Schiller AT-2+ Service Handbook

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

AT-2plus

6-Channel

ECG unit

Memory

Service Handbook

SCHILLER AG

Altgasse 68

CH-6341 Baar, Switzerland

Phone: + 41 41 766 42 42

Fax: + 41 41 761 08 80

Home page: http://www.schiller.ch/

May 2002 Article Number: 2.540014

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

AT-2plus Memory Service Handbook

Article Number 2. 540014d

Issue 1 : June 1998

Issue 2 : December 1999 Schematics: 2480BC, 2482CA, 2483BF, 2485BA

Issue c : September 2001 Schematics: 2480BC, 2482CA, 2483DA, 2485BA

Issue d : May 2002 Schematics: 2480BC, 2482CA, 2483DA, 2485BA

Associated Documents

Guide to the SCHILLER Interpretation and Measurement Program E/ D/ F Article No. 2. 510179

SCHILLER AT-2plus User Guide - English / German / French Article No. 2. 510220 SCHILLER AT-2plus User Guide - Italian / Spanish / Portuguese Article No. 2. 510221 SCHILLER AT-2plus User Guide - Swedish Article No. 2.510321 SCHILLER AT-2plus Short Form User Guide - Swedish Article No. 2.510245

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Where to Obtain Service

WELCH ALLYN SCHILLER Inc., 7420 Carroll Road, San Diego, CA , US-92121-2334 USA

USA / Canada

Asia Pacific

Tel.: +1 858 635 6023 Fax : +1 858 635 6611 Home Page : www.welchallyn.com SCHILLER Asia Pacific, 10 Jalan SS 3/33, Taman Universiti, 47300 Petaling Jaya, Selangor,

Malaysia Tel.: + 603 7877 5336 Fax : + 603 7877 5744

Austria

France

Germany (EU authorized representative)

India

Italy

Switzerland

All other countries

SCHILLER HmbH, Kampmüllerweg 24, A-4044 Linz, Austria

Tel.: + 43 732 709 90 Fax : + 43 732 757 000 SCHILLER Medical S.A, BP 50, 19, Avenue de la Gare, F-67162 Wissembourg / Cedex,

France Tel.: +33 3 88 63 36 00 Fax : +33 3 88 94 12 82

SCHILLER Medizintechnik GmbH, Rudolf-Diesel Strasse 14, D-85521 Ottobrunn, Germany

Tel.: + 4989 629 981 0 Fax : + 4989 609 509 0 SCHILLER Healthcare India Pvt. Ltd.,D.C.Silk Mills Compound, 'A' Wing, 1st floor, 5,

Chunawala Estate, Kondivitta Lane, Andheri - Kurla Road, Andheri (E, Mumbai - 400 059, India

Tel.: + 9122 826 3520 Fax : + 9122 826 3525 ESAOTE Spa (SCHILLER ), Via di Caciolle 15, I-50127 Firenze, Italy Tel.: + 39055 4229 201 Fax : + 39055 4229 208 SCHILLER Reomed AG, Riedstrasse 14, CH-8953 Dietikon, Switzerland Tel.: +411 744 3000 Fax : + 411 740 3710 SCHILLER AG, Altgasse 68, CH-6341 Baar, Switzerland Tel.: + 4141 766 4242 Fax : + 4141 761 0880 Home Page : www.schiller.ch

iii

Warranty

Terms of Warranty

The SCHILLER AT-2plus Memory is warranted against defects in material and manufacture for the duration of one year (as from date of purchase). Excluded from this guarantee is damage caused by an accident or as a result of improper handling. The warranty entitles free replacement of the defective part. Any liability for subsequent damage is excluded. The warranty is void if unauthorized or unqualified persons attempt to make repairs.

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

In case of a defect, contact your dealer or the manufacturer.

The manufacturer can only be held responsible for the safety, reliability, and performance of the apparatus if:

* assembly operations, extensions, readjustments, modifications, or repairs are carried out by

persons authorized by him, and

* the AT-2plus Memory and approved attached equipment are used in accordance with the

manufacturers instructions.

THERE ARE NO EXPRESS OR IMPLIED WARRANTIES WHICH EXTEND BEYOND THE WARRANTIES HEREINABOVE SET FORTH. SCHILLER MAKES NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE PRODUCT OR PARTS THEREOF.

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Safety Notices

WARNINGS & CAUTIONS

TO PREVENT ELECTRIC SHOCK DO NOT DISASSEMBLE THE UNIT. NO SERVICEABLE PARTS INSIDE. REFER SERVICING TO QUALIFIED PERSONNEL ONLY.

DO NOT USE THIS UNIT IN AREAS WHERE THERE IS ANY DANGER OF EXPLOSION OR THE PRESENCE OF FLAMMABLE GASES SUCH AS ANAESTHETIC AGENTS.

IF THE DISPLAY IS DAMAGED, A LEAKAGE OF FLUID MAY OCCUR. DO NOT INHALE THE VAPOUR FROM THIS FLUID AND AVOID CONTACT WITH MOUTH AND SKIN. IF CONTACT IS MADE, CLEAN CONTAMINATED AREA IMMEDIATELY WITH FRESH WATER.

THIS PRODUCT IS NOT DESIGNED FOR STERILE USE.

SWITCH THE UNIT OFF BEFORE CLEANING AND DISCONNECT FROM THE MAINS.

DO NOT, UNDER ANY CIRCUMSTANCES, IMMERSE THE UNIT OR CABLE ASSEMBLIES IN LIQUID.

DO NOT OPERATE THE UNIT IF THE EARTH CONNECTION IS SUSPECT OR IF THE MAINS LEAD IS DAMAGED OR SUSPECTED OF BEING DAMAGED.

DO NOT USE HIGH TEMPERATURE STERILISATION PROCESSES (SUCH AS AUTOCLAVING). DO NOT USE E-BEAM OR GAMMA RADIATION STERILISATION.

DO NOT USE SOLVENT CLEANERS

USE ONLY ACCESSORIES AND OTHER PARTS RECOMMENDED OR SUPPLIED BY SCHILLER AG. USE OF OTHER THAN RECOMMENDED OR SUPPLIED PARTS MAY RESULT IN INJURY INACCURATE INFORMATION AND/ OR DAMAGE TO THE UNIT.

THIS UNIT COMPLIES WITH EMC REGULATIONS FOR MEDICAL PRODUCTS WHICH AFFORDS PROTECTION AGAINST EMISSIONS AND ELECTRICAL INTERFERENCE. HOWEVER SPECIAL CARE MUST BE EXERCISED WHEN THIS UNIT IS USED WITH HIGH FREQUENCY EQUIPMENT.

IT MUST BE ENSURED THAT NEITHER THE PATIENT NOR THE ELECTRODES (INCLUDING THE NEUTRAL ELECTRODE) COME INTO CONTACT WITH OTHER PERSONS OR CONDUCTING OBJECTS (EVEN IF THESE ARE EARTHED).

THERE IS NO DANGER WHEN USING THE ECG UNIT FOR A PACEMAKER PATIENT OR WITH SIMULTANEOUS USE OF OTHER ELECTRICAL STIMULATION EQUIPMENT. HOWEVER, THE STIMULATION UNITS SHOULD ONLY BE USED AT A SUFFICIENT DISTANCE FROM THE ELECTRODES. IN CASE OF DOUBT, THE PATIENT SHOULD BE DISCONNECTED FROM THE RECORDER.

Safety Notices

THIS UNIT IS CF CLASSIFIED ACCORDING TO IEC 601-1. THIS MEANS THAT THE PATIENT CONNECTION IS FULLY ISOLATED AND DEFIBRILLATION PROTECTED. SCHILLER CAN ONLY GUARANTEE PROTECTION AGAINST DEFIBRILLATION VOLTAGE, HOWEVER, WHEN THE ORIGINAL SCHILLER PATIENT CABLE IS USED.

WHEN NON-MEDICAL DEVICES ARE CONNECTED TO THE RS-232 INTERFACE ENSURE THAT BOTH UNITS ARE SECURELY CONNECTED TO THE SAME EARTH POTENTIAL.

WHEN OPERATING THE UNIT ON BATTERY AND SIMULTANEOUSLY USING NONMEDICAL DEVICES, THE RS-232 INTERFACE MUST BE FULLY ISOLATED.

AN EXTERNAL DEVICE MUST ONLY BE CONNECTED USING THE ORIGINAL SCHILLER INTERFACE CABLE ASSEMBLY.

BEFORE USING THE UNIT, ENSURE THAT AN INTRODUCTION REGARDING THE UNIT FUNCTIONS AND THE SAFETY PRECAUTIONS HAS BEEN PROVIDED BY A SCHILLER REPRESENTATIVE.

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

WARNINGS & CAUTIONS

THE GUIDELINES FOR PATIENT ELECTRODE PLACEMENT ARE PROVIDED AS ON OVERVIEW ONLY. THEY ARE NOT A SUBSTITUTE FOR MEDICAL EXPERTISE.

THIS UNIT IS PROVIDED FOR THE EXCLUSIVE USE OF QUALIFIED PHYSICIANS OR PERSONNEL UNDER THEIR DIRECT SUPERVISION. THE NUMERICAL AND GRAPHICAL RESULTS AND ANY INTERPRETATION DERIVED FROM A RECORDING MUST BE EXAMINED WITH RESPECT TO THE PATIENTS OVERALL CLINICAL CONDITION. THE RECORDING PREPARATION QUALITY AND THE GENERAL RECORDED DATA QUALITY, WHICH COULD EFFECT THE REPORT DATA ACCURACY, MUST ALSO BE TAKEN INTO ACCOUNT.

IT IS THE PHYSICIANS RESPONSIBILITY TO MAKE THE DIAGNOSIS OR TO OBTAIN EXPERT OPINION ON THE RESULTS, AND TO INSTITUTE CORRECT TREATMENT IF INDICATED.

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

What's in this book

The service philosophy for the AT-2plus Memory is fault finding to module level. The purpose of this book is to provide all the information necessary to enable the service engineer to efficiently locate and replace a faulty module. This book assumes no detailed knowledge of the AT-2plus Memory but does require that the service engineer is familiar with standard workshop practices. The book is divided into the following chapters:

Chapter 1 - Operating Elements

The purpose of this chapter is to provide an easy reference for all the main operator functions and to give a basic introduction to the AT-2plus Memory. This chapter gives details of the operator controls with the operation and function of each key briefly explained. The information in this chapter provides a background to the operating functions only. Complete operating information is provided in the SCHILLER AT-2plus User Guide.

Chapter 2 - Functional Overview

This chapter provides a functional overview of the AT-2plus Memory. The description is supported by functional block diagrams.

Chapter 3 - Fault Diagnosis

This chapter provides a guide to locate a fault to module level. The diagnostics are presented in a logical sequence of fault finding algorithms and procedures. Illustrations are provided to support the text where needed.

Chapter 4 - Module Removal and Replacement

This chapter gives an overview of the physical construction of the AT-2plus Memory with the main physical attributes of the unit briefly described. The physical description is supported by illustrations showing the internal location of all modules. Removal and replacement instructions for all removable modules are also provided in this chapter. Each procedure is autonomous with details of tools, jumper settings, adjustments and settings or special requirements that are required before and after replacement. Functional checks that must be carried out after replacing a module are also provided.

Chapter 5 - Adjustments

This chapter provides all adjustments and settings. Also detailed in this chapter are basic functional test procedures that can be performed to check the functioning of the unit.

Chapter 6 - Spare Parts

This chapter provides the part numbers and reordering information for all replaceable modules. Also included in this chapter are details of any special test equipment or special tools required for adjustment or fault finding procedures.

vii

What's in this book

Chapter 7 - Technical Data

The full technical specification of the AT-2plus Memory is given in this chapter.

Chapter 8 - Glossary

This chapter explains all the acronyms and signal titles used in this book and in the AT-2plus Memory circuit diagrams.

Circuit Diagrams & Board layouts

The circuit diagrams and component layouts are provided for all boards. These details are provided for information only.

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

viii

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Introduction 1.2

List of Symbols 1.2

Location & Power 1.3

Switching On and Off 1.3

The Keyboard 1.4 LCD Screen 1.6 AT-2plus Short Form Operating Instructions 1.7 Modes of Operation 1.8 Automatic Mode 1.9 Manual Mode 1.10 Settings 1.12 Automatic Mode (ECG) Settings 1.20 Memory and Data Transmission Option 1.24

Erasing Memory Files 1.25 Transmitting Stored Files 1.25 Transmission Settings 1.25 Modem Transmission 1.26 Line Transmission 1.27

Software Updating via RS-232 1.28 Care & Maintenance 1.29 Replacing the Recording Paper 1.31 Thermal Paper Handling 1.32

Chapter 1

Operating Elements

Chapter 1

Operating Elements

Contents

Page 1.1

Chapter 1 Operating Elements

Introduction

The CARDIOVIT AT-2plus is a 6-channel ECG recorder with all (12) ECG signals simultaneously processed to provide instant ECG recordings. Two automatic recording modes can be individually preset to enable one button ECG recording of preferred print formats.

The AT-2plus includes the following features:

• Low weight and compact dimensions

• Large A4 size printout from integrated quality thermal printer

• Built-in rechargeable battery for mains-independent use - 4hrs normal use or 300 printouts on one battery charge

• Large, clear LCD for ECG preview prior to printing

• Simple one key operation for main functions

• Automatic or manual recording modes

• Selectable printing formats

• ECG memory for easy copying

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

• Interpretation program option (including measurements) for children and adults

• Alphanumeric keyboard for patient data entry and clinical comments

List of Symbols

Page 1.2

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Location & Power

Location

Do not keep or operate the apparatus in a wet, moist, or dusty environment. Also, avoid exposure to direct sunlight or heat from other sources. Do not allow the unit to come into contact with acidic vapours or liquids, as such contact may cause irreparable damage. The unit should not be placed near X-ray or diathermy units, large transformers or motors. The unit must be placed on a flat surface and must not be operated in areas where there is any danger of explosion.

Power Supply

The mains connection is on the rear of the unit. The mains indicator lamp on the keyboard is always lit when the unit is connected to the mains supply. The unit can either be operated from the mains supply or from the built-in rechargeable battery. The power source isa indicted on the top line of the LCD.

Chapter 1

Operating Elements

Power Indication

HR: 76/min

Wed 20-AUG-96 18:20:21

R L F C1 C2 C3 C4 C5 C6

When mains is connected a mains symbol is displayed (as shown above). When the unit is running on battery power a battery symbol is displayed:

When battery capacity is limited, the battery symbol flashes on and off.

To recharge the battery, connect the apparatus to the mains supply by means of the supplied power cable. A totally discharged battery needs less than 15 hours to be fully recharged (60% in less than 3 hours, 90% in less than 7 hours). A fully charged battery gives approximately 4 hours of normal use. The unit can remain connected to the mains supply without any danger of damage to either the battery or the unit.

Switching On and Off

The CARDIOVIT AT-2plus is switched on with the green ON key

and off by means of the red OFF key

The unit is automatically switched off after 5 minutes (30 seconds if battery capacity is limited) if no key is pressed and the patient cable is not connected.

Potential Equalisation

If the AT-2plus is used in conjunction with other patient connected equipment, we recommend that the potential equalisation stud on the rear of the unit is connected to the hospital/ building common ground with the yellow/green ground cable (Part-no. 2.310005). When working from an emergency vehicle, the vehicle common ground can be used.

Page 1.3

Chapter 1 Operating Elements

The Keyboard

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Page 1.4

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

The Keyboard (cont.)

1 Print extra copy - of Auto mode recording currently in memory. Press the ALT key first

followed by this key to obtain a copy in Auto format 2.

2 Display/enter patient data. When the patient data is displayed, pressing this key again

returns to the ECG. Use the up/down arrows to go to the next data entry field.

In the `Born` (date of birth field), only the patients year of birth need be entered if desired. When two digits are entered (patients year of birth), the AT-2plus calculates the age of the patient according to the year entered. When the full DOB is entered, the age is calculated precisely.

3 Myogram filter ON / OFF. The cutoff frequency can be defined and is detailed in

`Settings`.

4. The top figures on the number keys designated > and < changes the lead group displayed on the screen.

5. Auto sensitivity key - automatically sets the ECG printout sensitivity ( in AUTO mode only) to the best setting for the signal strength (5mm/mV or 10mm/mV)

6. The top figures on the number keys designated 5, 10, and 20 set the sensitivity of the ECG both on the screen and on the (manual) printout. The sensitivity is 5, 10 or 20 mm / mV.

Chapter 1

Operating Elements

7. The top figures on the number keys designated 5/10, 25, and 50 set the speed of the ECG both on the screen and on the (manual) printout. The speed on the screen can only be set to 25 or 50 mm / s. The speed of the manual printout can be 5, 10, 25 or 50 mm/s. The 5 and 10 mm/s settings are both on the same key which toggles the two speeds.

8. The top character `QRS` toggles the QRS beeper ON/ OFF

9. Delete last typed character.

10.Switch the unit OFF.

11.Switch the unit ON.

12.Manual mode recording - start continuous printout of ECG - until STOP key pressed

13.Auto Mode recording (in Auto mode 1). Press ALT followed by the AUTO key for auto mode 2.

14.STOP printout / confirm (new) setting

15.ALT key - key for initiation of setups and selection of second format for printout and auto mode recording

16.In ECG mode use the UP/DOWN arrows to adjust screen contrast. When entering patient data use the LEFT/RIGHT arrow keys to move cursor in data field. Use the UP/DOWN arrow keys to go up/down to the next data entry

17.Mains Indicator - lit when mains connected.

Second letters on the keyboard - è, é, ç, ø are reached by holding the ALT key pressed before the letter key. Accents on a letter e.g. ô, ñ etc. are reached by pressing <SHIFT> and then the letter. In addition the following special characters are available (AT-2plus Memory only !):

Key combination: SHIFT + 1 2 3 4 5 6 7 8 9 0 Character ! @ # $ % & / * " =

Page 1.5

Chapter 1 Operating Elements

LCD Screen

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

1. Current Heart Rate (averaged over 4 beats and refreshed every 2 seconds). The HR is also given on a manual printout. Note that with an auto mode printout the HR is averaged over

the full 10 seconds of the recording.

2. Top line - Current Day, Date and Time Bottom Line - System messages

3. Top Line - Current power source - mains or battery. When battery capacity is limited the battery symbol flashes.

Bottom line - `ALT` in this box indicates that the ALT key has been pressed.

4. Electrode connections - when a lead flashes it indicates that the electrode resistance is too high. The electrode must be reapplied

5. Lead indication (leads currently displayed on the screen). Change the lead group with the keys `1` and `2`.

6. Myogram Filter indication - `Filter` = filter ON; no indication = filter OFF. Switch the filter on or off with the Filter key.

7. An `A` in this box indicates that automatic sensitivity is selected (auto mode printout only). Switch automatic sensitivity on or off with key `3`.

8. Sensitivity - 5, 10 or 20 mm/mV. Change the sensitivity with the keys `4`, `5`, and `6`.

Page 1.6

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

AT-2plus Short Form Operating Instructions

Automatic ECG Recording

• Prepare skin, hook up patient.

• Switch unit on, press ON .

• Press and enter patient data.

• Press again and wait for at least 10 seconds until

a clear and stable trace is displayed.

• Press AUTO to record and print.

• Press COPY for additional copies.

Chapter 1

Operating Elements

Manual ECG Recording (Rhythm Strip)

· Prepare skin, hook up patient.

• Switch unit on, press ON .

• Press MAN START .

• Change lead group with

and

• Press STOP to stop the printout.

Electrode hook-up check

· Press

ALT

1mV

for electrode check.

AUTO3AUTO

Best results are obtained when the electrode voltage readings

(right column) are between ±50mV.

Filter On/Off

• Press to switch the (Myogram) filter On / Off.

System Configuration

• Press

ALT

1mV

1 1

to print system settings.

Page 1.7

Chapter 1 Operating Elements

Modes of Operation

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Automatic Mode

Automatic Mode provides a printout giving 10 seconds of ECG recording of all 12 leads with a choice of 2 different formats.

Lead format and chart speed can be programmed freely for each of the 2 formats before recording. With the optional interpretation program installed it is also possible to select the measurement

table, average cycles with optional markings and interpretation statements for the printout. For further information see paragraph `Settings for Automatic Mode`.

Manual Mode

Manual Mode provides a real time printout of 6 leads that are selected and indicated on the screen.

The following can be freely selected before or during recording:

• Lead Group • Chart Speed

• Sensitivity • Myogram Filter

For further information see paragraph `ECG Recording in Manual Mode` following.

Page 1.8

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Automatic Mode

In automatic mode, a full 12-lead ECG is printed in one of two predefined formats with a sensitivity of 10 mm/mV. These two formats are selected by the user to suit his specific needs and requirements.

When the AUTO SENSITIVITY key unit detects very large waveform amplitudes and sets the sensitivity for the extremity and/or precordial leads to 5 mm/mV to reduce the overlapping of traces. An `A` on the bottom line of the LCD indicates that Auto sensitivity is set.

To start the automatic ECG recording in Format 1, press the AUTO key:

To start the automatic recording in the second format, press the ALT key followed by the AUTO key:

AUTO

is pressed before recording in automatic mode, the

ALT

Chapter 1

Operating Elements

The printout gives the following:

• ECG recording of all leads in either Standard or Cabrera format according to selection

• Sensitivity

• Heart Rate

• Speed

• Filter Settings

• Time and Date

• Interpretation statements

• Average Cycles

• Intervals

• Axis

• Sokolow Index (ECG index for hypertrophy)

• Detailed Measurement Table

To obtain an extra printout of the ECG recording in Format 1, simply press the COPY key:

COPY

To obtain an extra printout of the second format, press the ALT key followed by the COPY key:

ALT - COPY

The Auto mode settings for the two formats are detailed in the paragraph entitled `Settings for Automatic Mode` later in this book

Page 1.9

Chapter 1 Operating Elements

Manual Mode

Manual mode provides a direct printout of the real-time ECG with full control of parameter selection.

To start the manual recording of a real-time ECG, press the MANUAL Printout key

To stop the manual recording (printout) press the STOP key

The printout provides you with the following:

• Six (selected) leads with lead identification.

• On the lower edge, the chart speed, user identification and filter settings (if on).

• At the top, the heart rate as current average of 4 beats, trace sensitivity, and the time and date

The following can be freely chosen during or before the recording:

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Lead Group by means of the LEAD FORWARD and LEAD BACKWARD

key

The following lead groups are selectable:

• I, II, III aVR, aVL, aVF (Cabrera: aVL, I, -aVR / II, aVF, III)

• V1, V2, V3 / V4, V5, V6

• II, aVF, III / V2, V4, V5

• V4, V5, V6 / V7, V8, V9

Note: The LCD only displays three leads at one time. When the lead forward or lead backward

key is pressed, the following /preceding three lead group is displayed

Leads

For software versions higher than 4.10 it is also possible to chose further leads. The desired leads are activated as shown in the table.

Entry Key Sequence Lead group Confirm

ALT 7 9

Select leads

Rhythm

II, avF, III, V2, V4, V5 Rhythm

II, avF, III, V2, V4, V5 Left posterior

V4, V5, V6, V7, V8, V9 Left posterior

V4, V5, V6, V7, V8, V9 Right precordial up to V5r

V1, V2, V3, V3r, V4r, V5r Right precordial up to V5r

V1, V2, V3, V3r, V4r, V5r Right precordial up to V6r

V1, V2, V3r, V4r, V5r, V6r Right precordial up to V6r

V1, V2, V3r, V4r, V5r, V6r NEHB

D, A, J NEHB

D, A, J

OFF

Press STOP

key

Page 1.10

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Manual Mode (cont.)

Chart Speed Select speed 5, 10, 25 or 50mm/s by means of the SPEED keys:

Notes: Key 7 is a toggle key -press once and 5 is selected, press a second

Sensitivity Select 5, 10 or 20 mm/mV by means of the SENSITIVITY keys:

Myogram Filter Switch the filter ON or OFF with the FILTER key:

Recentering To re-centre the ECG traces, press the 1mV key

Operating Elements

5/10

time and 10mm/s is selected. When the 25 or 50mm/s key is pressed, the same speed is set on

both the screen and the (manual) printout. When 5 or 10 mm/s is selected, this affects the manual printout speed only.

455

`FILTER` is displayed on the bottom line of the LCD when the filter is switched on.

1mV

Chapter 1

WARNING

AFTER HEAVY ARTEFACTS OR LEAD OFF, THE INDICATION OF THE HEART RATE MAY NOT BE RELIABLE.

Page 1.11

Chapter 1 Operating Elements

Settings

Each parameter is set by means of a code. This code comprises a combination of keys starting with the ALT key followed by two or three numbers. The setting is confirmed with the STOP key. As soon as the ALT key is pressed, the keyboard is dedicated to the programming function.

Note: When the ALT key is pressed `ALT` appears on the LCD (see previous page)

Note: The Alternative (ALT) function is only active for 4 seconds. If a programming key is

The setting is remembered and the keyboard released for other functions when the STOP key is pressed. Once a setting has been confirmed, it is stored in the memory even when the unit is switched off.

Example

If you want to reset your AT-2plus to the basic default settings, the key sequence given on page 14 is ALT; 0; 6; 6. STOP.

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

not pressed within 4 seconds, the unit reverts to standard mode. The ALT key must again be pressed to activate the programming mode

On the following pages the programmable parameters and the programming sequences are described in detail.

Page 1.12

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Settings (cont.)

The defined formats and settings for your unit can be checked as follows:

A printout of the defined settings will be produced and gives the following information, depending on the installed software:

Chapter 1

Operating Elements

ALT - 0 - 1 - 1

Unit designation Software version, Software option installed (C = Interpretation)

and interpretation version

Serial number Serial number of the unit Leads Standard (S) or Cabrera (C) ECG Format Long (ooo), Short (o) or Suppressed (-) MECG Average cycles as defined in auto ECG recording setup (e.g. 4 *

3 (25 mm/s) + 2)

Measurements Enabled (+) or Suppressed (-) Marks Enabled (+) or Suppressed (-) Interpretation Enabled (+) or Suppressed (-) Selected Rhythm leads Leads selected for R1, R2 resp. Automatic Centering Enabled (+) or Suppressed (-) Printout of signals Sequential or Simultaneous Baseline Filter 0.05, 0.15 or 0.30 Hz Mains Filter 50, 60 Hz or OFF (-) Myogram Filter 25 or 35 Hz, ON (+) or OFF (-)

Page 1.13

Chapter 1 Operating Elements

Settings (cont.)

Interpretation settings: N/A:+/- ‘normal/abnormal’ is written (+) or suppressed (-)

For AT-2plus Memory only:

Automatic Save Enabled (+) or Suppressed (-) Automatic Erase Enabled (+) or Suppressed (-) Baud Data transmission speed (9600 - 115200 bit/s, see page 1.25) Com-Type Communication mode, Line or Modem (see page 1.25)

Default Settings

To reset the unit to the basic default settings, proceed as follows:

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

U:+/- ‘unconfirmed report’ is written (+) or suppressed (-) A30:+/- patient age is assumed to be < 30 (-) or >30 (+) S: +/- low (-) or high (+) sensitivity

ALT - 0 - 6 - 6

Page 1.14

SETTINGS STANDARD WITH INTERPRETATION

LANGUAGE AS SET AS SET LEADS STANDARD (S) STANDARD (S)

ECG : 25MM/S, SHORT (O)

MECG: 2*6 (50MM/S + 1)

AUTO FORMAT 1 ECG: 25MM/S, SHORT (O)

AUTO FORMAT 2 ECG: 25MM/S, LONG (OOO)

RHYTHM LEADS V1 V1, II AUTOM.

CENTERING PRINTOUT OF

SIGNALS BASELINE FILTER

SETTING MAINS FILTER

SETTINGS MYOGRAM

FILTER SETTING MEMORY AND

SERIAL COMMUNICATION INTERFACE OPTION

MEMORY

INTERPRETATION SETTINGS

ENABLED (+) ENABLED (+)

SEQUENTIAL SEQUENTIAL

0.05HZ 0.05HZ

50HZ (60HZ) 50HZ (60HZ)

35HZ, OFF 35HZ, OFF

BAUD RATE 115200 BPS BAUD RATE 115200 BPS AUTO STORAGE ON (+)

AUTO DELETETION OFF (-) TRANS. MODE: LINE TRANS. MODE: LINE AUTO SAVE ENABLED (+)

AUTO ERASE DISABLED (-)

MEASUREMENTS: SUPRESSED (-)

INTERPRETATION: ENABLED (+)

MARKS: ENABLED (+) ECG : 25MM/S, LONG

(OOO) MECG: NONE MEASUREMENTS:

SUPRESSED (-) INTERPRETATION:

DISABLED (-) MARKS: ENABLED (+)

AUTO STORAGE ON (+) AUTO DELETETION OFF (-)

AUTO SAVE ENABLED (+) AUTO ERASE DISABLED (-)

N/A: SUPRESSED (-) U: ENABLED (+) A30: UNDER THIRTY (-) S: LOW (-)

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Settings (cont.)

Language

The language can only be set with the SWUP program.

User Identification

The user identification is printed on all recordings. The user ID can be the department, doctor or hospital etc. Enter the user ID as follows:

Press the ALT key followed by key 9, 3, 3

The user entry field is displayed on the LCD. Enter up to 30 characters via the keyboard.

Confirm the new user ID by pressing the ENTER key.

Chapter 1

Operating Elements

ALT - 9 - 3 - 3

Page 1.15

Chapter 1 Operating Elements

Settings (cont.)

Filters

There are three different filters which can be set individually as follows:

• Baseline filter

• Mains filter

• Myogram filter

Baseline Filter

The digital Baseline filter suppresses excessive baseline drifts. The setting options are as follows:

Entry Key

Sequence

ALT 5

Baseline Filter

Filter Setting Confirm

0.05 Hz

(default) 1 0.15 Hz 3 0.30 Hz

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Press

STOP

key

Confirm the selection by pressing

STOP

Note: The set value is the lower limit of the frequency range and is normally set to 0.05 Hz.

The settings 0.15 and 0.30 Hz should only be used when absolutely necessary, as the possibility exists that they could affect the original ECG signal, especially the ST segments.

Mains Filter

The Mains filter is an adaptive digital interference filter designed to suppress AC interference without attenuating or distorting the ECG.

Set the mains filter in accordance with the frequency of your local mains supply as follows:

Mains Filter

Entry Key

Sequence

ALT 8

Filter Setting Confirm

5 Mains Filter 50 Hz

6 Mains Filter 60 Hz

9 Mains Filter Off

Press

STOP

key

Page 1.16

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Settings (cont.)

Myogram Filter

The Myogram filter suppresses disturbances caused by strong muscle tremor. The set value will be the new upper limit of the frequency range as soon as the FILTER key is pressed on or programmed as default when the unit is switched on. When the Myogram filter is on `Filter` is displayed on the bottom line of the LCD.

Entry Key

Sequence

Chapter 1

Operating Elements

Myogram Filter

Setting Confirm

2 Myogram Filter 25 Hz

3 Myogram Filter 35 Hz

ALT 8

Myogram Filter active

when the unit is first

switched on (marked

on printout with +)

Myogram Filter off

when the unit is first

switched on (marked

on printout with -)

Press

STOP

key

Confirm the selection by pressing the STOP key

STOP

The myogram filter is switched on and off manually with the FILTER KEY

Note: An ECG recorded in auto mode is stored unfiltered. It is therefore possible to print the

stored ECG either with or without passing the myogram filter. Filter ON is indicated in the bottom information line of the LCD. When the FILTER key is pressed again, the filter is switched off and the `Filter` indication on the bottom information line of the LCD is removed. The cutoff frequency of the myogram filter is set to either 25 or 35 Hz.

Page 1.17

Chapter 1 Operating Elements

Settings (cont.)

Defining Lead Sequence & Printout

The required settings can be selected as follows:

Confirm the selection by pressing the STOP key

Entry Key

Sequence

ALT 7

Sequences, Print & Auto-centering

Definition Confirm

Standard Lead

3 Simultaneous Print 4 Sequential Print 5 Auto-centering ON 6 Auto-centering OFF

Sequence

Cabrera Lead

Sequence

STOP

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Press

STOP

key

The selectable printout forms are: Simultaneous All ECG leads are printed in the same time segment (in automatic

mode only).

Sequential Each group is a contiguous time segment of approximately 2.5 or

5 seconds (in automatic mode only).

Auto-Centering ON All ECG traces are centred dynamically for optimal use of paper

width.

Auto-Centering OFF ECG traces are set to a fixed baseline position and may possibly

overlap.

The Standard and Cabrera lead groups available for the AT-2plus are:

Lead Groups

Standard Cabrera

I V1 II V4 aVL V1 II V4

II V2 aVF V5 I V2 aVF V5

III V3 III V6 -aVR V3 III V6 aVR V4 V2 V7 II V4 V2 V7 aVL V5 V4 V8 aVF V5 V4 V8 aVF V6 V5 V9 III V6 V5 V9

Note: If the unit is reset to the default settings (see previous page), the user identification

must be re-entered

Page 1.18

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Settings (cont.)

Acoustic QRS Indication

Chapter 1

Operating Elements

The acoustic QRS beep can be switched on or off at any time by pressing the QRS key

Time / Date

The required settings can be selected as follows:

Setting the Time and Date

Key Sequence Enter Data Confirmation

Time

ALT 9 1 1 HHMMSS beep

Date

ALT 9 2 2 DDMMYY beep

Seasonal Time Variation

Key Sequence

Wintertime to Summertime (+1Hr)

Summertime to Wintertime (-1Hr)

ALT 9 4 4

ALT 9 5 5

QRS

(

Page 1.19

Chapter 1 Operating Elements

Automatic Mode (ECG) Settings

Two separate Auto formats can be defined for the AT-2plus. When defining auto format 1 the key sequence ALT `1` precedes the setting. When defining auto format 2 the key sequence ALT `2` precedes the setting.

Automatic ECG Format

Entry Key

Sequence

Commence Setup for

ALT

The automatic mode formats are detailed on the following pages. The ECG format is set as follows:

Entry Key Sequence Printout Confirm

ALT 1 or 2 1

Commence Setup for

ECG Format

1 1page x 12 leads at 25mm/s

One page with the first 8 leads

printed for 5s and the last 4

5 No leads printed

Leads are printed in short form

Leads are printed in long form

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Setup Format

Auto format 1

Auto format 2

leads printed for 10s

(1 sheet)

(2 sheets)

Press

STOP key

8 Chart Speed 25mm/s

9 Chart Speed 50mm/s

Leads are printed in format 4

* 3(25mm/s) + 1

rhythm(25mm/s)

Page 1.20

SCHILLER AT-2plus 6-Channel ECG Unit SERVICE HANDBOOK Issue d May 2002

Automatic Mode (ECG) Settings (cont.)

Average Cycles

The Average cycles are defined as follows:

Note: Lead selection for the rhythm lead(s) are defined on page 25.

Average Cycles (interpretation option only)

Entry Key Sequence Printout Confirm

No average lead

cycles are printed

4 x 3 (25 mm/s) + 2

rhythm leads

(25mm/s). The

average complexes

ALT

1 or

are printed in 4

groups of three leads

at a chart speed of

25mm/s

4 x 3 (50 mm/s) + 2

rhythm leads

(25mm/s). The

average complexes

are printed in 4

groups of three leads

at a chart speed of

50mm/s

2 x 6 (50 mm/s) + 2

rhythm leads

(25mm/s). The

average complexes

are printed in 2

groups of six leads at

a chart speed of

50mm/s

Chapter 1

Operating Elements

Press

STOP

key

Measurements and Markings (C version only)

To define the measurements and markings proceed as follows:

Measurements (Interpretation Option Only)

Entry Key Sequence Printout Confirm

Detailed table of

measurement results

omitted - however,

the values of electrical

axes, intervals, and

heart rate are not

suppressed.

Detailed table of

measurement results is

Referenece markings

are omitted

Reference markings

(beginning and end of

P wave and QRS,

and end of T wave)

are added to the ECG

average cycles

ALT

1 or

printed

Press

STOP

key

Page 1.21

Chapter 1 Operating Elements

Automatic Mode (ECG) Settings (cont.)

Interpretation (C version only)

To print or suppress interpretation statements on the printout proceed as follows:

Interpretation (Interpretation Option Only)

Entry Key Sequence Printout Confirm

ALT

1 or

Confirm the selection by pressing the STOP key

Full details of the interpretation option are given in the SCHILLER ECG Measurement and Interpretation booklet (Art. No. 2.510 179).

Interpretation Settings (C version only)

Interpretation is

omitted

Interpretation is

printed

STOP

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Press

STOP

key

The interpretation settings enable the user to determine whether or not certain comments will be added to the interpretation statements on the ECG printout. Furthermore, the patient’s age can be defined (<30 or >30) and if low or high sensitivity should be applied. Low sensitivity will suppress certain nonspecific ECG diagnosis; this may be advisable when carrying out ECGs for screening.

Interpretation Settings

Entry Key

Sequence

ALT 6

"Normal" / "Abnormal" is not

2 "Normal" / "Abnormal" is printed

3 "Unconfirmed report" is not printed

4 "Unconfirmed report" is printed

5 Patient age assummed to be < 30

6 Patient age assummed to be > 30 7 Low sensitivity

8 High sensitivity

Setting Confirm

printed

Press

STOP

key

Note: The `Patient age assumed to be..` setting is only applicable when patient data has

not been entered.

Page 1.22

+ 68 hidden pages