list.
When checked, includes supra ventricular tachycardias (SVT) episodes in the list.
When checked, includes ventricular tachycardia non-sustained (VT-NS) episodes in the list.
When checked, includes atrial tachycardias (AT), atrial fibrillations (AF), atrial high rate (AHR), and mode switch episodes in the list.
Other
Select View
When checked, includes other episodes in the list.
Select the type of episodes you want to view.
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Field and button definitionsDialog box fields and buttons
Episode duration
Encounter start
Assessment:
View
Add
Edit
Selecting a time shows you episodes lasting longer than the selected time.
Select Since Last Encounter to view only episodes that have occurred since the date and time of the last recorded encounter. Select Since Last In-Clinic Encounter to view only episodes that have occurred since the date and time of the last in-clinic encounter. Select Since Last Summary to view only episodes that have occurred since the date and time of the last encounter marked as a summary . Select All Episodes to view all episodes for that device.
Select an assessment value to view only the episodes associated with that therapy assessment.
Allows you to view more information about the selected episode.This button is only available when you are in view mode.
Adds information.
Allows you to edit existing information.
Delete
Comments:
Removes the item or items from the list.
Additional information about the episodes.
Adding an episode
You can manually add the information for an episode.
1. Open the patient record.
2. Select the encounter containing the episode that you want to add an episode to and click Edit.
3. Click the Episodes tab.
4. Click Add. The Add Episode dialog box is displayed.
5. Enter the data in the Episode Information section.
6. If you have episode parameter and value details to enter, click Details, then enter the data in the Edit Episode Details dialog box and click OK.
7. Click OK on the Add Episode dialog box.
8. Click Save on the Edit Encounter dialog box to save the encounter.
The encounter is displayed in the encounter tree.The newly added episode data is displayed on the Episodes tab.
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Editing an episode
You can add, delete, or change information in an existing episode by editing the encounter containing the episode.
1. Click the Encounters tab.
2. Select the encounter containing the episode that you want to edit and click Edit. The Edit Encounter dialog box is displayed.
3. Click the Episodes tab to edit information specific to an episode within the selected encounter.
4. Change the Last Interrogation or Episodes Last Reset dates as needed.
5. Use the filters at the top of the tab to locate a specific episode, then click the episode that contains the
data you want to edit.
6. Click Edit. The Edit Episode dialog box opens.
7. Update the Episode Information as needed, or click Details to update detailed episode parameters and their values.
You can also view the episode's EGM waveform at the bottom of the dialog box.
8. Click OK.
9. Click Save on the Edit Encounter dialog box to save the encounter.
Field and button definitions for the View, Add, and Edit Episode dialog boxes
This is a list of fields and buttons and their definitions. The Plots and Waveforms section of the dialog box appears only if you are editing an episode.This section
is not present on the Add Episode dialog box.
Field and button definitionsDialog box fields and buttons
Episode Information
ID
Type
Start
Duration
The numeric identifier for the episode.
The type of the episode as a general category.The value must be one of the follo wing values: AT-NS, AF (AHR), AF (AHR) Monitor, Asystole, AT, AT Monitor, Brady, Brady Mode Switch, Brady Rate Drop Response, Other, Patient Activated, Periodic, SVT, VT-NS, VF (VHR), VF (VHR) Monitor, Fast VT, VT Monitor, Slow VT, Slow VT Monitor, Very Slow VT, Very Slow VT Monitor, Null.
The date and time of the episode.
The duration of the episode. Click [...] to open the Edit Duration dialog box where you can update the duration value.
Avg. Atrial Rate
The average atrial rate in beats per minute measured during the episode.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
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Field and button definitionsDialog box fields and buttons
Max. Atrial Rate
Avg.Ventricular Rate
Max.Ventricular Rate
Activity
Location
Symptoms
The maximum atrial rate in beats per minute measured during the episode.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The average ventricular rate in beats per minute measured during the episode.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The maximum ventricular rate in beats per minute measured during the episode.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
Patient activity at the time of the onset of the episode.
Location of the patient at the time of the onset of the episode.
Patient-reported symptoms at the time of the onset of the episode.
Findings
# ATPs Delivered
# Shocks Delivered
Result
Assessment
Print
Findings about the episode.
The number of anti-tachycardia pacing therapies delivered.The value must be ten digits or less and cannot have a decimal point.
The number of shocks delivered.The value must be ten digits or less and cannot have a decimal point.
The result of the therapy used to treat the episode. The value must be one of the following values: Successful, Unsuccessful, Null.
The assessment of whether the detection or therapy was appropriate.The value must be one of the following values: Appropriate, Inappropriate, Indeterminate, Null.
The clinician's evaluation as to whether the episode should be printed on the corresponding reports.When selected, indicates the episode should be printed. If the Print Strip check box for the wa vef orm is selected, the episode is also marked to be printed.
Previous
Navigates to the previous episode in the episode list.
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Field and button definitionsDialog box fields and buttons
Next
Details
Plots and Waveforms
View strip
[...]
<<
>>
Print Strip
Delete Strip
Navigates to the next episode in the episode list.
Opens the Edit Episode Details dialog box where you can view and edit episode parameters and values.
Select the strip you want to view from the list.
Opens the Edit Strip dialog box where you can change the strip's name or type.
Opens the previous EGM waveform strip saved with the episode.
Opens the next EGM waveform strip saved with the episode.
The clinician's evaluation as to whether the w avef orm should be printed on the corresponding reports.When selected, indicates the waveform should be printed.
Deletes the strip from the encounter.This deletion is not saved until you save the edited encounter.
Display Plot
Inverted
Full Disclosure
Speed
Gain
Select the display format to use to display the EGM data: Interval, Rate, or Waveform. If you select Waveform, you can select the waveform channels and A-A, V-A, and A-V interval data to display, when available.Waveform plots also allow you to save a section from the waveform to a new strip.
Allows you to display the waveform inverted (top to bottom).
The clinician's evaluation as to whether the w avef orm should be viewed or printed in a full disclosure format. The full disclosure format does not include the atrial or ventricular intervals or event markers and displa ys 30 seconds per row in a vertical format.
The Speed setting in mm/sec. Select the horizontal scale for viewing waveforms.This setting allows you to see more detail in waveforms but is not saved or used for printing.
The Gain setting in mm/mV. Select the vertical scale for viewing wa veforms.This setting allows you to see more detail in waveforms but is not saved or used for printing.
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Field and button definitionsDialog box fields and buttons
Clear Selection
Save Selection
Selected
Waveform channel
Interval data
Edit
Allows you to clear any selected sections in the waveform plot.
Allows you to save the selected section of the waveform plot to a new strip.This new strip is saved with the episode when you save the edited encounter .
Displays the time interval for the selected section of the waveform. If the selection is less than 3 seconds, the equivalent rate, assuming a V-V interval, is also displayed.
Paceart displays data from two waveform channels. Use the list next to the channel's wav ef orm to change the channel that is displayed on the plot: RA-Tip to RA-Ring or RV-Tip to RV-ring.
Select the interval data to display on the waveform plot: A-A (atrial event) intervals, V-A (atrial event) intervals, or A-V (ventricular event) intervals.
Allows you to edit information about the strip.
Delete
Removes the item or items from the list.
Field and button definitions for the Edit Episode Details dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Add
Edit
Delete
Parameter
Value
Adds information.
Allows you to edit existing information.
Removes the item or items from the list.
The name of the parameter for the episode.
The value of the parameter for the episode.
Field and button definitions for the Add and Edit Episode Data dialog boxes
This is a list of fields and buttons and their definitions.
Parameter
Field and button definitionsDialog box fields and buttons
The name of the parameter for the episode.
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Field and button definitionsDialog box fields and buttons
Value
The value of the parameter for the episode.
Field and button definitions for the Edit Duration dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Duration
Years
Months
Days
Hours
Minutes
Displays the total duration based on the values you enter.
The duration in years.This field is displayed when you edit the device's remaining longevity.
The duration in months.This field is displayed when you edit the device's remaining longevity.
The duration in days.
The duration in hours.
The duration in minutes.
Seconds
Milliseconds
Duration text box
The duration in seconds.
The duration in milliseconds.While the Paceart System does save and use any millisecond values you enter, fractions of seconds are not displayed on screens or dialog boxes or printed on reports.
Allows you to manually enter the duration.Valid formats are dd.hh:mm:ss or YYyr, MMmo.
Navigating to Next and Previous episodes when editing an encounter
You can navigate to a different episode on the Edit Episode dialog box when editing an encounter.
1. Open the patient record.
2. Click the Encounters tab, then select the encounter and click Edit.
3. On the Edit Encounter dialog box, click Edit.
4. On the Edit Episode dialog box, click the Previous or the Next button.
Deleting an episode, episode details, or waveform
You can delete a selected episode, episode details, or waveform from an encounter.You cannot recover these once they are deleted from the Paceart System database. Make sure that you want to delete the information.
1. Open the patient record.
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2. Click the Encounters tab.
3. Select the encounter that contains the episode that you want to delete.
4. Click Edit. The Edit Encounter dialog box is displayed.
5. Click the Episodes tab.
6. Select the episode that you want to delete.
7. Click Delete.
8. Confirm that you want to delete the information from the database.
The Paceart System deletes it from the database.This deletion is not saved until you save the edited encounter.
9. Click Save on the Edit Encounter tab to sav e the edited encounter or Cancel to cancel any changes that you made to the encounter information.
EGM waveform viewer overview
You can view EGM waveforms from within the Paceart System by using the EGM waveform viewer on the View Episode or Edit Episode dialog box.
The waveform viewer shown under Plots and Waveforms on the View Episode or Edit Episode dialog box has three display formats: interval plot, rate plot, and waveform.The viewer defaults to the interval plot.
In the interval plot and rate plot formats you can select the focus area on the interval or rate display.This focus area carries over to all of the display formats.The default focus area is the beginning of the strip.You can also choose to see a V-V only plot, an A-A only plot, or a plot with both V-V and A-A.The plot marks are color-coded.
In the waveform format you can select an area, clear a selected area, and save a selected area. EGM waveforms can be printed as part of a report.
EGM waveform display formats
EGM data can be displayed using an interval plot, rate plot, or waveform.The default display is interval plot. Change the display by selecting a format in the Display field in the waveform viewer.
Plots
An interval plot display is a graphical representation of data associated with intervals in milliseconds across time in seconds.The time axis is compressed to better show episode trends.
Figure 3: Interval Plot
A rate plot display is a graphical representation of data associated with rate in beats per minute across time in seconds. As with the interval plot, the time axis is compressed to better show episode trends.
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Figure 4: Rate Plot
By default, both V-V and A-A values are plotted.You can choose to display only the V-V or only the A-A points.
The Paceart System displays the plot with a blue rectangle surrounding the def ault f ocus area.Y ou can mo ve the focus area by clic king in an area of the plot that is outside the blue rectangle .The rectangle automatically moves to the area you selected centering itself on the cursor location.The same focus area is the same in all three display formats.You can use the scroll bar at the bottom of the plot to see other areas of the strip without changing the focus area.
Waveform
This type of display is a graphical representation of any varying quantity against time.The Paceart System passes in the waveform channels and an atrial channel (A-A) to display by default.When available, the Paceart System displays interval data for the A-A (atrial e vent), V-A (atrial event), and A-V (ventricular ev ent). Other event outputs are not displayed in the viewer.
The viewer displays w avef orm data from two wav eform channels along with the interval and marker information associated with a strip. Markers are two or three letter acronyms. For definitions, see the Wav eform Markers table in the "EGM waveform markers" topic.
The time between two dark gray grid lines is a 1 second interval.The Paceart System supports up to a 32 minute strip.The longer the recording, the longer it takes the Paceart System to open it.
Figure 5:Waveform
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EGM waveform viewer
The Paceart System EGM waveform viewer gives you the ability to view EGM data.The waveform viewer functionality is restricted to stored EGM data that is imported into the Paceart System from device files and is associated to an episode in an encounter.
The viewer supports importing EGMs through the Medtronic 2090 or Encore Programmer, CareLink, and data retrieved from the programmer through SessionSync.
The Paceart System defaults to passing in the first and second (if applicable) waveform channels for the EGM display unless you ha ve sav ed another configuration.Y ou can select two channels from a list of av ailable waveform channels in the strip. Both of the channels can be the same.
You can view atrial and ventricular interval data associated with the strip. If there is missing data in the strip, you will not see any stored wa v ef orm, interval, and marker data.The Paceart System may also display some text in the portion of the strip with missing data that may include an indication of the length, in time, of the missing data.
Opening an EGM waveform file
You can import waveform files into the Paceart System by creating an in-clinic or implant encounter.You can import waveform files from CareLink into a remote encounter.
Make sure that you hav e a patient record open, that you hav e created an encounter and retrieved the w avef orm file from the programmer, and that you have the patient record open to the Encounters > Episodes tab.
1. Select the encounter and click Edit on the Encounters tab. The Edit Encounter dialog box opens.
2. On the Episodes tab, select the episode and click Edit. The Edit Episode dialog box opens and displays the waveform under Plots and Waveforms. It defaults to the Interval Plot display.You can change the display by clicking a different Display Plot option.
3. Click OK to close the Edit Episode dialog box and return to the Episodes tab on the Edit Encounter dialog box.
4. Click Save to save a new or edited encounter.
Selecting and saving a section of an EGM waveform
You can select and save a section of an EGM strip in the waveform display.
1. Click once in the waveform where you want your selection to begin. Ensure that you click within one of the regions where the hand cursor is visible. A red broken line is displayed.
2. Click once in the waveform where you want your selection to end. Ensure that you click within one of the regions when the hand cursor is visible.
A second red broken line is display ed and the space between the red lines is highlighted.This highlighted section is the selected area.You can click a third time anywhere on the strip to clear your selection and insert a new red broken line.
The time interval of the selection is also displayed. If the interval is less than 3 seconds, the corresponding rate, assuming a V-V interval, is also displayed.
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3. Click Save Selection. The Add Strip dialog box is displayed.
4. Enter a name for the strip in the Name field.
5. Select the type of strip in the Type field. You can leave the field blank or select Stored EGM or Sample EGM.
6. Select the Print Strip check box if y ou w ant the w a v eform to be printed as part of the Encounter Episode
Details report.
7. Select the Full Disclosure check box to display the waveform in the full disclosure format.The full disclosure format does not include the atrial or ventricular intervals or event markers and displays 30 seconds per row in a vertical format. Clear the check box to include atrial and ventricular intervals as well as event markers in the strip.
8. Click OK. The Paceart System returns you to the wavef orm display on the Edit Episode dialog bo x. Be sure to sa v e the encounter to save the new waveform strip with the encounter episode.
Clearing an EGM strip selection
You can remove the selection of an area of a strip in the wavef orm display f ormat by clicking Clear Selection. This will remove all red broken lines.
Printing a waveform
You can print an EGM waveform within an encounter report such as the Encounter Episode Details report. The height of the image will be the same as the height of the waveform on the display.You cannot print the
EGM plot displays.
1. Make sure that the strip has the Print check box selected in one of the f ollowing locations on the Episodes tab of the encounter.
The Add Strip dialog box
The Edit Episodes dialog box
2. Print the report.
Increasing the viewable size of a waveform
You can adjust the vertical and horizontal scale of a waveform in Edit mode to show more or less detail on the screen.
Adjust the horizontal scale by adjusting the Speed setting, and adjust the vertical scale by adjusting the Gain setting. Select small values to zoom out and show more of the waveform. Select larger values to zoom in and show more detail.
You can also increase the vertical size of a waveform channel by clicking the icon green arrow next to the channel name.This hides the other channel and the interval markers. Click the green arrow again to restore the original display.
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Additionally, you can increase the vertical size of display plots and waveforms by increasing or maximizing the View Episode or Edit Episode window.
These adjustments are not saved and do not aff ect the displa y of the wa v ef orm in the corresponding reports.
Waveform Viewer log
The Paceart System will generate a log with exceptions and messages triggered by the waveform viewer and log it to the same log file as the Paceart System.You can find this file at \PaceartLogs\paceart_log.txt.
EGM waveform markers
Event markers are Paceart System-specific two and three letter acronyms that represent device-recorded aspects of the recorded wavef orm (for example , a sensed or paced beat, a detected arrhythmia, or a therap y).
The Paceart System displays the markers in the wa vef orm display according to the mappings in the f ollowing table. If a marker has no known association, the Paceart System assigns it UNK (unknown marker). Atrial markers are displayed above the baseline.Ventricular and other markers are displayed below the baseline. The baseline is the black horizontal line in the Marker section of the Waveform display.
Waveform Markers
Marker Display AnnotationEvent DescriptionCategory
ASNon Refractory Sense - AtriumBRADY APPace - Atrium ARRefractory Sense - Atrium VSNon- Refractory Sense - Ventricle VPPace - Ventricle VRRefractory Sense - Ventricle VSDSensor Detect - Ventricle/Dual ASDSensor Detect - Atrium PPace (Positive) - Dual SSense (Positive) - Dual SRRefractory Sense (Positive) - Dual VPTTrigger Pace - Ventricle/Dual VSTTrigger Sense - Ventricle/Dual AE[Sensor Derived Event - Atrium] SE[Sensor Derived Event - Dual] P[Pace (Negative) - Dual] S[Sense (Negative) - Dual] R[Refractory Sense (Negative) - Dual] AST[Trigger Sense - Atrium] APT[Trigger Pace - Atrium] ID[Idle Marker] AXP[Activity Sensor Pace - Atrium] VXP[Activity Sensor Pace - Ventricle]
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Marker Display AnnotationEvent DescriptionCategory
AMP[MV Sensor Pace - Atrium] VMP[MV Sensor Pace - Ventricle] VE[Sensor Derived Event - Ventricle] MS[Mode Switch - Dual] ASB[Atrial Sense in PVAB - Atrium] ATP[Tachy Pace - Atrium]TACHY ATS[Tachy Sense - Atrium] AFS[Fibrillation Sense - Atrium] VFS[Fibrillation Sense - Ventricle] VTS[Tachy Sense - Ventricle] VTP[Tachy Pace - Ventricle] ATD[Tachy Detect Complete - Atrium] AFD[Fibrillation Detect Complete - Atrium] VFD[Fibrillation Detect Complete - Ventricle] VTD[Slow Tachy Detect Complete - Ventricle] VCD[Cardioversion/Defib Pulse - Ventricle] ACD[Cardioversion /Defib Pulse - Atrium] DU[Data Uplink ] CE[End of Charge] VTT[Fast Tachy Sense via VT -Ventricle] VTF[Fast Tachy Sense via VF -Ventricle] FTD[Fast Tachy Detect Complete - Ventricle] VSP[Ventricle Safety Pace Trigger - Dual] ATF[Fast Tachy Sense - Dual] APP[Preventative Pace - Dual] VTM[VT Monitor & SVT Detected - Ventricle] FD[Fast A&V Detected - Dual] FDR[Rejected Fast Tachycardia Detection - Dual]
MARKER
TDR[Rejected Tachycardia Detection - Dual] AC[Capture - Atrium]CAPTURE VCCapture - Ventricle BVP[Biventricular Pace - Dual]HF ERError MarkerERROR UNKUNKNOWNANY OTHER
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Marker Display AnnotationEvent DescriptionCategory
REVEAL
detection - overrange/Asystole detection ­ventricular sense
ADAsystole detection - escape time-out/Asystole
ADRRejected Asystole detection PAPatient Activation BDBrady Detection BSBrady Sense IGIgnored Event
Programming
The Programming tab is for entering detections, therapies , and brady data.You must be in add or edit mode to modify any information.
Programming data can be imported or entered directly into the Paceart System.
Brady
The Brady section includes information about modes and rates, AV delay , pacing and sensing, heart failure , automatic mode switch, and rate response.
To enable the Brady section in an encounter, the device must have the Brady Detections capability, the
Brady Therapies capability, or both selected in the encyclopedia.
Detections/Therapies
The Detections/Therapies section includes information about detection status, interval, and duration, redetection interval and duration, classifier, committed shoc k, sudden onset status and duration, rate stability status and duration, QRS morphology status and match, SHR to current status, duration, and rate, and SHR to VF status, duration and rate. It also includes summary and detailed information on therapies.
To enable the Detections/Therapies section in an encounter, the device must have the Asystole, Heart failure, Brady Detections, Brady Therapies, AT/AF Detections, AT/AF Therapies, VT/VF Detections, and/or VT/VF Therapies capabilities selected in the encyclopedia.
The Detections and Therapies table shows a list of detections according to related device capabilities. Each row is shaded gray if the zone is disabled or contains no detection values.You can select a row to see more details.The Therapies summary table displays the count and type of active therapies in the same order as programmed. Antitachycardia pacing (ATP) therapies list the type of ATP and the number of sequences. For example, a value of Burst(2) indicates two sequences of Burst ATP. Shock therapies list the energy and count. For example, a value of 35J X 4 indicates four sequential shocks of 35J each. If the zone is active but contains no active therapies, Monitored is displayed in the summary.
Field and button definitions for the Detections/Therapies section
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Detection Status:
The detection status for the selected zone.The value must be one of the following values: Enabled, Disabled.
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Field and button definitionsDialog box fields and buttons
Detection Rate/Interval:
Detection Duration
Redetection Rate/Interval:
Redetection Duration:
Classifier:
The programmed detection rate in beats per minute and interval in milliseconds.The value, in milliseconds, must not have more than two n umbers after a decimal point.
The minimum duration of time in seconds or beats that the arrhythmia must persist above the Detection Rate before the rate is considered arrhythmic.
The programmed redetection rate in beats per minute and interval in milliseconds.The value, in milliseconds, must not have more than two n umbers after a decimal point.
The minimum duration of time in seconds or beats that the arrhythmia must persist abov e the redetection rate before the rate is considered arrhythmic after therapy has been applied.
The detection classification scheme to be used for the zone if not independently configured.The value must be one of the following values:Via VF, Via VT.
Committed Shock:
Sudden Onset Status:
Sudden Onset Duration:
Rate Stability Status:
Rate Stability Duration:
The indicator of whether a shock therapy will be delivered without reconfirming the diagnosis/detection after charging is complete (inverse of reconfirm).The value must be one of the following values: Enabled, Disabled.
The indicator of whether sudden onset criteria are used in classifying an arrhythmia in the current zone. The value must be one of the following values: Enabled, Disabled.
The threshold of change, expressed as a percentage or interval length, used to determine if the rate acceleration is sudden.
The indicator of whether rate stability criteria are used in classifying an arrhythmia in the current zone.The value must be one of the following values: Enabled, Disabled.
The interval in milliseconds used to distinguish irregular rhythms from stable rhythms. The value, in milliseconds, must not have more than two numbers after a decimal point.
QRS Morphology Status:
The indicator of whether wavef orm morphology criteria are used in classifying an arrhythmia in the current
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Field and button definitionsDialog box fields and buttons
zone.The value must be one of the following values: Enabled, Disabled.
QRS Morphology Match:
SHR to Current Status:
SHR to Current Duration:
SHR to Current Rate:
SHR to VF Status:
The percentage of time over which the sudden onset criteria are applied. The value, in a percentage, must not have more than two numbers after a decimal point.
The indicator of whether rejection rules in the current zone will be disabled if a high rate episode is sustained. The value must be one of the following values: Enabled, Disabled.
The duration of time in seconds a high rate episode must endure before rejection rules in the current zone are disabled.The value, in seconds, must not have more than two numbers after a decimal point.
The minimum rate in beats per minute that must be sustained before rejection rules in the current zone are disabled.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The indicator of whether an episode will be promoted to the Ventricular Fibrillation zone if a high rate episode is sustained. The value must be one of the following values: Enabled, Disabled.
SHR to VF Duration:
SHR to VF Rate:
Add
Edit
Delete
Move Up
Move Down
The duration of time in seconds a high rate episode must endure before being promoted to the V entricular Fibrillation zone.The value, in seconds, must not have more than two numbers after a decimal point.
The minimum rate in beats per minute that must be sustained before being promoted to the Ventricular Fibrillation zone.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
Adds information.
Allows you to edit existing information.
Removes the item or items from the list.
Moves the selected item up in the list box.
Moves the selected item down in the list box.
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Field and button definitions for the Add/Edit Therapy dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Therapy Type: Shock
Therapy Type: ATP
Status
Energy
Voltage:
Pathway:
WaveForm
When selected, indicates a shock is delivered as therapy.
When selected, indicates antitachycardia pacing (ATP) is delivered as therapy.
Indicates the therapy status.The value must be one of the following values: Enabled, Disabled.
Energy for therapy in Joules. The value, in joules, must not have more than two n umbers after a decimal point.
The voltage for therapy in volts.The value, in volts, must not have more than two n umbers after a decimal point.
The indicator of whether the pathway is between the can and a single electrode on a lead or between two electrodes on the same or different leads.
The type of shock waveform. The value must be one of the following values: Monophasic, Biphasic.
CV Delay
Pulse Width (+)
Pulse Width (-)
Tilt (+):
Tilt (-):
Cardioversion therapy delay after a sensed R-wave in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The width of the positive phase in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The width of the negative phase in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The percentage fall in voltage on the capacitor from the beginning to the end of the negative phase of the waveform over the course of the entire pulse.The value, in a percentage, must not have more than two numbers after a decimal point.
The percentage fall in voltage on the capacitor from the beginning to the end of the positive phase of the waveform over the course of the entire pulse.The
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Field and button definitionsDialog box fields and buttons
value, in a percentage, must not have more than two numbers after a decimal point.
Therapy
Description:
Timing:
Amplitude:
Pulse Width:
Stimuli Count
Coupling Interval
The basic antitachycardia pacing (ATP) type. The value must be one of the following values: Burst, Ramp, Burst Scan, Ramp Scan.
The description of the pacing.
The timing of anti-tachycardia pacing.The value must be one of the following v alues: Before Charging Next Therapy, While Charging Next Therapy.
The programmed pulse amplitude in volts.The value, in volts, must not have more than two numbers after a decimal point.
The programmed pulse width in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
Initial number of stimuli in the ATP train. The value must be ten digits or less and cannot have a decimal point.
The measure of the delay between a conducted atrial event and a subsequent ventricular event measured in milliseconds or as a percentage.The value, in a percentage, must not have more than two numbers after a decimal point.
Coupling Int. Dec.
Ramp Dec.
Minimum BCL
# of Sequence
Max # of Pulse
The coupling interval decrement for each pacing train in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The interpulse decrement within each A TP pace train in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The minimum burst cycle length in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The number of sequences of antitachycardia pacing (ATP) for this therapy. The value must be ten digits or less and cannot have a decimal point.
The maximum number of pulses.The value must be ten digits or less and cannot have a decimal point.
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Field and button definitionsDialog box fields and buttons
Pulse Increment
Scan Decrement
Smart Mode
Disabled by Smart Mode:
BCL
S1S2 Ramp
The value to increase the number of pulses per burst for each successive burst in antitachycardia pacing (ATP) scheme. The value must be ten digits or less and cannot have a decimal point.
The scan decrement in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
Disables an antitachycardia pacing (ATP) therapy that was unsuccessful in 4 consecutive episodes so that the device can treat subsequent episodes more quickly with therapies that have been effective.
An indicator of whether the therapy was automatically disabled by the implantable device due to repeated unsuccessful therapy delivery.
The initial antitachycardia pacing (ATP) burst cycle length in milliseconds.
S1S2 ramp used for Ramp + therap y.The value must be ten digits or less and cannot have a decimal point.
S2SN Ramp
Scan Sequence
S2SN ramp used for Ramp + therap y .The value must be ten digits or less and cannot have a decimal point.
The scan sequence.
Field and button definitions for the Specify Duration dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Fixed
Beat Count:
Beat Ratio:
The fixed duration of time in seconds required at or above the rate criteria which will satisfy the criteria. The value, in seconds, must not have more than two numbers after a decimal point.
The specified number in beats of cardiac cycles required at or above the rate criteria which will satisfy the detection criteria.The value must be ten digits or less and cannot have a decimal point.
The specified ratio of cardiac cycles required at or above the rate criteria which will satisfy the detection criteria.The value must be ten digits or less and cannot have a decimal point.
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Field and button definitions for the Specify Interval Length dialog box
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Fixed
Percent:
The fixed duration of time in milliseconds required at or above the rate criteria which will satisfy the criteria.
The percentage of time required at or above the rate criteria which will satisfy the criteria.The value, in a percentage, must not have more than two numbers after a decimal point.
Field and button definitions for the Brady section
This is a list of fields and buttons and their definitions.
Field and button definitionsDialog box fields and buttons
Modes and Rates
Mode:
The programmed pacing mode.The value must be one of the following values: AAI, AAIR, AAT, AATR, ADI, ADIR, AOO, AOOR, DAD, DDD, DDDR, DDI, DDIR, DDT, DDTR, DOO, DOOR, DVI, DVIR, DVTR, ODO, OOO, OOOR, OVO, VAT, VDD, VDDR, VDI, VDIR, VDT, VDTR, VOO, VOOR, VVI, VVIR, VVT, VVTR, AAI<=>DDD, AAIR<=>DDDR, AAIsafeR, SafeR, SafeR/DDIR, DDD-CLS, DDDR-CLS.
Lower Rate:
Upper Rate:
Upper Sensor:
Hysteresis Rate:
Sleep Rate:
PVARP:
The programmed lower rate in beats per minute .The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The programmed upper rate in beats per minute.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The programmed maximum sensor rate in beats per minute.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The programmed hysteresis rate in beats per min ute. The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The programmed sleep rate in beats per minute.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The programmed post-ventricular atrial refractory period in milliseconds. The value, in milliseconds,
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Field and button definitionsDialog box fields and buttons
must not have more than two n umbers after a decimal point.
PVAB:
AV Delay
Adaptive Status:
Paced AV Delay:
Sensed AV Delay:
Adaptive Paced Min:
Adaptive Sensed Min:
The programmed post-ventricular atrial blanking period in milliseconds. The value, in milliseconds, must not have more than two n umbers after a decimal point.
The status of adaptive AV delay. The value must be one of the following values: Enabled, Disabled.
The base paced A V dela y in milliseconds .The value, in milliseconds, must not hav e more than two numbers after a decimal point.
The sensed AV delay in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The minimum AV delay at Stop Rate or Upper Rate in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
The minimum sensed AV delay in milliseconds.The value, in milliseconds, must not have more than two numbers after a decimal point.
Adaptive Start Rate:
Adaptive Stop Rate:
Adaptive Curve Desc:
Pacing and Sensing
Amplitude:
Amplitude:
The lower rate when AV Delay begins to shorten in beats per minute.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
The upper rate when A V Delay will be the shortest in beats per minute.The value, in beats per minute, must be ten digits or less and cannot have a decimal point.
Adaptive Curve Description in AV Delay.
The programmed atrial pulse amplitude in volts.The value, in volts , must not hav e more than two numbers after a decimal point.
The programmed right ventricular pulse amplitude in volts.The value, in volts, must not have more than two numbers after a decimal point.
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