Schiller AT-2+ Service Handbook

SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

AT-2plus

Memory

6-Channel ECG unit

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

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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

© SCHILLERAG 2001

Windows™ is a trademark of Microsoft Corporation.

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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
		Tel.: [phone]	Fax : [phone]
		Home Page : www.welchallyn.com
		SCHILLER Asia Pacific, 10 Jalan SS 3/33, Taman Universiti, 47300 Petaling Jaya, Selangor,
	Asia Pacific	Malaysia
		Tel.: + 603 7877 5336	Fax : + 603 7877 5744
	Austria	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	France
		Tel.: [phone]	Fax : [phone]
	Germany (EU	SCHILLER Medizintechnik GmbH, Rudolf-Diesel Strasse 14, D-85521 Ottobrunn, Germany
	authorized
		Tel.: + 4989 629 981 0	Fax : + 4989 609 509 0
	representative)
		SCHILLER Healthcare India Pvt. Ltd.,D.C.Silk Mills Compound, 'A' Wing, 1st floor, 5,
	India	Chunawala Estate, Kondivitta Lane, Andheri - Kurla Road, Andheri (E, Mumbai - 400 059,
		India
		Tel.: + 9122 826 3520	Fax : + 9122 826 3525
	Italy	ESAOTE Spa (SCHILLER), Via di Caciolle 15, I-50127 Firenze, Italy
		Tel.: + 39055 4229 201	Fax : + 39055 4229 208
	Switzerland	SCHILLER Reomed AG, Riedstrasse 14, CH-8953 Dietikon, Switzerland
		Tel.: [phone]	Fax : + 411 740 3710
		SCHILLER AG, Altgasse 68, CH-6341 Baar, Switzerland
	All other
		Tel.: + 4141 766 4242	Fax : + 4141 761 0880
	countries
		Home Page : www.schiller.ch

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SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

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.

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.

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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.

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SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

Safety Notices

WARNINGS & CAUTIONS

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.

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.

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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.

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SCHILLER AT-2plus 6-Channel ECG Unit

SERVICE HANDBOOK Issue d May 2002

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.

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SCHILLER AT-2plus 6-Channel ECG Unit	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

Chapter 1

Operating Elements

Contents
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

Page 1.1

Chapter 1	SCHILLER AT-2plus 6-Channel ECG Unit
Operating Elements	SERVICE HANDBOOK Issue d May 2002

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

•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	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

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.

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

The Keyboard

Page 1.4

SCHILLER AT-2plus 6-Channel ECG Unit	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

The Keyboard (cont.)

1Print 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.

2Display/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.

3Myogram 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.

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

LCD Screen

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	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

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.

Manual ECG Recording (Rhythm Strip)

·Prepare skin, hook up patient.

∙Switch unit on, press ON .

∙Press MAN START .

∙ Change lead group with	1	and	2	.

∙ Press STOP to stop the printout.

Electrode hook-up check

	·	Press	ALT	1mV	AUTO	AUTO	for electrode check.
				0	3	3

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			to print system settings.
				0	1	1

Page 1.7

Chapter 1	SCHILLER AT-2plus 6-Channel ECG Unit
Operating Elements	SERVICE HANDBOOK Issue d May 2002

Modes of Operation

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	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

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.

AUTO

When the AUTO SENSITIVITY key 3 is pressed before recording in automatic mode, the 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:

ALT +

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

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:

	Lead Group	by means of the LEAD FORWARD and LEAD BACKWARD
		key
		1	2
		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.

Select leads

	Entry Key Sequence				Lead group		Confirm
				0	Rhythm	ON
					II, avF, III, V2, V4, V5
				1	Rhythm	OFF
					II, avF, III, V2, V4, V5
				2	Left posterior	ON
					V4, V5, V6, V7, V8, V9
				3	Left posterior	OFF
					V4, V5, V6, V7, V8, V9
				4	Right precordial up to V5r	ON
	ALT	7	9		V1, V2, V3, V3r, V4r, V5r		Press STOP
				5	Right precordial up to V5r	OFF	key
					V1, V2, V3, V3r, V4r, V5r
				6	Right precordial up to V6r	ON
					V1, V2, V3r, V4r, V5r, V6r
				7	Right precordial up to V6r	OFF
					V1, V2, V3r, V4r, V5r, V6r
				8	NEHB	ON
					D, A, J
				9	NEHB	OFF
					D, A, J

Page 1.10

SCHILLER AT-2plus 6-Channel ECG Unit			Chapter 1
SERVICE HANDBOOK Issue d May 2002			Operating Elements
Manual Mode (cont.)
Chart Speed	Select speed 5, 10, 25 or 50mm/s by means of the SPEED keys:
	5/10	25	50
	7	8	9
Notes:	Key 7 is a toggle key -press once and 5 is selected, press a second
	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.
Sensitivity	Select 5, 10 or 20 mm/mV by means of the SENSITIVITY keys:
	5	10	20
	4	5	6
Myogram Filter	Switch the filter ON or OFF with the FILTER key:

		`FILTER` is displayed on the bottom line of the LCD when the
		filter is switched on.
	Recentering	To re-centre the ECG traces, press the 1mV key	1mV
			0

WARNING

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

Page 1.11

Chapter 1	SCHILLER AT-2plus 6-Channel ECG Unit
Operating Elements	SERVICE HANDBOOK Issue d May 2002

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

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.

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	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

Settings (cont.)

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

ALT - 0 - 1 - 1

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

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	SCHILLER AT-2plus 6-Channel ECG Unit
Operating Elements	SERVICE HANDBOOK Issue d May 2002
Settings (cont.)
Interpretation settings:	N/A:+/- ‘normal/abnormal’ is written (+) or suppressed (-)
	U:+/- ‘unconfirmed report’ is written (+) or suppressed (-)
	A30:+/- patient age is assumed to be < 30 (-) or >30 (+)
	S: +/- low (-) or high (+) sensitivity
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:

ALT - 0 - 6 - 6

	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)	MEASUREMENTS:
			SUPRESSED (-)
			INTERPRETATION:
			ENABLED (+)
			MARKS: ENABLED (+)
			ECG : 25MM/S, LONG
			(OOO)
			MECG: NONE
	AUTO FORMAT 2	ECG: 25MM/S, LONG (OOO)	MEASUREMENTS:
			SUPRESSED (-)
			INTERPRETATION:
			DISABLED (-)
			MARKS: ENABLED (+)
	RHYTHM LEADS	V1	V1, II
	AUTOM.	ENABLED (+)	ENABLED (+)
	CENTERING
	PRINTOUT OF	SEQUENTIAL	SEQUENTIAL
	SIGNALS
	BASELINE FILTER	0.05HZ	0.05HZ
	SETTING
	MAINS FILTER	50HZ (60HZ)	50HZ (60HZ)
	SETTINGS
	MYOGRAM	35HZ, OFF	35HZ, OFF
	FILTER SETTING
	MEMORY AND	BAUD RATE 115200 BPS	BAUD RATE 115200 BPS
	SERIAL
		AUTO STORAGE ON (+)	AUTO STORAGE ON (+)
	COMMUNICATIO-
		AUTO DELETETION OFF (-)	AUTO DELETETION OFF (-)
	N INTERFACE
	OPTION	TRANS. MODE: LINE	TRANS. MODE: LINE
	MEMORY	AUTO SAVE ENABLED (+)	AUTO SAVE ENABLED (+)
		AUTO ERASE DISABLED (-)	AUTO ERASE DISABLED (-)
			N/A: SUPRESSED (-)
	INTERPRETATION		U: ENABLED (+)
	SETTINGS		A30: UNDER THIRTY (-)
			S: LOW (-)

Page 1.14

SCHILLER AT-2plus 6-Channel ECG Unit	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

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

ALT - 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.

Page 1.15

Chapter 1	SCHILLER AT-2plus 6-Channel ECG Unit
Operating Elements	SERVICE HANDBOOK Issue d May 2002

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:

					Baseline Filter
		Entry Key				Filter Setting	Confirm
		Sequence
					0	0.05 Hz	Press
						(default)
		ALT	5				STOP
					1	0.15 Hz
							key
					3	0.30 Hz
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				Filter Setting	Confirm
Sequence
			5	Mains Filter 50 Hz
					Press
ALT	8		6	Mains Filter 60 Hz	STOP
					key
			9	Mains Filter Off

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SCHILLER AT-2plus 6-Channel ECG Unit	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

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.

Myogram Filter

Entry Key				Setting	Confirm
Sequence
			2	Myogram Filter 25 Hz
			3	Myogram Filter 35 Hz
				Myogram Filter active	Press
			1	when the unit is first
ALT	8				STOP
				switched on (marked
					key
				on printout with +)
				Myogram Filter off
			8	when the unit is first
				switched on (marked
				on printout with -)

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

Settings (cont.)

Defining Lead Sequence & Printout

The required settings can be selected as follows:

Sequences, Print & Auto-centering

Entry Key				Definition	Confirm
Sequence
			1	Standard Lead
				Sequence
			2	Cabrera Lead
				Sequence	Press
ALT	7		3	Simultaneous Print	STOP
					key
			4	Sequential Print
			5	Auto-centering ON
			6	Auto-centering OFF

Confirm the selection by pressing the STOP key

	STOP
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	Chapter 1
SERVICE HANDBOOK Issue d May 2002	Operating Elements

Settings (cont.)

Acoustic QRS Indication

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

ALT

9

4

4

Summertime (+1Hr)

Summertime to

ALT

9

5

5

Wintertime (-1Hr)

QRS

(

Page 1.19

Chapter 1	SCHILLER AT-2plus 6-Channel ECG Unit
Operating Elements	SERVICE HANDBOOK Issue d May 2002

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		Setup Format
	Sequence
		1	Commence Setup for
			Auto format 1
	ALT
		2	Commence Setup for
			Auto format 2

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

ECG Format

Entry Key Sequence					Printout	Confirm
				1	1page x 12 leads at 25mm/s
					One page with the first 8 leads
				2	printed for 5s and the last 4
					leads printed for 10s
				5	No leads printed
				6	Leads are printed in short form
					(1 sheet)
						Press
ALT	1 or 2	1		7	Leads are printed in long form
					(2 sheets)	STOP key
				8	Chart Speed 25mm/s
				9	Chart Speed 50mm/s
					Leads are printed in format 4
				0	* 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
								5	No average lead
									cycles are printed
									4 x 3 (25 mm/s) + 2
									rhythm leads
									(25mm/s). The
								6	average complexes
									are printed in 4
									groups of three leads
									at a chart speed of
									25mm/s
									4 x 3 (50 mm/s) + 2	Press
				1 or					rhythm leads
		ALT				2			(25mm/s). The	STOP
				2
								7	average complexes	key
									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
								8	average complexes
									are printed in 2
									groups of six leads at
									a chart speed of
									50mm/s

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,
					5	the values of electrical
						axes, intervals, and
						heart rate are not
						suppressed.
		1 or				Detailed table of	Press
					6	measurement results is
ALT			3				STOP
		2				printed
							key
					7	Referenece markings
						are omitted
						Reference markings
						(beginning and end of
					8	P wave and QRS,
						and end of T wave)
						are added to the ECG
						average cycles

Chapter 1

Operating Elements

Page 1.21

Chapter 1	SCHILLER AT-2plus 6-Channel ECG Unit
Operating Elements	SERVICE HANDBOOK Issue d May 2002

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
			5	Interpretation is	Press
	1 or			omitted
ALT		4			STOP
	2			Interpretation is
			6		key
				printed

Confirm the selection by pressing the STOP key

STOP

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)

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				Setting	Confirm
		Sequence
					1	"Normal" / "Abnormal" is not
						printed
					2	"Normal" / "Abnormal" is printed
					3	"Unconfirmed report" is not printed
							Press
					4	"Unconfirmed report" is printed
		ALT	6				STOP
							key
					5	Patient age assummed to be < 30
					6	Patient age assummed to be > 30
					7	Low sensitivity
					8	High sensitivity
Note:	The `Patient age assumed to be..` setting is only applicable when patient data has
	not been entered.

Page 1.22