Many useful tips that can improve the speed of your Holter scanning process are available to Philips Zymed Holter users. While many are covered in the user’s manual, these additional reminders can make your scanning more efficient.
Auto Stops and Page Mode
Zymed provides four different ways you can scan Holter studies: Page Mode, Superimposition (S.I.), QuickScan and Retrospective (Retro). Page Mode and Superimposition are prospective scanning modes. This means you are actually watching the beats as the Holter algorithm analyzes them. Retrospective means that you only see the heartbeats in Classes and Events after the system has run them through the algorithm. QuickScan is a hybrid solution which combines retrospective scanning with the ability for the Holter system to stop on all types of heartbeats turned on in Auto Stops.
By starting your Holter studies in Page Mode with all the Atrial, Ventricular New Classes and Diary Auto Stops turned on, you can quickly check to see that the Zymed system is calling beats correctly. After documenting some representative strips from the different Events that occur, turn off the Auto Stop for that Event and they system will continue to count them for you without you having to stop and review each one.
You can always change scanning styles mid-scan by clicking on the white box next to the “GO” button in the upper left corner of the screen (see Red arrow). After determining that the system is calling beats correctly, you can either stay in Page mode, or jump over to QuickScan or even Retrospective mode if you are scanning an uneventful study.
A Holter algorithm is a series of mathematical formulas used to define heartbeats based on their shape. On a beat by beat basis, the Zymed algorithm turns itself on and off on all three channels if it detects an artifact in any channel. The algorithm also attempts to name the beat on the good information provided. If your waveforms are too tall or too short, click on “Display” in the upper-right corner and then adjust the Gain on any or all of the channels to help the algorithm. (See Red Arrows)
While the Zymed algorithm is considered to be very accurate and calls beats correctly most of the time, occasionally a patient presents a beat that our Holter system either classifies incorrectly or as artifact. First, use the 12-Lead capability to diagnose the beat and determine what you are looking at (See Red Arrows).
Next, use the “Learn” function to learn the beat as either a Normal, Ventricular or Artifact beat (See Red Arrows below). This Learn feature can even be used to classify and deal with Paced beats if you forgot to turn on Pacemaker detection on the Holter Recorder or before scanning the Holter study.
The Call Function
The Call Function is by far the best upgrade to the Zymed Software Revision 2.9 for scanning Holter Data. It allows you to override the algorithm and decide what you want to call either a single beat or run of beats. First, enable the “Call” feature on the left toolbar. Then, highlight the beats you want to change by holding down your left mouse button and then dragging the mouse over those beats. When you release the mouse button, the “Call Arrhythmia” window will pop-up on your screen. Simply choose what you want to call the highlighted beats, and it will automatically change them in the scan. You will notice that it italicizes the Annotation above the beats so that they are delineated as User Defined beats. This will also show up should you choose to save a Strip (See Red Arrows).