User Manual - EcgAUTO v3.0 Rev1 - April 2012

ecgAUTO v 3.
0 software for automated ecg analysis

user manual version 1
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emka TECHNOLOGIES
table of contents
chapter 1. introduction chapter 2. installation
2.1 2.2 2.3 2.4 2.5 2.6 3.1 3.2 3.3 3.4 3.5 supplied items minimum configuration user privileges release notes configuring the users management running ecgAUTO for the first time toolbar customization panels display general setting tab creating and handling configuration files precision
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9 9 9 10 13 16
chapter 3. general information
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17 18 18 20 21
chapter 4. quick start chapter 5. loading data

5.1 5.2 6.1 6.2 6.3 6.4 6.5 6.6 7.1 7.2 7.3 loading raw data viewing loaded data (main screen) how ecgAUTO analyzes data overview of settings settings for Intervals mode settings for RR-only mode settings for average beat mode settings for rhythm and stability mode how analysis is done making settings slow analyzer (SLOW)
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chapter 6. ecg analysis settings
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53 56 58 87 90 90
chapter 7. non-ecg analysis
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94 95 97
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ecgAUTO version 3.0 user manual
7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 8.1 8.2 9.1 9.2 9.3 10.1 10.2 10.3 10.4 10.5 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8
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blood pressure analyzer (BP) blood flow analyzer (BF) left ventricular pressure analyzer (LVP) monophasic action potential analyzer (MAP) respiratory inductive plethysmography (RIP) noninvasive blood pressure analyzer (NIBP) electroencephalogram analyzer (EEG) sleep scoring module (EEG) epilepsy seizure detection module (EEG) building a library display settings building a protocol example protocol behaviour of protocol-based analysis local analysis using a protocol to perform an analysis reviewing and processing results recompute function notes about display of data epochs in hrv studies getting started general information header settings panels delta vs data panel fft panel (fast Fourier transform) hrv test signal viewing video signal performing batch analysis
99 101 103 107 109 110 122 136 146
chapter 8. libraries (for ecg analysis)
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159 172
chapter 9. defining and running protocols
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175 185 186
chapter 10. analysis
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189 194 199 228 229
chapter 11. HRV studies (variability module)
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231 231 232 233 235 246 247 255
chapter 12. advanced features

12.1 12.2
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12.3 12.4 13.1 13.3 13.4 13.6 14.1 14.2 14.3 14.4 14.5 14.6 15.1 15.2 16.1 16.2 16.3
reading the key events log-book summary of keyboard shortcuts creating results files select steps to be saved saving loading results files (Review mode) types of print-outs settings customizing print-outs export text files export xml files export xls files uninstall via the control panel uninstall with the installer overview make settings user interaction
260 262
chapter 13. results files
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268 275 276 279
chapter 14. presenting your data
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281 284 286 290 295 295
chapter 15. uninstalling ecgAUTO
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297 297
chapter 16. usersMANAGEMENT
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301 302 305
chapter 17. troubleshooting
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chapter 1. introduction
ecgAUTO
data.
is post-processing software for the analysis of ecg data and several other types of
ecgAUTO analyzes ecg data using shape recognition techniques. For this, it requires a library of
reference waveforms. Each reference waveform has markers for key points such as onset of P wave, R wave peak, end of T wave...
With the aid of these reference waveforms, ecgAUTO can process ecg data and position markers, and then calculate parameters such as interval durations, amplitudes, areas etc., which are based on the markers. can analyze any type of ecg signal - from any species and from any lead. It also provides the user with full control of the analysis:
ecgAUTO
to precisely define how the software should analyze to check the beat-by-beat results of the analysis to modify the position of markers The analysis is normally beat by beat, but it can also be based on average beats if this improves the quality of the results.
ecgAUTO
can also analyze non-ecg signals1, namely:
slowly varying rhythmic signals (SLOW analyzer) blood pressure (BP analyzer) blood flow (BF analyzer) left ventricular pressure (LVP analyzer) monophasic action potentials (MAP analyzer) lung volume, based on signal from thoracic and abdomen belts (RIP analyzer) electroencephalogram (EEG analyzer) blood pressure measured noninvasively (NIBP analyzer)
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1 the non-ecg analyzers are available as options. An analyzer will only be available to you if it is included in the license you purchased.
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user privileges
chapter 2. installation
This chapter describes the installation procedure for ecgAUTO with users management. Several GLP options are available when you buy ecgAUTO:
usersMANAGEMENT, a module that provides controlled access to emkaTECHNOLOGIES software. studyMANAGEMENT, a module that helps users organize a set of experiments, configurations and
corresponding data into objects called studies. electronic signature module
audit trail software (either auditCENTRAL or auditSERVER)
If you have purchased ecgAUTO with studyMANAGEMENT, audit trail or electronic signature module, please refer to the GLP module user manual for the complete installation procedure (ecgAUTO and GLP modules).
2.1 supplied items

Your ecgAUTO package should consist of: an installation kit (CD-ROM and license key) a user manual
2.2 minimum configuration

You can install ecgAUTO on any PC-compatible computer running under Windows 98, NT, 2000, XP or Windows 7. However, we recommend the following minimum configuration for optimal performances: core i3 class computer 8 Gbytes of RAM 200 Gbytes hard disk storage space Windows 7
2.3 user privileges

When running ecgAUTO on a computer operated with Windows 7, any user needs to have administrator privileges. ecgAUTO application must also be lauched with administrator privileges. 9
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ecgAUTO version 3.0 user manual installation
2.4 release notes

Each emkaTECHNOLOGIES software distribution kit is provided with release notes. Release notes detail the corrections, additions or improvements between two versions/updates of the software. Three different documents exist: version release notes: modifications between major versions of a software update release notes: contains the minor updates made on the current major version of a software master update release notes: this document is the same as the previous one, but includes the update release notes of optional modules, e.g. usersMANAGEMENT Before installation, release notes can be found in the software installation directory of the CD-ROM. After installation, release notes can be found in a Release notes folder in the installation folder.Insert the ecgAUTO installation DVD-Rom in your computer. Launch Windows explorer, then open the ecgAUTO folder on the DVD drive.
figure n1. install .exe file icon
Double-click on the ECG-Install.exe file to launch the installer. The welcome panel displays:
figure n2. install welcome panel
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Then the user information panel displays.
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release notes
Enter your personal details, select Anyone who uses this computer, then click Next.
figure n3. install - personal information
In the destination folder panel, a default installation folder is proposed:
figure n4. install - installation folder
Click Browse to change the destination folder if required, and Next when done. important! If you accept the default folder and location, your previous installation of ecgAUTO will be overwritten. For example, if you install ecgAUTO v2.8.1.5, it will overwrite files and folders created during installation of ecgAUTO v.2.8.1.4, ecgAUTO v. 2.8.1.3, ecgAUTO v. 2.8.1.2 or ecgAUTO v. 2.8.1.1. If you do not want this, create an installation folder with a unique name, for example ECG_2_8_1_5 which contains the three version numbers (2.8.1) and the build number (5). In the select installation type panel, select the type of installation then click Next. 11
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Unless advised otherwise by emkaTECHNOLOGIE, do not change the default option (typical) .
figure n5. install - installation type
In the Ready to install the Application screen, click next to begin the installation.
figure n6. install - ready to install
A message confirms successful installation.
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figure n7. install - successful install
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configuring the users management
Click on Finish. When prompted, click Yes to restart the computer.
figure n8. install - restart system
2.5 configuring the users management

2.5.1 introduction to glp modules
Various glp modules are available for use with emka TECHNOLOGIES software, namely: the audit trail module, which will be either auditCENTRAL or auditSERVER depending on the characteristics of your installation the user management module, called usersMANAGEMENT the study management module, called studyMANAGEMENT the electronic signature module called eSIGN These modules were developed for researchers to be able to perform studies in compliance with glp and 21 cfr part 11 requirements. Audit trail, studyMANAGEMENT and eSIGN are optional modules, that can be activated if they are included into the package you bought. The procedure to activate and configure these modules is explained into the glp modules User Manual.
usersMANAGEMENT is an optional module, that can be activated or not at the first launch of ecgAUTO. The procedure to configure this modules is explained in the next chapter. usersMANAGEMENT purpose is to control access to each program, by forcing users to enter
their login name and password.
The key component of usersMANAGEMENT is the users base, a database file containing encrypted information about users and their access rights. When usersMANAGEMENT is activated, ecgAUTO will ask for a login name and password at launch. If you want to activate usersMANAGEMENT, go to chapter 2.5.2. If you dont want to activate usersMANAGEMENT, go directly to chapter chapter 3. 13
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2.5.2 first run of ecgAUTO software

1. Be sure that your USB software license key is plugged in. 2. Launch ecgAUTO by double-clicking the icon or via the start menu. 3. The GLP administrators panel appears as shown below. Read carefully the following section for an explanation on the different options. If you have any doubts, please contact your customer service representative at emka TECHNOLOGIES for further assistance.
ecgAUTO ecgAUTO.
can be run with a number of options :
with or without usersMANAGEMENT to possibly control who is allowed to run with or without audit-trail, study management and electronic signature. If your package does not include these modules, they are dimmed in the GLP administrators panel. If youre package includes these modules and you which to activate them, please refer to the glp modules User Manual and skip the following procedure.
figure n9. 1st run of ecgAUTO software panel
4. To activate usersMANAGEMENT, click the Yes check box. If you do not want to activate chapter chapter 3.
usersMANAGEMENT, click the No
check box and go directly to
If you activated usersMANAGEMENT, the field containing the name and location of the users base becomes accessible. By default, the users base is named users.umb and its path is the folder of the launched program. If this file does not exist, the software will propose to create it, answer Yes.
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A users base can be local or distant. To change the default folder or to select an existing users base click at the right of the field. An explorer appears, allowing you to select the folder where you want to store the users base or where the existing base you want to select is located.
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configuring the users management
caution! You must select a folder in which simple users have read and write access. 5. Click Ok. The following panel appears.
figure n10. users identification panel
6. Click on Users to bring up the access control panel for the users base (figure n11)
figure n11.
access control panel
7. Enter the Login (Administrator) and Password (userscontrol) then click Ok. important! emka TECHNOLOGIES strongly recommends that the user administrator modify the default password of the administrator account; otherwise, anyone who knows the default password will be able to edit the current users base. To modify the default password, please refer to chapter 16. 8. The users base editing panel appears.
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figure n12. users base edition panel
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9. Add a user to the list of users (on the left): click on Add in the Users section. The Add new emkas software user panel appears.
Select the authentication method EMKAthen define the login name and user name for the user install1. 10. Click OK to return to the ecgAUTO: users management window. The user has been added. 11. Add Authorized softwares to the user: click the Add button under Authorized software. The name of the currently used emka TECHNOLOGIES software appears, select ecgAUTO in the scrolling list. ensure that Status is Active and select User level Administrator To suppress a software of the list, select the software, and click on Del. Please refer to chapter chapter 16 for information about the other fields, including the user level (which determines which functionalities the user can access in the program).
2.6 running ecgAUTO for the first time

At the first launch of ecgAUTO, the following alert messages will appear:
Click OK.
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This is a fictitious user, created for installation purpose.To add real users, see chapter 16
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toolbar customization
chapter 3. general information

This chapter gives general information about ecgAUTO:
ecgAUTO
toolbar customization and panels display
General settings tab Configuration files Precision tab

This chapter is intended to be a reference chapter. Do not worry if you do not fully understand the explanations below - items are described in more detail in relevant chapters.
3.1 toolbar customization

At the first ecgAUTO launch, main panel presents the following toolbar:
This toolbar is composed of different modules, corresponding to each menu item. Each module can be moved and customized. To move a module, click on the left part and move it at the same time:
figure n13. moving a module
To customize a module, click on the right part and select the item you want to be displayed:
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figure n14. module customization
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ecgAUTO version 3.0 user manual general information
3.2 panels display

When several panels are opened, you can choose to display one panel in front of the others,with the pin window option. Pin window
3.3 general setting tab

Select Tune General Settings from the main screen to open the General Settings panel (see figure n15).
figure n15. general settings panel
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The different settings are as follows:

Send .x text file to secondary directory Send .z text file to secondary directory Send .xx archive text file to secondary directory
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general setting tab
.x .z .and xx files are the three types of results files produced by ecgAUTO.
If OFF, the results file is saved in the folder from which the raw data file (type subject.dnn or subject.mkt) was loaded. If ON, you must specify where the results file is saved. This functionality is useful in different situations: for example, when the source folder is a CD (on which no data can be immediately transferred) or to separate raw data files from results files.
Seek.mkt or .d file in secondary directory from .z file
This setting determines where ecgAUTO looks for the raw data file when you load a .z file. If OFF, ecgAUTO will look in the folder specified in the .z file. If ON, ecgAUTO will look in the folder you specify here.
Seek .mkt or .d file in secondary directory from config
This setting determines where ecgAUTO looks for the raw data file when you load a configuration file. If OFF, ecgAUTO will look in the folder specified in the .configuration file. If ON, ecgAUTO will look in the folder you specify here.
Create .xx archive text file when saving .x file
If ON, ecgAUTO systematically generates an .xx archive text file everytime you save results.
All result text files with read-only attribute
If ON, all .x and .xx files will be read-only.

Results file name appended with lead label
If ON, the lead name (as defined in iox) will be appended to the name of the results file.
Beat edition and invalidation/revalidation require comment Allow multiple simultaneous ECG sessions. Specific extension to append to text file name.
If ON, enter a specific extension in the field. This extension will then be appended to the text
file name when you do an analysis on this PC.
This functionality allows you to define unique file names for each PC - it is therefore useful when analyses will be performed on different PCs.
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ecgAUTO version 3.0 user manual general information
Limit to text file line number.
If ON, enter the maximum number of lines in your text file. This functionality may be used to ensure compatibility with third-party software (for example, some spreadsheet packages may not be able to import text files that have more than a certain number of lines. This limit is usually imposed to avoid too long refresh time).
Force software to run in single screen mode.
If you use two screens for display, clicking ON will ensure that ecgAUTO only dsiplays in the primary screen.
Protocol analysis skips inactive streaming zones. Beat # above which trend graphs require manual refresh Step # above which average beat plot requires manual refresh Allow to load renamed iox2 raw data files
By default, ecgAUTO makes it impossible to load iox data files that have been renamed (thus ensuring GLP compliance). If you are not working in a GLP environment, click to ON to remove this restriction.
Single point correlation increment (low sampling rate only) Produces native Excel file during save results operation Produces ASCII text file during save results operation
3.4 creating and handling configuration files

All software settings are saved in a configuration file with the extension .ecg.cfg. The configuration file contains this information: settings about calculation modes settings about software operation a protocol 20 display settings a library
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precision
When you first install the software, a default configuration file named noname.ecg.cfg is loaded. It is very unlikely that the default configuration file is suitable to your needs - you will need to modify it as desired. The following options are available from the main screen:
File Save configuration File Save configuration as (the name of the current data file is proposed as a default name) File Load configuration File Load default configuration
The configuration is systematically attached to the binary result file: when you reload an analysis file, you also reload the configuration used when the file was created.
3.5 precision
Open the List Display and text export settings panel by selecting Tune Parameters in list/to
file.
In the display column of the precision tab (figure n16), you can modify the precision of displayed data (number of digits after the decimal point).
figure n16. setting precision of displyed values
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chapter 4. quick start

Here is a brief overview of the key steps to perform successful ecg analysis: 1. Start the software with a valid username and password. 2. Load a data file, then select the input(s) you want to analyze. 3. Make sure an appropriate library is present in the configuration. 4. In the configuration settings panel make sure the expected bpm value is suitable: adjust other settings as required. 5. Run a local analysis to check that things work as expected. 6. Adjust the display selection of parameters in the main table. 7. Build a protocol and make sure it produces valid analysis steps where you want them. 8. Start a protocol analysis. 9. If satisfied with the results, save them.
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loading raw data
chapter 5. loading data

ecgAUTO can directly analyze raw data files produced by emka TECHNOLOGIES data acquisition software, iox or eACQ. It can also analyze files produced by DSI telemetry implants and other third-party
acquisition systems, after converting these files to an iox-compatible format. This chapter describes: how to load raw data files of different formats how to view loaded data
5.1 loading raw data

The main screen (figure n17, the screen that appears on startup) contains two sections. These sections are empty until you load raw data.
figure n17. main screen (before raw data loaded)
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ecgAUTO version 3.0 user manual loading data
Sections below describe how: to load raw data files generated by iox (section 5.1.1). For each subject in each experiment, iox creates a master site file with extension .dmm (iox version 1, mm is a 2-digit number) or .mkt (version 2). to convert and load non-iox raw data files. to convert and load text files (described in section 5.1.1). Typically, text files are raw data files acquired by another acquisition system (other than emka TECHNOLOGIES or DSI) and converted to text format to make them accessible to other systems. Given the inherent variation of text files, you must teach ecgAUTO how to process the text file created by a particular system. The module required to do this is only available as an option. If this option was included in your set-up, the main screen contains the File Raw data from converter Convert to text file item.
5.1.1 loading raw data files generated by iox

5.1.1.1 load the file
From the main menu, select File Load IOX data file or click on A standard Windows explorer panel appears. To preselect a file, select it then click Load to bring up the Data preview screen (figure n18). You must respect certain rules when loading the data file and selecting the inputs (Data preview panel): if there are any ecg inputs, they must be selected first, the same sampling rate must be used on all ecg leads (this rule also applies to analysis of ecg inputs only), the sampling frequencies of non-ecg inputs does not have to be the same, you can load each type of non-ecg analyzer up to three times. Different selection rules apply for nibp analysis (see section 7.9). 26 All the inputs of the preselected files are loaded (two inputs loaded in figure n18). For each input, there is a preview panel containing raw data. If your selected inputs are invalid (e.g. ecg inputs have different sampling rate, nonecg input is selected before an ecg input), the background colors becomes pale.
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loading raw data
When your selection becomes valid, the background colors are strong.and an additional field appears (the analyzer drop-down menu). 1 5 6
4 6
figure n18. Data preview screen
The different parts of the Data preview screen are: toolbar 1
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with this toolbar, you can: move raw data backward by 1 screen or 1/2 screen move raw data forwards by 1 screen or 1/2 screen zoom in/out (decrease/increase screen width) adjust screen width (number of seconds of raw data in preview panel; the default is 5) reset panel size select all inputs as ecg leads add the raw data file to the batch analysis file selection panel pin the window print the data preview panel slide 2
Drag the slide cursor or click anywhere on the slide to move to that point in the data within the preview panel. file information about the preselected file Specifically: full file name, including full path, date and time that file was created duration of experiment, study tag (if the experiment was not linked to a specific study, no study appears) other readable files in folder 4 3
This panel contains a list of all .d** or mkt files in the same folder as the file you selected. You can click on any file to load it. input information about preselected file For each input, you can see: a label in the format S-n (l-n) inputname, where n is an index applied by ecgAUTO and inputname is the input name defined in iox sampling rate input index (first input selected is input 1, second one is input 2) 28 analyzer to be used for that input the conversion formula, if the input has a conversion applied (see below); otherwise this field contains no conversion 5
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loading raw data
preview panel
There are 3 ways to move forwards and backwards along the data: toolbar buttons; the slider; via the study schema panel. study schema panel 7
This panel contains a schema of the entire experiment: periods appear with their name, dose, and color as created when running the experiment in iox; comments the bottom-most bar is colored green where raw data are available; if a protocol exists, steps are shown as red rectangles on the lower part of the schema. The study schema is described in more detail in section 9.1.1 Although there is no predefined upper limit to the amount of data which can be displayed, it may take a few seconds to display long stretches of data. There is dynamic interaction between the cursor on the study schema panel, the slide and the raw data preview.
5.1.1.2 select input(s) to analyze

Click on the preview panel of an input to select it for analysis. The background color of selected input(s) turns from gray to green. Inputs are numbered in the order that you select them, i.e. the first lead you select will become input 1 (or the primary lead), the second one input 2, the third one input 3 etc (see figure n20 in which four leads are selected). If you change your mind about the order, click again on the primary lead to deselect all leads. Make sure that the correct analyzer is selected for each input:
ECG SLOW BP BF LVP MAP RIP RIP sum RIP calib figure n19. list of available analyzers in ecgAUTO EEG EPL RF NIBP NIBPecg
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All selected ecg leads (inputs with ecg analyzer) must have the same sampling rate. If this is not the case, the background color of all selected inputs becomes pale. The icon is available (not dimmed) when the current selection is valid.
input numbers selected analysers
figure n20.
selecting non-ecg and ecg inputs
5.1.1.3 apply conversion and/or time shift (optional)

When ecgAUTO loads data produced by iox, it loads raw data as well as the associated calibration values. In accordance with glp, the calibration values cannot be edited. On some occasions, you may want to convert the data, for example if incorrect electrode placement has produced an inverted ecg signal, or if an incorrect gain setting is used. ecgAUTO can apply a simple linear correction to the signal as follows: ConvertedValue = a x OriginalValue + b where a and b are user-defined parameters On other occasions, it is desirable to apply a time shift. For example, in a cardiovascular experiment using several different devices (amplifiers, flow meters), each device will lead to a small but different time shift. You may decide that proper analysis requires that some inputs are shifted in relation to others, to correctly reflect true physiological situation.
ecgAUTO allows you to apply a conversion and/or time shift via the raw data conversion
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panel.
To access this panel, right-click the conversion field in the Data preview panel (figure n21). If a conversion is applied, this field is blue and contains the conversion formula; if no conversion is applied, this field is gray and says no conversion.
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loading raw data
right-click in conversion field to access raw data conversion panel
figure n21. accessing the raw data conversion panel
In the conversion panel (figure n22): enter a and b for the conversion formula select whether you want to apply the conversion before or after filtering for a time shift, enter in the offset (sample) field the number of acquisition samples you wish to shift the input. The offset(ms) field gives you the time equivalent of the chosen offset (in ms). if necessary, enter new label and units in the provided fields The changes you make in the conversion panel are immediately visible in the Data preview panel - original data in red, converted data in blue (figure n22).
figure n22. changes in conversion panel (left) are instantly applied to the Data preview panel (right)
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Information about this conversion and time-shift is: included in the header of text files (see section 5.1.2) included in the calibrated input header saved with the configuration. In this way, when you load a binary file (a type of results file), the conversion is automatically applied to the data file which is subsequently loaded.
5.1.1.4 load data into main screen

Select when you are satisfied with your input selection and settings.
The Data preview panel closes and the signal appears in the main screen.
5.1.2 convert and load non-iox raw data files

This task is done through a separate program called File conversion utility. To open this program select File Raw data from converter Convert non-iox raw data. The main panel appears(1) (figure n23).
figure n23. main panel of File conversion utility
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The File conversion utility is able to convert several file formats. You should read the first two sections below, discussing general aspects of file conversion.
(1) if the panel does not appear, it is probably hidden in the background. Use the key combination alt-tab to cycle through open applications.
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loading raw data
Subsequent sections refer to specific file formats - you only need to read the section relevant to your needs. The actual conversion procedure is given in full only for Dataquest 3 files as it is similar for all file types. conversion of non-iox files You should be aware of the following points: The File conversion utility creates d00 files (the native format of iox version 1). d00 files have a maximum recording duration given by the formula 2,147,483,647 divided by the sampling rate. At 500 Hz, this gives a maximum recording duration of just over 49 days. The File conversion utility cannot convert files larger than 2 Gb (this is because files are read using 32-bit signed integers) file options Click Options to open the Options panel, consisting of tabs (figure n24). Settings under the File Names tab determine the default file names proposed by the File conversion utility. Under the Time Format tab, you should select the option ECGAuto only (unless there is an absolute need to run the data file in iox). This allows you to convert data files with a total data duration (excluding zones where no data recording took place) of around 21 days if sampled at 1 kHz.
figure n24. default file naming options menu
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5.1.2.1 conversion of dataquest v.3 files

The File conversion utility has its own version number (distinct to that of ecgAUTO ). Different versions are used to convert different versions of Dataquest files: conversion utility version 2.2.0.3 or earlier converts data produced by Dataquest version 3 or earlier (described in this section). conversion utility version 2.2.0.5 or higher (supplied with ecgAUTO version 2.4.0.3 or higher) is also able to convert files produced by Dataquest version 4 or earlier (described in next section). requirements To convert Dataquest v.3 files, you need: an appropriate version of ecgAUTO an emka TECHNOLOGIES license to use the convertor. file types Data files produced by DSI software include:
waveform files (e.g. RatM01.100, RatM01.101, RatF03.100, RatF03.101)
The file name format is subject.nxx, where subject is the subject name, n is the input channel (0-F) and xx is the alphanumeric recording index (00 to ZZ) .
parameter files
(e.g. , RatM01.P00, RatF03.P00)
The file name format is subject.Pxx, where subject is the subject name, and xx is the alphanumeric index (00 to ZZ) .
log files (e.g. RatM01.R00, RatF03.R00)
The file name format is subject.Rxx, where subject is the subject name, and xx is the alphanumeric index (00 to ZZ). For the conversion you need only the waveform files. procedure From the menu panel of the conversion utility panel, select File Load DSI data file (for Dataquest< version 3 files). 1. From the menu panel of the conversion utility panel, select File Load DSI data file 34 2. The file selection panel opens: Select one or more waveform files then click Select. 3. The Load DSI files panel opens, displaying all available recordings which contain the same subject and at least one of the inputs of the selected recording. 4. Check the recordings you want to convert (as a default, all are checked):
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loading raw data
figure n25. Load DSI files panel
5. To select all recordings containing a particular input, click on the inputs in the Waveforms list on the right (in the example above, you may select ecg and/or pressure). Click OK. 6. The file(s) is loaded.
figure n26. a Dataquest ART file loaded in the conversion utility
7. If desired, you may aplly a time shift. 8. Select Convert Create IOX binary site file. In the folder selection window that appears, you must select where to store the converted file on the hard drive. The converter proposes a file named according to the file naming options you have chosen (see above). By default, the file name subject_label.d** is proposed where label is the label that the user attached to this input (usually it qualifies the type of data, e.g. ecg or bp).
iox
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Click save. 9. The file is converted. A message appears to confirm creation of the converted file. Click OK to return to the previous screen. 10. When you close the conversion utility (File Quit), the last converted file is automatically loaded into ecgAUTO.
5.1.2.2 conversion of dataquest v.4 files

The File conversion utility has its own version number (distinct to that of ecgAUTO). Different versions are used to convert different versions of Dataquest files: conversion utility version 2.2.0.3 or earlier converts data produced by Dataquest version 3 or earlier (described in previous section). conversion utility version 2.2.0.5 or higher (supplied with ecgAUTO version 2.4.0.3 or higher) is also able to convert files produced by Dataquest version 4 or earlier (described in this section). requirements To convert Dataquest v.4 files, you need: an appropriate version of ecgAUTO an emka TECHNOLOGIES license to use the convertor (USB key). a DSI license, supplied by DSI as a USB key (the Sentinel key) a Dataquest A.R.T. 4.0 CD. The Sentinel key and the CD each have their own key code. Please note that these key codes do not have to be identical. file types See corresponding section for dataquest v.3 files. installation procedure 1. insert the CD in the driver. 2. If the InstallShield wizard starts, click Cancel 3. right-clic on the CD to open its content 4. right-click on the setup.exe 5. click on Properties 36 6. under compatibility, select the radio button Execute this program in compatibility mode for and chose Windows XP (Service Pack 3)(1). Click Apply
(1) net. For windows 7, you can be asked ton install the diver HASP. It can be easlly found on Inter-
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loading raw data
7. launch the setup.exe: The InstallShield wizard starts:
Click Next. 8. in the Customer Information screen, enter your user name, company name and the key code (on the CD cover).
9. in the Choose Desination Location panel, select Browse then select a folder in which you have installed ecgAUTO . If you have more than one instance of ecgAUTO installed on your computer, select the folder of the one you wish to use to convert the dataquest files. In the example below, the user will, after installation, be able to convert files from version 2.5.1.
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important ! It is imperative that you install the convertor in an ecgAUTO folder if the convertor is not installed in an ecgAUTO folder, ecgAUTO will not be able to access the convertor, and conversion will not be possible.
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10. click Next in the Select Program Folder screen.
11. the Confirm Information gives a summary of entered information.
If you are happy with settings, click Next to proceed. Otherwise, click Back to return to previous screens. 12. the following message appears:
38 Click OK.
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loading raw data
13. the following screen informs you that the installation has completed and that you must restart the computer before being able to use the convertor.
conversion procedure 1. From the menu panel of the conversion utility panel, select File Load Dataquest ART4 data. 2. the file selection panel opens: Select one or more waveform files then click Done.
3. the Load DSI Data panel opens, displaying all available recordings which contain the same subject and at least one of the inputs of the selected recording. You can see on the left part, the list of implants + ambient pressure and on the right the list of all available signals per implant. So, for implants R9C5992, R9J6690 and R9M7042; you will have pressure, ECG, temperature. In addition, you can get derived parameters computer by Dataquest such (activity, pulse pressure, diastolic, Heart rate, mean pressuren systolic)
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At this point just click OK. It will take few seconds (minutes) to convert the file, and then you will have the waves displayed on the screen. Select the Implant from the list (right top) and select the Tab waveform .
4. check the recordings you want to convert (as a default, all are checked): 5. to select all recordings containing a particular input, click on the inputs in the Waveforms list on the right. Click OK. 6. the file(s) is loaded.
7. if desired, you may aplly a time shift. 8. select Convert Create IOX binary site file. In the folder selection window that appears, you must select where to store the converted file on the hard drive. 40 The converter proposes a file named according to the file naming options you have chosen (see above). By default, the file name subject_label.d** is proposed where label is the label that the iox user attached to this input (usually it qualifies the type of data, e.g. ecg or bp).
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loading raw data
Click save. 9. The file is converted. A message appears to confirm creation of the converted file. Click OK to return to the previous screen. 10. When you close the conversion utility (File Quit), the last converted file is automatically loaded into ecgAUTO.
5.1.2.3 conversion of Ponemah files

The File convertor utility was created on the basis of documentation provided with Ponemah versions 3.0, 3.1, 3.4 and 4.1. Compatibility with other Ponemah versions has not been tested. file types There are several types of files created by Ponemah systems:
.raw .pro
Contains the raw data signal. Can contain data from more than one subject
Protocol file containing a description of the .raw file, notably description of subjects and channels. Apart from the extension, it has the same name as its corresponding .raw file.
.evt
Event file containing events, which roughly correspond to marks of .mkt files
The following file types may also be present as part of the recording (depending on the version of Ponemah) but they are not essential for conversion.
.jmp
Jump table file containing a table of offsets allowing .raw fles to be read faster.
Introduced in version 3 Ponemah; in theory, the jump tables have been incorporated into .raw files from version 3.4 onwards.
.der .log .mea .mxi .dri .wav
Derivative file containing derived data. Contains logging rate and other modifications made during the analysis. Contains measurements made during replay. Contains reduced data for groups. Contains derived data for groups. Contains voice events.
conversion To convert a Ponemah recording, you only need to import the .raw file. However, if the .raw file contains data from more than one subject, it is preferable to select the the .pro file too. If the .pro file is absent, conversion will go ahead but only one .d00 file will be created in which all signals from all original subjects have been assigned to one subject. The user must then create the additional subjects and assign the signals to each appropriately. 41
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time information Time information from the original Ponemah files are carried over to the .d00 files, except for the Daylight Saving Time (DST) state.
5.1.2.4 conversion of CARecorder files

The File convertor utility was created on the basis of documentation provided with CARecorder versions 1.3 to 4.2. Compatibility with other CARecorder versions has not been tested. In these cases, the utility willl attempt to convert the files, but we cannot guarantee that the results are reliable. file types The following file types are created by CARecorder systems:
.raw .cfg
Contains the raw data signal. Can contain data from more than one subject. Configuration file containing a description of the .raw file. Contain calculated parameters. Contains the raw data signal. Can contain data from more than one subject Contains events. Contains settings, calibration values.
Apart from the extension, it has the same name as its corresponding .raw file.
.der/.dri .raw .evt .log
conversion To convert a CARecorder recording, you need to import the .raw file and its associated .cfg files. time information Time information from the original Ponemah files are carried over to the .d00 files, except for the Daylight Saving Time (DST) state.
5.1.3 loading text files

1. Select File Raw data from converter Convert text file to start the text conversion module. 2. A file selection panel appears. Select all files to be converted by clicking on them one by one and clicking Add to add them to the selected files panel. 3. When you have selected all the text files to be converted, click OK. 42 4. The main screen appears. The name of the selected file appears at the top (1 in figure n27). Other parts of the screen are described below.
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loading raw data
figure n27. text file conversion module
The module is designed to process any text data files. Given the diversity of text data files, human input is required to tell the module how to import only the required information. In short you must tell the module how to read (or parse) the text data file. You make these importation settings in the syntax description part (2 in figure n27) and via the contextual menu, obtained by right-clicking any cell in the parsed header part (3 in figure n27).
figure n28. contextuel menu of text conversion module
The parsed header part as well as the File Header Panel (figure n29) are updated dynamically to reflect your settings. Cells that will be parsed are highlighted (green for data lines and yellow for other cells).
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figure n29. the blank File Header panel is updated dynamically as you make settings
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Here is a list of importation settings you must make: file header size For ecgAUTO, the file header consists of the first lines of the file before the data lines begin. important! in some text data file, there are two rows containing labels and units, respectively, just immediately before the data lines. You should consider these to be part of the file header. To adjust the file header size: enter the number of lines in the Header size is field or click on any cell on the last line of the header, then select Define Header end in the contextual menu. field separator(s) In the Fields separator part, choose the appropriate combination to allow correct parsing. Only common sense and your knowledge of the files actual content can help you make the right choices. Choosing the wrong set of separators might produce the wrong parsing and, for example, misinterpret decimal data value as two set of integers, etc. specific separators Enter specific separators used for date, time and decimals in the Date sep., Time sep. and Decimal sep. fields. parsing of consecutive separators In some files, correct parsing requires that consecutive identical separators be treated as one separator only. Click the Consecutive separator as one box if this is the case.
column definition After you have specified on which line the data starts, you must tell the software: which columns contain data where to find the label and measurement unit for each column 44 To specify that a column contains data: click on a cell in that column to select it, right-click to open the contextual menu, then select Set as data column. To specify the label for a data column: click on a cell in that column to select it, right-click to open the contextual menu, then select Set Data (Input) Name.
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loading raw data
To specify the measurement unit for a data column: click on a cell in that column to select it, right-click to open the contextual menu, then select Set Data (Input) Unit. sampling rate (sampling interval) You must define the sampling rate for the whole file. If the sampling rate (in hertz) is contained in a cell, click on the cell to select it, right-click to open the contextual menu, then select Set as Sampling Freq (Hz). If the sampling rate is not contained in a cell, you can define the sampling rate in the Default Acq Freq field. If a sampling interval is defined in a cell: click on the cell to select it, right-click to open the contextual menu, then select Set as Sampling Interval (sec) or Set as Sampling Interval (ms), as appropriate . date and time Enter the date format in the Date format field. The data and time may be contained in the same cell or in two separate cells. Use the contextual menu to select the appropriate option: Set as period start Date & Time, Set as period start date or Set as period start time. In figure n30, you can see an example of importation settings made for a text data file with 2 data columns (each with a label and a unit), and a definition of data-start date and time, and sampling rate.
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figure n30. text file conversion module with importation settings
5. When your importation settings are correct, click on ASCII to structure to start file processing (this may take some time for a long file). Information about the output file appears in the Output file description part of the main screen. Note that the conversion factor (gain and offset) is automatically calculated. 6. If you are satisfied, accept or edit the proposed file target name (in the Output filename field), then click on Produce File. The last processing (actual conversion) now takes place 7. When the conversion has completed, an information message appears, giving the name of the original file as well as the name of the newly created file (figure n31). This file is now automatically loaded into ecgAUTO.
figure n31. confirmation of file conversion
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reusing importation settings:
To make the current importation settings the default settings (for the next time you open the text conversion module), click Store config (lower right corner).
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viewing loaded data (main screen)
batch conversion: It is possible to convert several files at the same time with the same importation settings. The procedure is as follows: 1. Start the conversion module. 2. Select one of the files to be converted. 3. Make the importation settings. 4. Save the settings. It is good idea to convert a file to ensure that results are as expected and correct. 5. When settings are satisfactory, load all data files to be converted into the conversion module. 6. When you validate your file selection list, all conversion actions will be automatically performed (the step by step approach of the single file conversion is no longer necessary).
5.2 viewing loaded data (main screen)

Data are loaded, and then appear in the main screen (figure n32). Please note that the signal displayed on the main screen is always a filtered signal; filtering includes baseline straightening, plus some noise reduction filters. 1 3 2
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figure n32. main screen (data loaded, before analysis)
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The different parts of the main screen are as follow (figure n32): tool bar From left to right, you can use these buttons to: move to the left within the data window, by a large and small increment zoom in (shorten length of data in window) cancel zoom zoom out (increase length of data in window) move to the right within the data window, by a small and large increment
toogle auto analysis mode move the data window one width to the left move the data window one width to the right move the data window so that the current cursor position becomes the new window start.
This is the width (duration) of data that displays when you click on a beat in the table.
Toggle switch to expand/contract the central information zone. data window 2 Contains the traces. sliders 3 Different sliders allow you to: resize different panels move the data window navigate rapidly in the table 48 adjust gain and offset of the derived signal (when visible) adjust position of the isoelectric line (when visible)
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central information zone 4 The zone contains the following information start time of data window name of loaded file name of the current configuration number of waveforms currently stored in the configuration. study tag (if the experiment was not linked to a specific study, no study appears) end time of data window Click on the button to display panels.
If the central information zone is expanded to two rows (by clicking the appropriate toolbar icon), the second row also shows, from left to right: real start time (i.e. at acquisition) position within current period, period color, period name real end time (i.e. at acquisition).
figure n33. central information zone (expanded)
table
5 The table displays all event marks according to what happened during the iox acquisition sessions that produced the data file. Click on a mark to move the data window to this event (which is in the middle of the data window).
5.2.1 navigation shortcuts

You can also navigate and zoom using the keyboard and mouse. In all cases, you must first make the graph active (by clicking on it needed): move the data window one width to the left and right, respectively
Ctrl-- / Ctrl-+ and Shift-- / Shift-+ move the cursor left/right in small and large steps, respectively. Scrolling the mouse wheel upwards/downwards also moves the data window one width to the left and right, respectively. To move the data window by lower increments, keep either the Ctrl or Shift button pressed while scrolling. www.emka.fr 49
and zoom in or out, keeping the current cursor position as the center of the data window.
5.2.2 graph settings

To access the graph settings panel (figure n34): select Graph Settings or select the scales and color tab or right-click anywhere in the data window
figure n34. scale and colors tab of graph settings panel
From this panel you can make general display settings and input display settings. The general settings allow you to: define the cursor style and colour, Add an X-axis (time) grid and define the interval size (5,10,20,50 or 100 ms). Grid center is automatically repositioned where the vertical cursor is located. show/hide the Y-axis (includining labels and scale), set how many graphs (traces) are shown in the data window at one time set the number of graphs (traces) in each scroll step when you use the PageUp and PageDown arrows. 50 show or hide sampling points on the trace (figure n35). This allows you to judge whether your data were correctly sampled or not.
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figure n35. sampling points displayed in main screen
Input-specific settings are available in the bottom part of the panel. The first row is for making changes to all inputs at once; below the first row is a row for each input for making inputspecific changes. Input settings allow you to: use manual or autoscaling for the Y axis. In the former case, you enter the minimum and maximum values for the Y axis. add a grid to the Y axis define the color of the horizantal gridlines define the trace color define the background color show or hide an isoelectric line (figure n36). Please not that this not a true isoelectric line but simply a horizontal line that you can adjust by using the slider on the right. show or hide the derivative signal (figure n36). You can adjust the gain and offset by using the two silders to the left.
gain/offset sliders for derivative
derivative trace
slider for isolelectric line
isolelectric line (yellow)
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figure n36. main screen with isoelectric line and and derivative signals visible
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5.2.3 data file information

To access information about the loaded file, open the Raw data file information panel by clicking the button next to the file name in the central information zone of the main screen.
figure n37. raw data information panel
5.2.4 dual table view

It is possible to duplicate the table and then navigate independently within each table, using the horizontal slider or the left/right arrows of the keyboard if the table is active (figure n38). To duplicate the table, click-drag the left border of the existing table.
figure n38. dual table view
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how ecgAUTO analyzes data
chapter 6. ecg analysis settings

This chapter describes the settings about how ecgAUTO analyzes ecg data.You will learn how to: change how ecgAUTO computes parameters apply and adjust the settings of different filters define new parameters
To allow you to understand the effect of your settings, the ecg analysis process is described first.
6.1 how ecgAUTO analyzes data

The ecg analysis process has two or three stages (depending on settings). 1. position markers in current segment requires the library 2. find previous R peak based on segments of data that have already been analyzed. allows calculation of the RR interval (the interval between R peaks of neighbouring complexes), and therefore heart rate. 3. detect extra beats optional does not require a library is alternative method for calculating RR interval when current segment cannot be analyzed These stages are described below.
6.1.1 position markers

When analyzing a segment of data, ecgAUTO aims to find a library waveform that has a sufficiently similar shape.
ecgAUTO will compare the data waveform with each library waveform. It starts with the first
library waveform, and continues comparing waveforms until it has a pair of sufficiently similar waveforms. At this point, ecgAUTO will, depending on the settings, either (i) stop searching and use the library waveform as the reference waveform.
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ecgAUTO version 3.0 user manual ecg analysis settings
(ii) or, continue until the data waveform has been compared with all the library waveforms. ecgAUTO remembers all sufficiently similar waveforms and then uses the most similar waveform as the reference waveform.
ecgAUTO
then positions markers with the aid of the reference waveform.
figure n39 shows a waveform that was fully analyzed, i.e. for which ecgAUTO was able to position all required markers: start of Q (<Q) , end of S wave (>S), R peak, and end of T wave (>T).
figure n39.
a fully processed waveform
Sometimes a sufficiently similar waveform cannot be found (segment analysis failure) because, for example, there is no sufficiently similar library waveform or the signal is too noisy. In this case, ecgAUTO does not position any markers and moves to the next segment.
6.1.2 find previous R peak

First, ecgAUTO considers the most recent analyzed waveform. If this waveform is not too far away in time and signal fluctuation is acceptable, RR is calculated. Signal fluctuation is determined by comparing the amplitude of the previous R peak and the current R peak. It is considered acceptable if amplitude difference is below a user-specified threshold. 54 If the above strategy does not return a result, ecgAUTO looks just before the current waveform for a non-analyzed waveform similar in shape. If such a waveform is found and the signal fluctuation is acceptable, RR is calculated.
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how ecgAUTO analyzes data
If this second strategy does not return a result, the current waveform is rejected1.
6.1.3 detect extra beats

In ecg intervals mode (the standard analysis mode), ecgAUTO only returns data for a given ecg complex if it has been able to fully analyze it. If the signal is noisy or the library does not contain sufficiently similar waveforms, the analysis will therefore be partial. However, even if it is not possible to position all marks, it is very often feasible to detect the R peak. If extra beat detection is activated, ecgAUTO will attempt to detect the R peak of complexes that could not be fully analyzed. An extra beat is detected when its QRS complex is sufficiently similar to the QRS complex of adjacent ecg complexes that were fully analyzed. Furthermore, extra beat detection is activated, the main screen table will report these two parameters: HR_all_RR: an HR value based on all detected R peaks (which is of course a better estimate than the one derived from the RR of the only beats that were fully processed). All_RR#: number of RR intervals Extra beat detection is useful when simultaneous analysis of ecg and heart function (for example, with BP, LVP or BF analyzer) is performed. figure n40 shows the extra beat detection in use.
these 5 waveforms with colored background could not be completly processed
with extra beat detection activated, 3 of the wavefroms included as extra beats figure n40. extra beat detection: graph report
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As a consequence, no beat is reported if an RR interval cannot be attached to it.
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6.2 overview of settings

All settings are made from the Analysis settings panel which can be accessed by: clicking the icon in the main screen toolbar
or, selecting Tune Tune analysis from the main screen The settings in the Analysis settings panel vary according to the search mode (which itself is made in the Analysis settings panel, under the General tab). The four search modes are: search mode intervals from average beat description ecgAUTO performs standard ecg analysis using the filtered signal as displayed in the main panel as input data. This is the most commonly used mode. ecgAUTO performs ecg analysis on synthetic waveforms produced by adding up a known number of raw data waveforms. This mode can be useful when the signal is very noisy. ecgAUTO performs an ecg analysis limited to detection of R peaks and RR intervals.This mode is based on morphology rather than shape-recognition techniques - this means that it does not use reference libraries. The analysis is very fast, but in difficult situations (noisy signal) it may become less reliable than the intervals mode. ecgAUTO performs an analysis based on rhythm and stablity.
rr only
rhythm and stability
Please note that the search modes available to you depend on your licence and the software version . The settings are grouped under different tabs. There will be one to four tabs, depending on the search mode and the number of inputs (whether one input or several inputs) (figure n41).
figure n41.
analysis settings panel for 1 input (left) or several inputs (right) for intervals search mode
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General ECG tab This is where you define how ecgAUTO calculates parameters, including filter settings. This tab is always available, although some settings are specific to certain search modes.
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overview of settings
Single lead ECG tab This is where you define how the analysis is performed on all inputs and where you define new and edit parameters. This tab is not available for the RR only and rhythm and stability modes. If your configuration has more than one input, the primary input is the first one that you selected during input selection (see section 5.1.1). Apart from RR and HR, which are only computed on the primary lead, the parameters you define here are available in other leads . Multilead ECG tab If your configuration has more than one lead, this is where you make settings for inputs other than the primary lead. These inputs are sometimes called auxiliary leads. Interlead ECG tab If your configuration has more than one lead, this is where you can define parameters based on all leads, an interlead parameter.For example, you can define an interlead parameter that is equivalent to the shortest PR interval among the leads. To access settings, right-click on the text zone of the tab to open corresponding settings panel:
right-click in the text zone to access the settings panel
figure n42.
analysis settings panel
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6.3 settings for Intervals mode

6.3.1 General ECG settings
The General ECG settings for the Intervals search mode are shown in figure n43
figure n43. ECG mode and signal filtering: Intervals mode
The General ECG tab is where the search mode is selected (blue circle in figure 37). The settings under this tab are very similar for intervals, from average beat and rhythm and stability modes. They are very different for rr only mode. This section covers only settings for intervals search mode.:
ecgAUTO applies up to five filters to the raw signal trace:
derivative filter23 baseline removal filter noise removal or smoothing filter notch filter spike removal filter The derivative filter is used to obtain the derivative signal. The function of the baseline and noise removal filters is self-explanatory. Both can be applied either manually or automatically (as a function of estimated heart rate). For both, filtering is done by calculating a centered average value with triangular weighting coefficients (1 in the center, diminishing to 0 for points further away from the center). 58
2 The derivative filter is not available for ecg analyzers.
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settings for Intervals mode
The notch filter filters out 50 Hz or 60 Hz noise. Such noise is frequently seen on ecg traces, as an artefact produced by electrical devices in the laboratory. Using the notch filter when no 50 or 60 Hz noise is present has no effect, but nevertheless slows down the anlysis process. The spike removal filter may be able to remove spikes that are polluting the signal. Spikes may be electrical artefacts, or caused by other devices, such as electrical stimulators. Spikes are, by definition, of high amplitude and short duration. Most often, spikes are the only features that display such amplitude in such a short duration. This provides the possibility to filter them out. warning about filter settings Inappropriate filter settings can lead to analysis failure or errors. If the filter distorts the signal to the extent that library waveforms and the filtered signal differ too much, analysis will be impossible. Even if analysis is possible, you must be aware that a strong noise removal filter will cause the QRS complex to spread out and therefore increase its calculated duration. It is a sound policy to decide early on which filters are suitable for a given type of experiment and to keep the settings unchanged. Of course, any filtering done by ecgAUTO has no effect on the raw data of the master site files produced by iox. settings expected heart rate In the expected HR field, specify the expected heart rate of the ecg data to be analyzed: < 200 bpm, 150 to 300 bpm, 250 to 350 bpm, above 300 bpm. If filter mode is set to auto, the expected HR will adjust the baseline removal filter width and noise removal filter width (these fields will therefore be non-editable). At higher heart rate, baseline wandering is done at a lower frequency (the risk of distorting the ecg complexes is less) and noise filtering is reduced (the risk of suppressing signal as well as noise is higher). The expected HR setting has no effect on the minimum or maximum ecg heart rate that the software will be able to analyze. The only effect is on the width of the filters applied. baseline removal filter / noise removal filter If filter mode is set to custom, you can adjust the baseline removal filter width and noise removal filter width. To see the effect of your settings on the signal, click on Apply in the Configuration settings panel menu, and look at the result on the data graph of the main panel. To evaluate the effect of the filters, select Graph Raw, base, filter in the main screen. In this view (figure n44), the original raw signal is green, the wandering baseline (before it is subtracted from the signal) is blue and the final filtered signal is dark brown . In the figure, the baseline filter is probably too strong (it is set at 350ms but 400 ms or 450 ms would probably be more appropriate). www.emka.fr 59
figure n44. effect of baseline and noise removal filters on raw data
max RR length (ms) In the max RR lengths field, you specify a maximum length for the RR interval. This setting prevents data from being skewed if signal loss should occur during your recording. Without a maximum RR length, detected beats on either side of a zone of signal loss - regardless of its duration - would be considered to be consecutive beats; the RR calculated on this basis would potentially be wrong. caution ! the maximum RR length should be chosen with care because too low a value will exclude genuine RR intervals notch filter In the notch filter field, select none, 50 Hz or 60 Hz. Although the notch filter can significantly improve signal quality, it is still strongly recommended to make every possible effort to produce a clean signal. Filtering should be the last solution tried.4 figure n45 shows the effect of applying a 50 Hz notch filter.
application of 50 Hz notch filter
figure n45. effect of notch filter
spike removal filter Three options are availble under spike removal filter setting: 60 off - spike removal filter is inactive. pure spikes only high abs value
The notch filter slows down analysis. Do not apply unless needed.
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Additional settings become available when select one of the active modes.
figure n46. settings for spike removal filter, in pure spikes mode (left) and high abs mode (right)
In pure spikes mode, there are five settings: the first three are how to detect the spikes, while the last two are how to remove the spike spike max width: the maximum width of the spike spike min dynamic: the minimum amplitude of the spike spike sign: positive, negative or indifferent spike filter action type spike removal width: this is the width of data removed (centered on the spike peak). A spike is detected if (i) its width is less than spike max width, and (ii) its amplitude is greater than spike min dynamic, and (iii) it is positive, negative or either positive or negative (depending on the spike sign setting).
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spike removal filter applied spike max width: 8.00 ms spike min dynamic: 1.500
figure n47. example of good application of spike removal filter
An effective application of the spike removal filter is shown in figure 41. In the zoomed view, it can be seen that the spike is of 2.5 mV amplitude and is less than 5 ms wide. The R peak is around 4 mV in amplitude and 25 - 30 ms wide. Therefore with settings such as Spike max width: 8 ms Spike minimum dynamic: 1.5 mV the spike is safely detected and the R peak is not mistaken for a spike.
6.3.2 Single lead ECG settings

There are three parts (see figure n48): summary panel of current analysis procedures settings access to predefined list of parameters list of currently defined parameters 3 2 1
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1 2 3
figure n48.
single lead ECG tab of Analysis settings panel (1)
6.3.2.1 editing the analysis procedure

To edit the analysis procedure, right-click in the summary panel to open the General settings for ECG interval analysis panel (figure n49). The different settings are described in the following sections.
figure n49.
modifying analysis procedure
6.3.2.2 analysis precision

In the analysis precision field, you specify how closely a library waveform should resemble a complex under analysis for it to be considered sufficently similar. There are seven precision levels, from lowest to hightest. The higher the precision level, the higher the measurement precision, but the lower the success rate of the analysis. In other words, with a high precision rate, fewer beats will be analyzed. It is a good policy to start with medium and then try to increase the precision.
6.3.2.3 artefact maximum amplitude

In the artefact max amplitude field, you specify the maximum amplitude of artefacts or signal fluctuation between the current and previous R peaks that does not lead to rejection of the current R peak (and therefore of the complex). It is expressed in % of the amplitude of the current/previous QRS complex (the lower value is taken). A good starting value is 30%. Use a lower value to be conservative, a higher value to be tolerant. www.emka.fr 63
6.3.2.4 model waveform selection:

There are three options: first possible starts at the beginning of the library and tests waveforms one by one. It uses as the reference waveform the first sufficiently similar waveform that it finds. This waveform is placed in the first position, ready to be used when ecgAUTO attempts to analyse the next ecg complex.
ecgAUTO
best possible tests all waveforms in the library then uses as the reference waveform the most similar waveform among any sufficiently similar waveforms.
ecgAUTO
average possible
ecgAUTO tests all waveforms in the library. All sufficiently similar waveforms are used to
produce a set of marker positions. The average position of each marker is used for the reference waveform.
note: analysis in the Best possible or Average possible modes might take signficantly longer than in first possible mode (up to 2 to 10 times longer, depending on the number of waveforms in the library).
6.3.2.5 extra beat detection

In the extra beat detection mode field, select one of the three operating modes: only if gaps or average rr: extra beat detection is not performed unless the gap or average RR parameters must be produced (these parameters require the detection of extra beats). always on reported as full beat: extra beats are detected and also reported in the main table as any other fully analyzed beats. This implies that some data lines will be complete (having known values for all parameters) while others, corresponding to the extra beats, will only have known values for RR and HR. In the extra beat detection precision field, you specify how similar two QRS complexes must be to be considered sufficently similar. There are 5 levels ranging from lowest to highest. In figure n50 , extra beat detection is in reported as full beat operating mode. Four extra beats were detected; in the table, only HR and RR parameters are reported for these extra beats. 64
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extra beats
extra beats
extra beats extra beat figure n50. reported as full beat mode (extra beat detection)
6.3.2.6 RR detection required

In always mode, only those ecg complexes which are preceded by a valid RR are reported. In if possible mode, ecg complexes are reported whether or not the are preceded by a valid RR. ecg complexes without a valid RR are attributed an arbitray RR value which is required for the software to run. always is the recommended mode. if possible is particularly suitable for isolated arrhythmyia detection.
6.3.2.7 managing parameters

The parameters that will be produced appear as a list at the bottom of the panel when Single Lead ECG tab is selected (figure n51). In all cases this list starts with the compulsory parameters, RR and HR. RR is the time between R peak of a previous complex to the R peak of the current complex
HR
stands for heart rate and is calculated from RR
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figure n51.
Single lead ECG tab of Analysis settings panel (2)
Each parameter appears on a separate line, containing the following items: toggle switch to deactivate/activate calculation parameter label parameter type description of the parameter (generated by ecgAUTO) Parameter-related functions are available via the Parameter definition panel. Right-click on a label to select that parameter (whose background turns yellow) and open the Parameter definition panel (figure n52).
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right-clicking in a label such as QRS selects the parameter (which turns yellow) and opens the Parameters definition panel (above) figure n52. right-click on a label to select the parameter and open the Parameter definition panel
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The top half of the Parameter definition panel is where you define parameters (described in the next section). After making required changes in the parameter definition area: click append to add the newly defined parameter to the list (it appears at the bottom of the list) click insert to insert the newly defined parameter in the list (above the selected parameter) click replace to replace the selected parameter with the newly defined parameter click delete to delete the selected parameter (in this case, any changes you made in the parameter definition area are ignored). At any time, click print to print out the parameter panel or cancel to cancel the operation.
6.3.2.8 defining parameters

This section describes how to define different types of parameters: interval level amplitude level change area corrected QT average RR custom if para in range simple math isolated P wave gap detection noise stability percent of area average HR interval (multibeat) interval (multilead) subject specific consecutive index
The definition can involve the following marks: <P P P> <Q Q R S S> <T TT+ start of P wave peak of P wave end of P wave start of Q wave peak of Q wave peak of R wave peak of S wae end of S wave start of T wave negative peak of T wave positive peak of T wave www.emka.fr 67
T> R
end of T wave R wave peak of previous complex
6.3.3 managing the parameter types

The different parameter types, a description and their settings are as folllows:
6.3.3.1 interval
An interval parameter gives the duration between 2 markers. It is used to compute parameters such as QT, QRS, P duration etc. To define: specify markers as the beginning and the end of the interval.
6.3.3.2 level
A level parameter gives the average value of the signal between two points definedwith respect to a mark .To define, enter the start and stop marks and the offsets (negative or positive).
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6.3.3.3 amplitude
An amplitude parameter gives the difference between the signal value at a specified mark (usually the peak of a waveform) and a reference level.This reference level should already have been defined as a level parameter.
6.3.3.4 level change

A level change parameter is the difference between two specified level parameters. Such a parameter is useful to compute ST elevation as the difference between ST level and the isoelectric level.
6.3.3.5 area
An area parameter gives the area enclosed by the signal curve and a base between two time points The base is either a horizontal line defined as a level parameter, or a straight line (usually not horizontal) between two points. If the base is 0, the returned value is the integral of the curve between the two points. In the example below, the parameter Parea returns the the area enclosed by: the signal; vertical line 10 ms before start of P ; vertical line 15 ms after end of P; and iso (a user-defined level parameter). 69
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6.3.3.6 corrected QT
Six correction formulas are available: QT / sqrt (RR/1000) QT 0.087*(RR - 1000) log600 * QT / logRR [Bazett] [Fridericia] [Vandewater] [Matsunaga] [Nuyens] [Hayes] QT / cubic root (RR/1000)
QT + 0.3173 * (170 RR ) QT + 7 * (sqrt(250) sqrt(RR)) (sqrt = square root)
with Qt in ms, RR in ms
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6.3.3.7 average rr
An average rr parameter returns the average RR value. Select the averaging mode: last n RR: for the average of the last n RR (including the current RR) where n is the value in the field number of RR to produce average value full n sec: the average of all RR found in the m seconds to the peak of the current RR, where m is the value in the field signal length (s) from which to collect RR. The contribution of the first RR, which is normally only partially included in the time period, is propotional to its part which is included in the time period.
6.3.3.8 custom parameter

A custom parameter is a parameter calculated as a mathematical function of already defined parameters.
Right-click on in the custom formula field to open the formula creation panel. Build our formula using the two-drop down lists and mathemetical operators. Then press the return button (on the right) to validate your choice.
mathematical operators
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6.3.3.9 para in range

A para in range parameter returns another parameter if a third parameter satisfies a specified condition (equal to, not equal to, greater than, greater than or equal to, less than, less than or equal to). HR lies between 60 and 85 (inclusive). The returned value is void (no value returned) if this condition is not satisfied.
6.3.3.10 isolated p wave

This parameter returns the number of isolated p waves detected between the previous complex and the current complex (it is 0 if none detected). Isolated P waves can only be detected in the primary input. You can define the label (isoP is the default name) It is also possible to indicate the level of precision required in the detection. A high precision means high sensitivity and high specificity - this means that there will be only a few false positive results but some isolated P waves may be missed. If you lower the precision, you lower the sensitivity and the specificity - this means that there will be more false positive results but isolated P waves are less likely to be missed. When the isolated P wave detection is active, and when the analysis has detected at least one isolated P wave, a special P wave table becomes available.
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6.3.3.11 gap detection

A gap is a zone of data between the previous detected complex and the current complex in which ecgAUTO detects signal changes but is not certain that these are a valid ecg complex. The gap detection parameter returns either the length of the gap in seconds or 0 if no gap is detected. Gaps can only be detected on the primary input. When gap detection is active, and when the analysis has detected at least one gap, a special gap table becomes available.
6.3.3.12 noise estimator

The noise estimator parameter returns a value indicating the level of noise of the current ecg complex. It was designed to allow users to rapidly navigate directly to zones of noisy signal from a trend graph. The noise estimator parameter has no user-adjustable setting and can only be computed on the primary input.
6.3.3.13 stability estimator

The stability estimator parameter returns a value indicating the change in shape between the previously detected ecg complex and the current ecg complex. The returned value is comparable to a correlation coefficient: it lies between 0 and 1, and the higher the value, the more similar the two shapes. 73
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The Stability estimator parameter has no user-adjustable setting and can only be computed on primary input.
6.3.3.14 time to reach % of area

This parameter returns the time (in ms) taken to reach a specified percentage of a specified area (defined as an area parameter). In the example below (screenshot and figure), the returned value is the time taken to reach 30% of Tarea (the whole area is highlighted pink).
this is the time point at which 30% of teh total area is reached
6.3.3.15 average HR
This parameter returns the HR directly deduced from the average RR parameter described above. If no such parameter has been defined, it returns a void value. The average HR parameter has no user-adjustable setting and can only be computed on the primary input.
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6.3.3.16 multibeat interval

This parameter returns the time from a specified mark on the previous ecg complex and a specified mark on the current ecg complex. In the figure below,TP is the interval from end of T of the previous complex to onset of P of the current complex. If you choose two marks within the current complex, the append, insert and replace buttons are dimmed (such a parameter should be defined using the interval parameter described above).
6.3.3.17 multilead interval

This parameter returns the interval duration from a mark taken on the main ecg lead and a mark taken on any other input. In the example below: input 1 is an ecg lead input 2 as LVP Q_dPdt+ is a multilead interval taken from the mark start of Q on the ecg signal to the mark dP/dt+ on the LVP signal. The interval is shown as in figure n53.
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input 1 (ecg)
input 2 (lvp)
figure n53.
interlead interval on signals
interlead intervals
6.3.3.18 subject specific

The two panels of the subject-specific parameter are shown in figure n54. The discussion below focuses on QT correction because the subject-specific parameter type was developed to be used in this context (of course, it may be used in different contexts).
figure n54. subject-specific panel (left) and formula panel (right)
It is becoming widely accepted that QT correction is subject-dependent and ecgAUTO provides you with the tools to produce a QT correction formula using data of a particular subject. 76 In older version of ecgAUTO, if a user wanted to apply a specific formula to each subject, it was necessary to have a specific analysis configuration for each subject. This could be very cumbersome.
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When the subject-specific parameter type is used: the configuration can contain more than one QT correction formula
ecgAUTO automatically selects then applies the correct formula when analyzing data from a given subject.
how ecgAUTO recognizes the subject from its data Each formula is associated with unique string of characters called the subject key. When an analysis is launched, ecgAUTO searches the data file name for the occurrence of any of the subject keys. If it finds one, the corresponding correction formula is applied during the analysis. This feature therefore requires that users name data files in an appropriate manner. For example, files may be named acording to the convention
studyXXX_sessionXXX_subjectNNN_doseXX.mkt
e.g.
study010_session020_subject101_dose10.mkt, study010_session020_subject121_dose10.mkt, study010_session020_subject122_dose10.mkt
The subject key for study010_session020_subject122_dose10.mkt could be defined as subjectXYZ, _subjectXYZ or _subjectXYZ_ or even just XYZ_ When an analysis is launched, the following rules are applied if... no subject key is found within the file name one subject key is found within the file name more than one subject key is is found within the file name, e.g. if there are subject keys named subject122 and session020 when the user launches analysis of study010_session020_subject122_dose10.mkt subject-specific correction applied? no yes no
two types of formulas: residue and correction Lets suppose that the correction function, f(RR), or correction formula is 181 + 0.02 * RR. Please note that in all cases, you will have made the following settings (discussed later): the name of the new parameter generated by the formula, e.g. QTspe (measured) parameter to which the correction formula is applied, e.g. QT. (measured) parameter used in the correction formula, e.g. RR. www.emka.fr 77
When the formula type residue is selected, the formula is QTspe = QT f(RR) = QT (181 + 0.02 * RR) QTspe is the difference between the measured QT and the calculated QT. This is often called the residue. If the formula was a perfect representation of QT, there would be no difference and QTspe would always be 0. The correction formula cannot exactly predict the value of QT as a function of RR. Therefore, QTspe will always be a small number, either positive or negative.
When formula type correction is selected, the formula is QTspe = QTref + QT f(RR) = QTref (181 + 0.02 * RR) This formula contains one additional parameter compared to the residue formula, QTref. QTref is a corrected QT value calculated using a fixed (user-provided) RR reference value. So If the reference value for RR is 1000ms, QTref = 181 + 0.02 *1000 = 381ms Then QTspe = 381 + QT f(RR) = 381 + residue. Traditionnaly, QT data have been reported as corrected values. But if, for example, a treatment produces a lengthening of QT, then QT will systematically be longer than the calculated QT, and the residue will always be positive. It seems to us that reporting the residue from the correction formula is easier to handle and to use. how to use subject-specific parameter In the subject-specific screen, first select the formula type (residue or correction), then enter: parameter label and parameter unit: the label and unit of the parameter generated by the formula; formula type: either correction and residue (see below). corrected parameter label: the label of the parameter to which the formula is applied, e.g. QT. 78 Input parameter label : the label of the parameter used in the correction formula, e.g. RR. the reference value for RR (correction mode only)
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figure n55.
making settings for residue (left) and correction (right) formulas
Click Append to add your new parameter then to the list of parameters.
Then right-click the newly created parameter to return to the parameter definition panel (two of the fields are now dimmed (not available for editing).
The subject-specific panel contains a list of formulas that you have previously defined (if any). Each formula is shown with its subject key and formula. See below how to edit or modify a formula
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To add a new formula for a new subject, you need to: 1. load raw data files for this new subject 2. add waves in the library to get a correct analysis including at least QT and RR values 3. execute analysis protocol 4. display the XY trends graphs. Put RR on X axis & QT in Y axis. (figure n55) 5. Select the fitting type
figure n56. XY trends graph with RR on X axis and QT on Y axis
6. Click on fitting! from the menu 7. On the XY settings panel, double-click on protocol label. Regression, residue, and correction formula must appear in the low part of this panel.
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figure n57. XY settings panel
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8. Adjust the RRref to needed value. 9. With Ecg subject-specific formula panel opened, click on the transfer formula button from XY settings panels 10. File information, subject key, formula are now transferred in the Ecg subject-specific formula panel. 11. Adjust the Subject key to a unique identifier of this subject included in the file name. You can manually modify as well the formula. 12. Press append when everything is fine.
figure n58. Ecg subject specific formula panel
13. Finally, press transfer! from the menu. The formula appears in the panel below (figure n59).
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figure n59. Settings for subject specific custom ECG parameter panel with a formula
14. Click replace 15. Click apply in the analysis settings panel. 16. Save the configuration To add a new formula for a new subject, you must start again the same procedure. how to edit or modify a formula Right-click on the subject and formula list to open the formula panel containing a list of the same formulas and a graph of each curve (formula panel). The top of the formula panel contains the same list of formulas, with two additional (optional) fields, called original file (name of the file from which the formula was defined) and a comment field. Each formula is also shown graphically in the bottom-right graph . When the formula is transferred directly from the XY plot fitting panel, the current file name is automatically loaded into the list. Nevertheless, both origin file and comment fields remain freely editable by the user.
changes are saved when you click
Transfer!
formula editing area
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figure n60.
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formula panel
To edit an existing formula select it by clicking anywhere on its line. Its data then become available for editing in the text fields under the list (file name, subject key, formula and comment). After entering or modifying the values in the text fields: click append to create a new formula then add it to the end of the list click insert to create a new formula then add it to the list, after the selected formula click replace to replace the selected formula with the new information click delete to delete the selected formula Any changes you make are not definitive until you click on Transfer! which transfers the changes to the subject-specific panel. Click Close! to return to the subject-specific panel Your new subject-specific type parameter is ready for use!
6.3.3.19 consecutive index

This parameter returns a value indicating the position of the ecg complex within a series of consecutive complexes.This parameter is typically used when looking for sequences of consecutive abnormal beats. Settings are as follows;
parameter value type:
on all beats: parameter will return 1 if only 1 previous RR is known, 2 if only the 2 previous RR are known etc. on last of suite else zero: as on all beats but only returns a non-zero index for the last complex in a series. on last of suite of min index, else zero: as on last of suite else zero but only when the series has more beat than indicated in minimum consecutive index .
minimum consecutive index: if beat has a consecutive index lower than the required minimum,
no value is returned for this parameter.
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6.3.3.20 simple math

This parameter returns the result of a simple mathematical operation performed on a userdefined data zone. The fields data zone start offset and data zone stop offset define the start and end of the data zone in relation to the mark selected in reference mark. The available mathematical operations are as follows:
maximum: returns minimum: returns
the maximum signal value the miniimum signal value - minimum of all signal variations (up or down) maximum signal derivative minimum signal derivative
amplitude: maximum maximum derivative: minimum derivative:
accumulated amplitude: sum
In the example below, the returned value will be the maximum signal that occurs in the period running from 2 ms before to 2 ms after the start of the P wave.
predefined parameters There are three lists of predefined parameters: RR HR RR HR PR QRS QT 84 RR HR Pdur PR QRS iso Ramp STlevel STe QT QTcBazett QTcFredirica To load a list of predefined parameters, click on load in the middle of the Analysis settings screen then select the list.
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caution! all existing parameters are erased when the list of predefined parameters is loaded. invalid parameters A red background appears for invalid parameters (figure n61). There are three possible reasons: same label used more than once (the duplicate label is red-highlighted, e.g. PR in the figure) a reference to a parameter that does not exist (in the figure, QTc refers to QT1, which does not exist) a reference to a parameter that exists but appears further down in the list of existing parameters (in the figure, Tdrop refers to parameter Tlevel which is at the botton of the list; no conflict would exist if Tlevel had been defined higher than Tdrop in the parameter list).
figure n61.
examples of invalid parameters
6.3.4 Multilead ECG settings

If there is more than one lead selected, you must proceed as follows to select the parameters for the different leads: under the Single lead ECG tab, load and, if necessary, define all the parameters that will be computed then, under the Multilead ECG tab, select on which leads each parameter will be computed The Multilead ECG tab displays a grid with 1 column per lead and 1 row per parameter (figure n62). The intersection of each column and row is a toggle switch, allowing you to switch ON/OFF the computation of a particular parameter on a particular lead.
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figure n62.
Multilead ECG tab of Analysis settings panel -
When selecting parameters for different leads, you must be aware that: RR and HR are only computed on the first lead and are always ON. if a parameter is set to OFF in the Single lead ECG tab, it is not available for selection (it appears dimmed). a parameter is computed on a given lead only if it is ON under the Single lead ECG and ON for that lead in the Multilead ecg tab. In the example shown below: PR wil not be computed since it is OFF on all leads; QRS will not be computed, since it is OFF in the Single lead ecg tab. QT will only be computed on leads d2
figure n63.
Multilead ECG tab of Analysis settings panel - 2
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settings for RR-only mode
6.3.5 interlead ECG settings

If you are computing a parameter on more than one lead, it becomes possible to compute one of the following interlead parameters. min: minimum value of the parameter across all leads on which it is computed. max: maximum value of the parameter across all leads on which it is computed. aver: average value of the parameter across all leads on which it is computed. med: median value of the parameter across all leads on which it is computed. disp(a): absolute dispersion defined as disp (r): relative dispersion defined as max - min (max + min)/2
The Multilead ECG tab displays a grid with 1 row per parameter and one column per interlead parameter. The intersection of each column and row is a toggle switch, allowing you to switch ON/OFF the calculation of a particular interlead parameter on a particular lead. In the example shown in figure 57: the median of PR is computed no interlead computation is possible on QRS because it is only calculated on one lead (toggle switches are dimmed) min, max and absolute dispersion are computed for QT.
figure n64.
Interlead ECG tab of Analysis settings panel
6.4 settings for RR-only mode

In this mode, analysis is less complicated than in intervals mode and, as the name suggests, it is based on detection of R peaks. This mode is used by used
ecgAUTO users when it is sufficient to detect R peaks, which are then
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to compute heart rate. For example, researchers who will only do heart rate analysis on their ecg data can select RR-only mode. Given that RR-only mode is based on morphology rather than shape-recognition techniques: no reference waveforms are required, therefore the analysis runs whether or not a waveform library exists in the active configuration. the analysis is very fast in difficult situations (noisy signal), the analysis it may become less reliable than the intervals mode. It will produce no results or erratic results when R peaks do not clearly stand out. Only the General ECG settings are available in the RR-only search mode.When you select the RR only search mode in the General ECG tabs, several settings specific to this search mode become available:
figure n65. settings specific to RR-only mode
A candidate R peak must meet several user-defined criteria to be accepted as an R peak: the time since the last detected R peak or the last candidate R peak rejected because of this criterion, whichever occurs later, does not exceed the time in max RR length May be used to avoid reporting data loss as long RR it is wider than the R peak width its RR interval (time from previous R peak) is greater than the sum of PR width and
RT width
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any events occurring since the last R peak have an amplitude less than x% of the average of the last R peak and the candidate peak, where x is the value entered in
max inter beat artefact
its amplitude is greater than one xth of the average amplitude of several previous R peaks, where x is the value entered in R to other amplitude ratio
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settings for RR-only mode
For example, if you enter 2, the candidate R peak will be accepted if the amplitude is greater than the average amplitude of previous peaks. Lowering this value increases the risk that the software will pick narrow artefacts of low amplitude as R peaks. Settings it too high prevents all but the very tallest R peaks (when compared to a other narrow peaks) from being detected. its sign meets the criteriion specified in R peak sign (positive, negative or indifferent) Please note, the fields for R peak width, PR width and RT width are only modifiable if RR-only settings mode is set to custom. Select one of the other options to use the predefined values for these 3 fields, optimised for different sized animals: Large animal; dog, pig Medium animal: primate, rabbit Small animal: rat, guinea pig Extra small animal: mouse
figure n66. using predefined settings for mouse
Two parameters are always produced by the RR-only analysis :

RR HR
R peak to R peak interval length (ms) heart rate associated to current RR (bpm)
If the setting extra parameter computation is ON, the following parameters are also produced:
noise stab min max amp sign
estimation of noise on signal around current R peak stability: estimation of change of signal shape from previous to current ecg complex minimum signal value on current ecg complex maximum signal value on current ecg complex max - min (amplitude of signal value on current ecg complex.) sign is a value from -1 to 1 inclusive: +1 if maximum is x percent larger -minimum 89 0 if maximum is within +/-percent of absolute value of minimum -1 if -minimum is x percent larger than maximum www.emka.fr
where x percent set as min_percent_difference_fornon-zero_sign

delta % difference
in percent between current RR and average of previous and following RR
average is computed on n RR before current and m RR after current RR n and m defined as averaging_number_pre-current and averaging_number _after-current
6.5 settings for average beat mode

When you select the average beat search mode in the General ECG tab, one additional setting becomes available (as compared with the intervals search mode):
figure n67. settings specific for average beat mode
In the beat number to produce average field, select the number of beats to be used in the synthetic average beat.
6.6 settings for rhythm and stability mode

When you select the average beat search mode in the General ECG tab, one additional 90 setting becomes available (as compared with the intervals search mode):
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settings for rhythm and stability mode
figure n68. settings specific to rhythm and stability mode
In the stability precision field, select the level of stability required.
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chapter 7. non-ecg analysis

The analysis capabilities of ecgAUTO were vastly extended in version 2. In addition to ecg data, ecg, it is now possible to use the following analyzers: SLOW BP BF LVP MAP RIP EEG NIBP EEG simple averaging blood pressure blood flow left ventricular pressure monophasic action potential lung volume acquired noninvasively with impedence belts electroencephalogram data including sleep-scoring module blood pressure measured noninvasively electroencephalogram, with sleep scoring and epilepsy seizure detection modules
The non-ecg analyzers are available as options. An analyzer will only be available to you if it is included in the license you purchased.
As for ecg analysis, a number of filters can be applied to the signal before it is processed (by a specific analyzer). Signal filtering is performed in the following order: baseline removal spike removal noise removal notch filter. derivative computation.
Please note that depending on the analyzer some types of filters will not be applied (for example, the baseline removal filter is used for ECG, EEG, RF but not for BP, LVP, BF, MAP)
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ecgAUTO version 3.0 user manual - non-ecg analysis
7.1 how analysis is done

ecgAUTO behaves
as follows when you launch an analysis involving non-ecg signals.
first, ecg signals, if any, are analyzed. The analysis procedure is identical to that used when analyzing ecg signals only then, ecg complexes detected on input 1 are used to locate beats for signals with BP, LVP, BF and MAP analyzers (these are the beats of these signals originate with cardiac activity) finally, signals with other analyzers are analyzed As a consequence, if an ecg complex is not detected in input 1, ecgAUTO will not attempt to locate the non-ecg cardiac-related beat. And, of course, even if the ecg complex is detected, the non-ecg cardiac-related beat may not be (because there are several possible causes of analysis failures: improper settings, noisy signal, artefacts, etc). These points are illustrated in figure n69, in which ECG and BP analyzer are used. Non-analyzed ecg complexes. Probable cause: noisy signal or incomplete library. No attempt was made to detect the corresponding BP beats.
Some BP pressure beats not analyzed even though corresponding ecg complex analyzed. It is likely that thresholds values were inadequate.
figure n69. simultaneous ecg and bp analysis
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The screenshot in figure n70 is from an experiment with three inputs (LVP, ECG, BF). The synchronicity of the beats is apparent.
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making settings
figure n70. experiment with 3 inputs (LVP, ECG, BF analyzers)
7.2 making settings

To make settings you must open the analysis settings panel - as for ecg analysis, select Tune Tune analysis or click on the icon to open it (figure n71). When your selection includes nonecg inputs, the first tab General ECG & Analyzers is selected and contains a box for each selected analyzer. Each box contains a summary of current current settings. To modify settings, right-click on a box to open the analyzer settings panel (figure n72 shows the analyzer setting panel for the BP analyzer).
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In the remainder of this chapter, we describe settings common to all analyzers, then analyzerspecific settings and parameters.
figure n71. analyzer settings panel (ecg and non-ecg inputs)
figure n72.
BP analyzer settings panel
7.2.1 common settings

validation threshold The absolute minimum amount of signal variation that must separate a trough from a peak, and a peak from the next trough in order for that peak to be valid. rejection threshold 96 The maximum amount of signal rebound which can be tolerated between a trough and the next peak or between the peak and the next trough. If a rebound of amplitude greater than the rejection threshold exists, the beat is rejected.
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slow analyzer (SLOW)
noise removal filter width this is the half width, in ms, of the triangle filter used as high pass (normally to remove high frequency noise). derivative filter width(1) This is the half width, in ms, of the triangle filter used as a high-pass filter to obtain the derivative signal. baseline removal filter width (ecg and eeg analyzers only) For other signals, one does not want to remove the continuous component of the signal !
7.3 slow analyzer (SLOW)

The SLOW analyzer provides minimum, maximum and average values of a signal. It is commonly used on slowly changing signals such as activity, temperature, pH... The segments (strips) of data analyzed by the SLOW analyzer depend on which analyzers are applied to which inputs.
7.3.1 settings of the SLOW analyzer

If there is at least one SLOW analyzer and input 1 is a SLOW analyzer and no other input has a beating signal(2) analyzer: the SLOW analysis is performed on a strip of length specified in the data strip length (s) field. the time shift from the start of one strip to the start of the next strip is that specied in the data strip start shift (%) field (therefore if the value is less than 100%, the segments are overlapping segments; if the value is 100%, segments are contiguous strips).
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(1) (2) This setting is not available for analyzers for which a derivative signal has no scientific value. A beating signal analyzer is one that analyzes rhythmic signals, i.e. ecg, BP, LVP, BF, MAP, RF.
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If there is at least one SLOW analyzer and input 1 is a beating signal analyzer: SLOW analysis is performed on the strips defined by the BB interval
figure n73.
SLOW analyzer settings panel
7.3.2 parameters produced by the SLOW analyzer

parameter average maximum minimum median duration of processed signal area under the curve abbr aver max min med dur area unit description
ms baseline on zero
figure n74.
SLOW analysis
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blood pressure analyzer (BP)
7.4 blood pressure analyzer (BP)

7.4.1 settings of the BP analyzer
figure n75.
BP analyzer settings panel
derivative at begin upstroke
value is to define the position of the upstroke_mark at the end of diastole (upstroke_mark is often used to compute QA interval. QA is computed as an interlead interval in ecg analysis)
BRS (Baroreflex sensitivity)
It is off by default. Click on off to see the BRS specific settings. : of beats showing simultaneous increase or decrease of pressure and interval to be considered a valid sequence.
minimum consecutive beat number latency beat number : for example, if latency = 2, pressure of beat index n is paired with interval
of beat n+2.
pressure value: which
parameter (usually systolic or mean) is used as pressure reference.
mark to compute pulse interval: usually peak to peak, thus on SP = systolic. minimum pressure variation: if pressure of 2 consecutive beats varies by a smaller amount, the
beat cannot be included in a series.
minimum interval variation: if interval of 2 consecutive beats varies by a smaller amount, the
beat is cannot be included in a series. is void and not reported.
minimum correlation: if a linear fit produces a r2 value smaller than this correlation, the series
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7.4.2 parameters produced by the BP analyzer

parameter beat-to-beat heart rate diastolic blood pressure maximum derivative systolic blood pressure mean blood pressure amplitude of blood pressure abbr BB HR DBP dPdt+ SBP MBP ABP D_DN_ time DN_pres area unit ms bpm U U/s U U U ms description interval from previous systolic peak to current systolic peak calculated on a beat-to-beat basis (using BB) peak diastolic pressure of current beat. maximum rate of pressure change between current diastole and following systole peak systolic pressure of current beat mean pressure over period between current and next diastolic peaks DBP - SBP time from diastolic point to next dichrotic notch (ms) pressure at dichrotic notch area under the curve from diastole to diastole. Area base is the straight line from the 2 diastole point
dicrotic notch pressure area
conduction ConducT1 times 1 conduction ConducT2 times 2 KEY: U is user-specified calibration unit BRS analysis specific parameters: parameter abbr unit BRS_deltaP BRS_shiftII BRS_deltaI BRS_# 100 BRS_correl BRS_slope
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description variation of reference pressure between previous and current beat ; always available. interval of shifted beat ; if latency = 2, corresponds to BB value of beat n+2 ; always available variation of shifted interval between previous and current beat ; always available number of beats in detected valid BRS series ; available only for valid series r2 correlation factor of linear fit of current BRS series ; available only for valid series slope of linear fit of current BRS series ; available only for valid series
blood flow analyzer (BF)
7.5 blood flow analyzer (BF)

7.5.1 settings of the BF analyzer
figure n76. BF analyzer settings panel
pressure channel index
If a blood pressure signal is available, the BF analyzer can compute the total peripheral resistance. In this case, select the blood pressure input in this field.
time unit used for flow unit
Select minute if flow is in V/min or second if it is in V/s (V = volume unit).
7.5.2 parameters produced by the BF analyzer

parameter abbr BB HR minF maxF dFdt+ unit ms bpm U U U/s description interval from previous peak flow to current systolic peak calculated on a beat-to-beat basi (using BB) minimum flow (taken before current peak flow) maximum positive derivative between current minimum flow and current maximum flow. 101
heart minimum flow maximum flow maximum positive derivative
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parameter mean flow stroke volume negative stroke volume cardiac output
abbr meanF SV SVCO
unit U
total peripheral TPR resistance
description mean flow computed from current minimum flow to next minimum flow U *s integral of flow curve from current minimum flow to next minimum flow U *s computed as SV but only takes into the negative values of flow (computes the total back flow during a beat (U * s) / min SV x HR i.e. volume of blood pumped per minute U [pressure TPR is calcualted as average pressure divided by input] / cal U meanF. Average pressure is computed on the input specified as the pressure channel and signal is averaged between time points corresponding to current and next minimum flow
KEY: U is user-specified calibration unit
figure n77. BF analyzer markers
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left ventricular pressure analyzer (LVP)
7.6 left ventricular pressure analyzer (LVP)

7.6.1 settings of the LVP analyzer
figure n78.
LVP analyzer settings panel
The start of the diastole is determined according to the mode selected in the Begin Diastole detection mode field. Specifically, it is taken as the point where the derivative equals: a specified value (dPdt=value mode), or a specified percentage of the max dP/dt (dPdt=%dPdt+- mode). Once you select a mode, you can enter the corresponding value or percentage in the field immediately below. The end of diastole is determined by similar settings. Specifically, it is taken as the point where the derivative equals: specified values (dPdt=value mode), or specified percentages of the max dP/dt (dPdt=%dPdt+- mode). Once you select a mode, you can enter the correspoding value or percentage in the field immediately below. 103
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The systolic period is determined according to the mode selected in the Begin Diastole detection mode field, as follows: the beginning is taken as x ms after the point of maximum positive derivative dPdt, where x is the value in Begin Systole time shift from dPdt+ the end is taken as y ms before the point of minimum derivative dPdt, where y is the value in End Systole time shift from dPdtED offset for W3 (U) is
the pressure offset added to pressure at end of next diastole used for calculation of Tau using the Weiss method (see below). The parameter P_%1 is the pressure at the point where the derivative is x% of maximum derivative, where x is the value in take P_%1 at % of dPdt+. The pressure is taken between the end of diastole and the beginning of systole (i.e. on the rising edge of the beat). Similarly, parameter P_%2 is the pressure at the point where the derivative is x% of maximum derivative, where x is the value in take P_%2 at % of dPdt+ parameter P_%2 is taken as the point where pressure is x% of the dpdt+, where x is the value in take P_%2 at % of dPdt+. The parameter dPdT_P1 is the derivative of the point between the end of diastole and the beginning of systole (i.e. on the rising edge of the beat) where the pressure equals the value in take dPdt_P1 at indicated pressure. Similarly, parameter dPdT_P2 is the derivative of the point between the end of diastole and the beginning of systole (i.e. on the rising edge of the beat) where the pressure equals the value in take dPdt_P2 at indicated pressure.
7.6.2 parameters produced by LVP analyzer

parameter beat-to-beat interval heart rate pressure at beginning of diastole minimum pressure during diastole pressure at end of diastole average pressure abbr BB HR BDP minDP EDP meanDP unit ms bpm U U U U average pressure computed from beginning to end of diastole description beat-to-beat interval, from from previous systole until current systol calculated on a beat-to-beat basis (using BB)
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left ventricular pressure analyzer (LVP)
parameter pressure at beginning of systole maximum pressure during systole pressure at end of systole average pressure developed pressure
abbr BSP maxSP ESP meanSP devP dPdt+ dPdt-
unit U U U U U U/s U/s ms ms ms ms ms ms
description
average pressure computed from beginning to end of systol difference between maxSP and minDP maximum positive derivative between end of diastole and beginning of systole minimum negative derivative between end of diastole and beginning of systole interval between beginning and end of diastol interval between beginning and end of systole interval between end of systole and beginning of next diastole interval between end of diastole and beginning of next systole dPdt+ divided by pressure at that point time taken for the negative derivative to increase from its minimum value (dPdt-) to half this minimum value (dPdt- / 2) time taken for the negative derivative to increase from its minimum dPdt- value to this minimum value divided by the e constant (dPdt- /e) calculated according to Weiss method. Tau(W1) = [t1 t0] / [log(p0) log(p1)] where t0 and p0 are time and pressure at dPdtp1 is pressure at beginning of next diastole t1 is time point of dPdt+ (max) of next beat calculated according to Weiss method. Tau(W2) = [t1 t0] / [log(p0) log(p2)] where P2 is pressure at end of next diastole plus pressure in ED offset for W field
filling time ejection time relaxation time contraction time
filT ejeT relT ctrT
contractility index ctr Tau(/2) Tau Tau(W1)
Tau(W2)
P_%1
(other variables as above) pressure at the point where the derivative is x% of maximum derivative, where x is the value in
take P_%1 at % of dPdt+.
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parameter
abbr dPdT_P1
unit
P_%2
description derivative of the point between the end of diastole and the beginning of systole where the pressure equals the value in take dPdt_P1 at indicated pressure. the pressure at the point where the derivative is x% of maximum derivative, where x is the value in take P_%2 at % of dPdt+ derivative of the point between the end of diastole and the beginning of systole where the pressure equals the value in take dPdt_P2 at indicated pressure.
dPdT_P2
KEY: U is user-specified calibration unit
figure n79.
LVP analyzer markers
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monophasic action potential analyzer (MAP)
7.7 monophasic action potential analyzer (MAP)

7.7.1 settings of the MAP analyzer
figure n80.
MAP analyzer settings
Baseline computation mode: average within limits mode: the baseline is the average between two points: the base-start point is taken as maxdV/dt - x% of BB the base-end point is taken as at maxdV/dt - y% of BB
where BB is beat-to-beat interval, x is the value in base starts field and y is the value in base stops field ) % of area mode: the baseline is the line where x% of the signal area is below it, where x is the value in the field x% of total area. Plateau detection mode: morphology mode: uses a built-in algorithm to detect the plateau. This mode works well with standard MAP shapes. % of area mode: the plateau is determined as the line for which x% of the signal area is above it, where x is the value in x% of total area is below baseline. 107
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APD start mode: The MAP analyzer generates four Action Potential Duration (APD). 2 modes exist to determine the time point from which APD are computed.: time point of max derivative: Time point where max positive derivative is reached. upstroke crossing: Time point where the horizontal line going throughthe APD stop point crosses the upstroke. APD relaxation top: 3 modes exist from pleateau from peak from maximum APD relax mode: 2 modes exist: % drop of signal from plateau (using baseline as reference or 100%drop) % of area above: level for which specified percentage of signal area is above the level.
7.7.2 parameters produced by MAP analyzer

The following parameters are produced by the MAP analyzer. It is assumed that the signal has been calibrated using the volt (V) as unit parameter beat-to-beat interval heart rate baseline slope end-diastolic voltage abbr BB HR base slope EDV unit ms bpm V V/s V description beat-to-beat interval from previous max until current max calculated beat by beat (using BB) average signal between base-start and baseend points average signal slope between base-start and base-end points starting from the dVdt+ point (maximum derivative ) and going backwards, EDV is the voltage where the derivative falls below 5% of dVdt+
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maximum signal value. plateau voltage amplitude
peak plt amp_mx
V V V
calculated as difference between plateau value (plt) and baseline value (base)
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respiratory inductive plethysmography (RIP)
parameter amplitude amplitude
abbr amp_pk amp_pl dVdt+
unit V V V/s
action potential APD_1 V duration 1 action potential APD_2 V duration 2 action potential APD_3 V duration 3 action potential APD_4 V duration 4 area area V*ms KEY: U is user-specified calibration unit
description calculated as difference between plateau value (plt) and baseline value (base) calculated as difference between plateau value (plt) and baseline value (base) maximum rate of change of voltage between base and peak time between APD-start and APD-stop-1 time between APD-start and APD-stop-2 time between APD-start and APD-stop-3 time between APD-start and APD-stop-4 area above level defined for APD_4
figure n81.
MAP analysis
7.8 respiratory inductive plethysmography (RIP)

The RIP analyzer is part of the setup for the emkaBELT module (option with the emkaPACK telemetry system) for measuring lung volume noninvasively in large subjects such as dogs, primates and pigs. The RIP analyzer uses three input types, through not all have to be used in every case. For correct functioning of the RIP analyzer, the input types must be selected in the correct order when you open the data file in ecgAUTO. The four possible cases are: Case 1 (one belt, relative measurements) Input 1 RIP Case 2 (one belt, absolute measurements) Input 1 RIP Input 2 RIP_calib 109
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Case 3 (two belts, relative measurements) Input 1 RIP_sum Input 2 RIP Input 3 RIP Case 4 (two belts, absolute measurements) Input 1 RIP_sum Input 2 RIP Input 3 RIP Input 4 RIP_calib Full information about the RIP analyzer, including settings and produced parameters, are given in the emkaBELT module user manual
7.9 noninvasive blood pressure analyzer (NIBP)

The NIBP analyzer can operate in two modes: 1-input mode: only nibp input used 2-input mode nibp input and ecg input used The mode is determined when you select inputs (section 5.1.1) - it cannot be modified once the inputs have been selected. If you want to change the mode, you need to reload the file and apply the new desired input selection. For 1-input mode: select the nibp input and link it to the NIBP analyzer For 2-input mode: first select the nibp input and link it to the NIBP analyzer; then select the ecg input and link it to the NIBP_ecg analyzer. In 2-input mode, the ecg input is analyzed using the RR-only search mode (refer to section 6.3.1 for details about adjusting RR detection settings). It is easier to fine-tune ecg analysis settings while working on only the ecg input. To do so, reload the file and only select the ecg input, set the analysis to RR-only search mode and tune the analyzer until you obtain optimal settings. Then, reload the file for nibp analysis (selecting the nibp input and then the ecg input) and apply the optimal ecg settings you previously obtained. The sections below are relevant to both input modes unless otherwise indicated. 110
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noninvasive blood pressure analyzer (NIBP)
7.9.1 settings of the nibp analyzer

This section describes the settings in the order of their appearance in the NIBP analyzer settings panel (figure n82). a first group of settings specify how the input signal is filtered. a second group of settings defines how the pressure pulses are selected for inclusion in the analysis. a last group of settings defines how blood pressure data are derived from selected pressure pulses.
figure n82.
NIBP analyzer settings
Filters: baseline removal, noise removal, notch and spike removal filters are already described in detail in section 6.3.1. Only a short reminder is included below.
baseline removal filter width
The baseline removal filter acts as a high-pass filter to remove the background cuff pressure so that only the pulse pressure remains. Choose a high value between 2000 ms and 3000 ms.
noise removal filter width
This is a low-pass filter that removes the high-frequency small artefacts from the pressure signal. A typical value is 40 ms.
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notch filter and spike filter
The notch filter removes electrical noise from the mains supply (50 Hz or 60 Hz), while the spike filter removes artefactual sharp spikes. pressure pulse vs ecg: hardware time lag (ms) There are two reasons why the pressure wave occurs later in time than its corresponding ecg complex: hardware lag: this is an artefactual lag, which delays pressure signal more than ecg and which is introduced by the hardware. physiological lag (also called transit time): this is the time it takes for the pressure pulse to travel from the heart to the point of measurement, the tail. It is sometimes valuable to measure actual physiological transit time. In order to do that correctly it is necessary to eliminate any lag that the hardware may have superimposed on the physiological transit time. The hardware lag associated with emkaPACK model tle-03 is 550ms. Therefore, when analyzing data produced with this particuler device, enter 550 in the field Pressure pulse vs ecg ; hardware time lag (ms). Subsequently, ecgAUTO will shift the pressure curve leftwards by this amount. Priority of different time shifts in ecgAUTO The time shift entered in Pressure pulse vs ecg ; hardware time lag (ms), whether it is zero (no time shift) or greater than 0, overrides any time shift applied to the nibp input in the Data preview window (figure n83). For example, if the time shift is set to 300 in the Data preview window then later set to 200 in NIBP Settings, 200 is used, and the 300 setting is lost. If the conifguration is saved, then the next time a file is opened, the 200 value will show in the Data preview panel as well as in the NIBP analyser settings.
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time shift value in NIBP analyzer settings (left) overrides value in Data preview window (below)
figure n83.
priority of time shift settings
minimum high inflation pressure (CU, usually mmHg) maximum low inflation pressure (CU, usually mmHg) These two values are used for the software to detect cuff inflation cycles. In order for a cuff inflation cycle to be detected, the cuff pressure should first exceed the minimum high inflation pressure, and later drop below the maximum low inflation pressure. Typical recommended values are 190mmHg and 40mmHg. Note that these two settings also influence the detection of valid pressure pulses (see below). After having detected a cuff inflation cycle, the software : Removes the average cuff pressure to produce a residue curve showing only the pulses due to pressure oscillation corresponding to each heart beat. Applies a number of criteria to determine which of these pulses are valid ; 113
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Uses the valid pulses to fit a curve from which the parameters mean, systolic and diastolic pressure are computed. Pressure pulses are accepted for analysis if: the cuff pressure corresponding to that pulse is lower than the minimum high inflation
pressure
and the cuff pressure corresponding to that pulse is higher than the maximum low inflation
pressure
and pulse amplitude is higher than minimum pulse amplitude (typical value 1 mmHg) and pulse amplitude is lower than maximum pulse amplitude (typical value 15 mmHg) and, in 2-input mode only, the pulse occurs, with respect to the previous peak of R, within a transit time range specified with limits to transit time values drop-down menu. Settings mentioned in this section are further described below. limits to transit time values (this setting is only available when in 2-input mode): 2 modes are available: in auto mode, the transit time minimum and maximum values are automatically determined by the software around the computed median value for transit time. in set limits mode, the transit time range is fixed and determined by the values you enter in the fields transit time min value and transit time max value. To avoid the pulse rejection potentially caused by the transit time criteria, select set limits mode and use a very wide interval, for example 100 and 400. pulse amplitude computation mode 3 modes are available : upstroke: the amplitude is computed from the previous trough (minimum) to the current pulse peak up/down average: the amplitude is computed as the average of upstroke and downstroke downstroke: the amplitude is computed from the current pulse peak to the next trough 114 The recommended setting is up/down average.
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pulse amplitude correction factor (this setting is only available when in 2-input mode): When the heart rate fluctuates significantly, as is often the case for dogs where HR can go from 30 bpm to 200 bpm within seconds, diastolic pressure also varies with heart rate, short RR intervals being associated with high diastolic values while long RR (low HR) are associated with low diastolic pressure. Since systolic pressure is more stable, heart rate fluctuations lead to fluctuations in pressure pulse amplitude. In order to produce a cleaner bell shape XY plot of cuff amplitude vs cuff pressure points on which curve fitting is more efficient, a correction may be applied which, when negative, decreases the amplitude of pulses associated with RR longer than the median RR and increases the amplitude of pulses corresponding to RR shorter than the median RR. This correction setting is available from the NIBP analyzer settings panel and also in the NIBP analysis panel. Adjusting it on the NIBP analysis panel produces immediate effect on the XY plots, curve fitting and all associated data and may thus be used to determine the optimal value for the correction factor. For dogs, the recommended value is -15, but values as low as -30 may be effective in some files. If you have any doubts or are not convinced by the improvement this correction provides, enter 0 to suppress it. minimum pulse amplitude (CU, usually mmHg) maximum pulse amplitude (CU, usually mmHg) A pulse is invalid if its amplitude is not within the range defined by these values. These two limits are shown as yellow horizontal lines on the XY plot. After having produced the XY plot of valid pulses vs cuff pressure corresponding to that pulse, the software : Tries to fit the chosen type of fitting curves (type of fitted curve) Computes the correlation coefficient of this fit If the fit correlation is above the minimum set limit, uses the fitted curve to compute mean, systolic and diastolic pressure Settings mentioned in this paragraph are further described below. 115
maximum correlation Set value from 0 to 1, with recommended setting at 0.6 www.emka.fr
The higher the value, the lower the success rate of the analysis and the higher the analysis precision. The lower the value, the higher number of analyzed inflation cycles and the lower the analysis precision. type of fitted curve The plot of pulse amplitude vs cuff pressure produces an approximately bell-shaped curve. ecgAUTO produces a fitted curve of the type specified in type of fitted curve, from among the following: 3rd degree polynomial 4th degree polynomial 5th degree polynomial Gaussian (normal) Gaussian and 5th degree polynomial . The Gaussian curve and 5th degree polynomial methods usually produce good fits. The last option takes the average of the two curves produced by the 5th degree polynomial fit and the Gaussian fit. Percent of max amplitude to measure diastole Percent of max amplitude to measure systole The fitted curve is used to obtain the systolic and diastolic pressures. Specifically: the systolic pressure is the pressure on the rising part of the curve corresponding to x% of the amplitude, where x is the value in percent of max amplitude to measure
systole
the diastolic pressure is the pressure on the falling part of the curve corresponding to x% of the amplitude, where x is the value in percent of max amplitude to measure
diastole
We suggest settings of 90% for systolic and 85% for diastolic pressure.
7.9.2 parameters produced by the NIBP analyzer

parameter mean blood pressure systolic blood pressure diastolic blood pressure amplitude of blood pressure correlation co-efficient abbr mean SP DP ABP r2 unit mmHg mmHg mmHg mmHg description SP - DP correlation co-efficient corresponding to the goodness of fit of the fitted curve of pulse amplitude vs cuff pressure
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parameter heart rate PTT fitting type
abbr HR PTT fit_type
unit bpm
description calculated from beats within the inflation/ deflation cycle pressure transit time (also know as physiological lag) (2-input only) number corresponding to fitting type: 1 = Gaussian (normal curve) 2/3/5 = 2nd, 3rd or 5th degree polynomial
7.9.3 reviewing data

After analysis, the data table in the main screen contains one line of data per measurement cycle (figure n84). Some of the lines will not have all parameters. This is because either (i) the data could not, for whatever reason, be analyzed and/or (ii) the corresponding fitted curve has an r2 below the user-specified threshold.
figure n84.
nibp data in the main screen (after analysis)
It is possible to invalidate/validate data points/lines (via the Data panel or Pulse panel). It is not possible to edit, e.g. modify the value for mean pressure, systolic pressure etc. To see in detail how data were analyzed, select View NIBP analysis in the main menu or click on the icon to open the NIBP analysis panel (figure n85). 117
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cuff pressure panel Curve of cuff pressure vs time (original, blue, and after baseline filtering, green) Correction factor applied (to displayed results only) Correlation co-efficient Calculated parameters Drop-down menu for fitting type selection step and beat index number, site time pulse panel See text. pulse amplitude scattergram data panel (See text) Pulse amplitude vs RR interval slider to adjust relative size of panels in window transit time histogram Transit time histogram (this is the delay in ms between each ecg complex and the blood pressure wave associated with it, peak parameter used) pulse pressure curve Curve of pulse pressure vs time. Also visible are: the ecg trace, in miniature lines used to calculate transit time filled circles for R peak of ecg wave and systole and diastole The transit time for the selected pulse is indicated by a thin blue line.
NOTE: This curve is obtained by substracting the green curve from the blue curve in the cuff pressure panel. figure n85. nibp analysis panel
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The different panels are dynamically related. For example, when you click a data line in the Data panel: the cursor of the Cuff pressure panel, the Pulse bell curve and the Pulse pressure panel moves to the relevant data point the time transit histogram updates. Adjusting the correction factor in the correction field(3) allows you to see its effect on the analysis results without affecting the data file (i.e. new calculated results are temporary only and only used for display). In this way, you can rapidly determine the optimal correction factor. When you decide which factor you want to use, you must return to the NIBP analyzer settings panel to enter it.
pulse panel
This plot of Pulse amplitude vs cuff pressure graph contains the: pulse bell curve diastolic, mean and systolic points (with unfilled circles and vertical dotted lines). data points (filled if valid, unfilled if invalidated). In the upper left corner, you can select the scale for the two axes. The drop-down menu allows you to select point selection mode: in point mode, clicking anywhere on the graph snaps the cursor to the closest data point in polyg mode, clicking and dragging the mouse draws a selection polygon
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(3) The value that initially appears in the correction field is the pulse amplitude correction factor and is carried over from the NIBP analyzer settings panel.
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After selecting one or more points using either of these modes: press delete to invalidate them press insert to validate them press = to reset these points to their orginal validity state (as produced by the software analysis). data panel
Each line corresponds to an inflation/deflation cycle. When data lines are first loaded into the Data panel, valid lines have a blue background (as above) and non-valid lines have a grey background. . Click on a data line in the Data panel to select it (alternatively you may click on the point in the Pulse bell curve). When a line is selected, the validate box is green if the cycle is valid or red if the cycle is nonvalid (regardless of whether the validity status is software- or user-determined).
soft, valid, curr cuffPres pulse(o) pulse(c) transitMs comment
validity status (see below) cuff pressure original pulse amplitude (before correction) corrected pulse amplitude transit time in ms
The software tells you why non-valid lines are non-valid in the column (for example, the transit time may be too long) Press Delete on the keyboard to validate an nonvalid line or to invalidate a valid line. As you make edits, several things happen: update of Cancel editions field, showing the number of nonvalidated edits update of reset all field, showing the total number of edits 120 color coding on left side of Data panel changes Green indicates lines that have been validated
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Yellow indicates recent non-validated changes the color coding on the right side of the Data panel changes. There are 4 possible states (colors): valid line (non edited) nonvalid line (edited) nonvalid line (edited) valid line (edited)
The columns in the Data panel provide additional information, where 0 is nonvalid and 1 is valid
soft valid curr
Original value (determined by the software according to your settings) Edited and validated value Edited but not yet validated value
Click validate all to validate all edits that have not yet been validated. Click cancel editions to cancel edits that have not yet been validated. Click reset all to cancel all edits (validated or not ). The software considers the net effect of edits. For example, if you validate a nonvalid line then invalidate it, the software considers that 0 edits have been made. display options for pulse pressure curve zoom in (time scale) return to standard tuime scale (whole inflation/deflation cycle visible) zoom out select amplitude scale (for example, -6 mmHg + 6 mmHg
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ecgAUTO version 3.0 user manual -
7.10 electroencephalogram analyzer (EEG)

The eeg analyzer is specifically designed to analyze eeg or emg type signals. It also has special features to allow for: sleep scoring epilepsy seizure detection. Of course it can also be used to analyze any signal on which you want to perform event detection and/or FFT power spectrum assessment.
7.10.1 Filters
eeg signal (like ecg) is subject to baseline fluctuation and due to global changes in the subject electrical potential. Analysis is best performed if such baseline is removed. This done applying the baseline removal filter. Noise removal filter is available but should be used with caution since it will greatly affect the high frequency content of the signal. Extra optional filters are available on this analyzer: band pass and cutoff Chebyshef and Butterworth filters. Use the numerical settings to indicate frequency limits. For details on these very standard filters, please see general handbook on signal filtering. For most EEG analysis recommended filter settings are : Baseline removal : 3000 ms Noise removal : 0 ms (meaning no filtering) Notch removal: use only if you have significant 50Hz or 60hz electrical noise Spike removal: off ; use it only if you have clearly identifiable artefactual spikes. Frequency filter: off unless you have good reason to use it.
7.10.2 Epochs length and successive starts

Unlike analysis performed on beating signals such as ecg, blood pressure etc, the eeg signal is nonperiodic.You must therefore tell the analyzer how to select the segments of data to analyze. We call these segments epochs, the term traditionally used in the field of eeg analysis. In the epoch length mode field, you tell the eeg analyzer how to define the length and position of successive epochs. User defined means the epoch has the length you specify in epoch length field. Same as FFT epoch length is self explanatory. See FFT section below. 122 The time shift between the start of successive epochs, is defined as a percentage of epoch length and specified in epoch start shift field. If this value is < 100%, epochs overlap; if it is set to 100% epochs are contiguous; if it is set to >100%, epochs are non-contiguous.
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electroencephalogram analyzer (EEG)
For example, if you set epoch length to 10s and epoch start shift at 60%. 1st epoch starts at time 0 2nd epoch starts at time 6s 3rd epoch starts at time 12s Etc
7.10.3 FFT
FFT stands for Fast Fourier Transform. FFT is an algorithm which allows very fast computation of the Fourier transform of a segment of input signal. Fourier transform is a mathematical tool used, among other things, to find out how any input signal can be expressed as a combination of multiple simple sine waves of different amplitudes, frequencies and phase shift. This a very standard tool on which you will find more detailed explanation on many books and web links. FFT is often used for EEG analysis in order to determine how much of the signal consists of fluctuations within certain frequency ranges often referred as Greek letters alpha, delta etc. Although the Fourier transform can be applied on any signal, the fast FFT algorithm, by design, can only be run on data strings that contain a number of data points that is a power of 2, such as 2, 4, 8, 16. Therefore FFT can only be run on data strings containing, for example: 512 (or 29) data points 1024 (or 210) data points 2048 (or 211) data points 4096 (or 212) data points This is why, in the setting for FFT computations, FFT input point numbers are available as a list of preset values ranging from 128 (or 27) to 1,048,576 (or 220).
7.10.4 Epoch and FFT lengths, possible conflict

Epoch length is user defined in either of two modes: user defined same as FFT epoch length We first discuss the default mode user defined If you set your epochs to have the same length as the FFT input point number, you end up having epochs with fractional number of seconds. For example, if the FFT is set on 4096 points and if the sapling frequency is 500Hz (1 point every 2ms), this results as an FFT input data string of 8.192s. 123
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Supposing that you have set epoch start shift at 50% this means that successive epochs will start, and will be reported in the resulting data tables, at time points: 0s 4.096s 8.192s 12.288s If you prefer that these time points are whole (integer) number of seconds you may choose to define epoch length not as being identical to FFT input length but as whatever number of seconds you decide (user defined mode). Suppose you have indicated that epoch length is 10s, with epoch start shift still at 50%. Now successive epoch starts will be: 0s 5s 10s 15s which may be easier to read and handle, but which has a possible weakness. In each 10s epoch, only the first 8.192s of data will be processed, since this is the length of FFT input data. The remaining 1.808s of data will not be processed in the current epoch, but in the following epoch, as long of course as there is sufficient overlap. In the example of the figure below, sampling frequency is 200Hz (5ms between sampling points), and if you then set the FFT to 4,096 points (or 20,.475s), which is longer than the indicated 12s epoch, there is a conflict because the FFT input data is longer than the available epoch length. FFT will not be computed an you are warned of this situation by the epoch length setting turning red.
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figure n86.
EEG analyzer settings panel
An alternative is to use the epoch length mode set to same as FFT epoch length. In this mode, and for the example in the figure, epoch length will be exactly fitted to FFT data input length or 10, 235s. Time values associated to each epoch will no longer increment as integers, but no data is lost for FFT processing within each epoch.
The third possibility is to allow the software to resample input raw data. This is done by putting the FFT_input_data_setting to resampled to fit epoch length. 125
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In the example in the next figure, epoch length is 10s and FFT input point number 2048, meaning that with the original raw data sampling rate of 5ms (200Hz) FFT input data would be 10.12s, longer than the required 10s length. In this case no FFT would be computed. But once the mode is set to resampled to, data is resampled at 204.7Hz so that 2048 points will exactly fit in the 10s epoch. In that case: FFT is produced from the whole epoch, with no data left out of the FFT processing zone; Epoch length can be set to any value; But, as a consequence, sampling rate is set to an unusual value of 204.7Hz.
7.10.5 Epoch and FFT lengths, how it is shown on the main panel traces
The following screen shots indicate how data, FFT zone and power spectrum are displayed depending on computation and display settings. Display settings are the ones form the next figure.
figure n87. EEG FTT spectrum settings panel
Case 1: Epoch length : 12s (red rectangle) Epoch start shift : 110% (no overlap, 10% gap between successive epochs) 126 FFT input data not resampled FFT input point number : 2048 (or 10.235s, FFT processing zone shown in green) FFT spectrum displayed across the complete epoch (in light blue on active epoch)
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Case 2: Epoch length : 12s (red rectangle) Epoch start shift : 50% (50% overlap) FFT input data not resampled FFT input point number : 2048 (or 10.235s, FFT processing zone shown in green) FFT spectrum displayed reduced in width to account for reduced display possibility caused by epoch overlap (in light blue on active epoch)
Case 3: Epoch length : 12s (red rectangle) Epoch start shift : 100% (no overlap, exactly contiguous) FFT input data resampled FFT input point number : 2048 resampled on 12s with FFT processing zone shown in green) FFT spectrum displayed reduced in width to account for reduced display possibility caused by epoch overlap (in light blue on active epoch)
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7.10.6 FFT windowing

Select the type of windowing (in the FFT windowing mode field). Windowing is a mathematical method to progressively decrease the weight of data points at either end of a sequence of points used as the input of an FFT. These are aimed at limiting the effects of sudden data stop of the edges of the studied data zone. The three options are the three most commonly used methods (triangle, Hamming, Hanning).
7.10.7 FFT power spectrum

As briefly explained above FFT is used to find out how much signal fluctuation exist at different frequencies. Without going into the details, this result is usually displayed as a power spectrum graph, which plots power as a function of frequency. If a spectrum exhibits a peak around some frequency, this means that, within the input data there is significant oscillation at that frequency. For example, if the power spectrum is flat except for a strong peak at 10Hz and a smaller peak at 15Hz, you can conclude that the input signal mainly consists of a combination of a high amplitude sine wave at 10Hz with a lower amplitude sine wave at 15Hz. See below a picture of power spectrums from 2 synchronous EEG and EMG recordings. In this example, it can be seen that on trace n2, the highest energy is found around frequency 5Hz which shows the maximum value for the raw power spectrum (light green trace). It is often interesting to report the frequency that produces the highest power within a spectrum. But if this maximum search is performed on the raw power spectrum data, it may sometimes return a value resulting from a local spectrum peak which does not truly reflect the highest energy frequency zone. To alleviate this: you can define max power low limit and max power search high limit to indicate on which windows the search is performed. you may also indicate a smoothing factor (spectrum smoothing width) used to produce a smoothed spectrum on which the maximum will be detected, as long as it is within the indicated search window. The detected highest power frequency is reported as one of the analysis parameters and also displayed as a red dot on the spectrums.
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figure n88. EEG analysis FTT spectrum panel
7.10.8 FFT power in specified frequency bands

You can define up to 8 frequency bands for which ecgAUTO will calculate a parameter which is the sum of power spectrum within the limiting frequencies. Enter the upper and lower limits in the fields for each band in the appropriate field. Unused bands must contain 0 in both fields - no parameters are returned for these bands. Frequency bands have default labels band_1, band_2, You may enter your own choice of labels, for example alpha, delta. These labels will then be used as column headers of the corresponding parameters produced by the analysis. The software imposes no limits to your choice of frequency limits.The limits can be duplicated and the bands may or may not overlap. On the spectrum graphs, these frequency bands are shown in 2 ways : Frequency limits are shown as horizontal rectangles in the upper half of the graph Power in each band is shown as vertical bars in the lower right, and the number above each rectangle is the power in that band as % of the total power in all bands.
7.10.9 FFT power ratios

Power spectrum data translates the frequency content of the input signal. It also depends on the amplitudes of the input signal. Absolute amplitude are often irrelevant in EEG analysis since they greatly depend on quality of electrode contact with the tissues and other factors. What is usually of more interest, and also provides a more reliable information, is how spectrum power is more concentrated in some frequency bands then in other frequency bands. 129
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To compute such data the software allows you to define up to 4 ratios, using the data derived from FFt computations as inputs. For example, in the picture above, 2 ratios are defined: Ratio_1 as the power in band_2 divided by total power Ratio_2 as the power in band_4 divided by total power
7.10.10
Setting summary
When you close the EEG analyzer settings panel, you see the Analyzer settings panel with a text summary of the current settings. Frequency band limits chosen for FFT analysis are displayed in Hz and with their bpm equivalent.
figure n89.
Analysis settings panel
7.10.11
parameter maximum signal minimum signal epoch duration 130 energy
parameters
abbr max min dur energy power unit description maximum signal within the epoch minimum signal within the epoch epoch duration (is constant if in timebased mode) sum of squares of all data points energy divided by epoch duration (in seconds)
In all cases the analyzer generates the following parameters for each input:
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parameter variance
abbr variance
unit
description sum of squares of differences between data point and average value, divided by number of data points. frequency with the highest power
maximal power frequency
max _power_freq
If FFT mode is on, the analyzer also generates the following parameters: parameter fft total power total power within band x abbr fft total pw band _x unit description sum of total power from each band total power within band x (whose upper and lower frequency limits are defined by the user) band_x_(%) (band x / fft total pw) x 100 band_1_val/band_3_val band_1_val/band_3_val
7.10.12
eeg results
The results of EEG analysis are shown in figure 3 (time-based epochs of 20s with a start shift of 110%).
figure n90. eeg analysis results: time-based, non-contiguous epochs
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Reviewing editing epochs invalidating/revalidating an epoch The invalidation/revalidation process is identical to that used in ecg analysis. view FFT spectrums To view the power spectrum from which the data of an epoch were calculated, highlight the corresponding line in the table of the main screen, then select View eeg FFT spectrum to display the eeg analysis FFT spectrum panel (figure n91). This panel contains: full spectrum graph (light green trace) smoothed spectrum graph (dark blue trace): this trace is used to detect the frequency of highest power (red point) colored horizontal bar graph to show current limits of frequency band colored vertical bar graphs to show power (in %) in each frequency band Information on epoch index, cursor values, scale settings etc.
figure n91.
single epoch power spectrum (EEG analyzer)
displaying FFT spectrums on main panel Use the plot on main trace button on the EEG analysis FFT spectrum panel (figure above) if you simultaneously want to display the spectrum under each epoch in the main panel as in example below. 132 From the menu bar of the EEG analysis FFT spectrum panel, click on settings to open the next panel. Use the buttons to adjust display of the graphs on the EEG analysis FFT spectrum panel and/ or the spectrum display under the main traces.
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On the main trace, the spectrums are plotted using part of the graph devoted to each raw data trace. If you do not want both to superimpose, first set low and high values for the raw data trace scales so that the trace occupies the upper part of its graph, then set the spectrum share of main (%) setting to a low value around 40% so that the spectrum only occupies the lower 40% of the graph. If you do not want to see any grid, set the number of axis didvisions to 1 or, better, set the grid colour to transparent. Any changes to those settings only take into effect when you refresh the graphs (fro example by cliking again on an epoch).
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7.10.13
Exporting FFT spectrums in text file
It is sometimes required to export, for each epoch, the numerical values of the FFT spectrum. To do that you must: Activate the with FFT spectrum in the beats -> txt tab of the List display and text export settings panel. Choose a spectrum export undersampling setting from 1 to 256 (use no export to inhibit export only on that channel). Set a value for spectrum export max frequency (Hz) Validate these settings Run an analysis (changed export settings only take effect for any new analysis) Save the results What this export feature produces: Suppose your compute FFT with 2048 input data points. By design, the FFT algorithm produces a spectrum with 1024 output data values. Be design of the FFT algorithm, each data point of this spectrum represents the power with a frequency band width df = 1 / (n X dt) where : df if the band width in Hz n the number of input data points dt the raw data sampling interval in seconds For example, if the data was sampled at 200Hz (dt = 0.005s), with the 2048 input data points of our example, each spectrum value represents power over an interval of 0.0976Hz. Said differently, this means that the first value of the spectrum represents power between 0Hz and 0.0976Hz, the second point power between 0.0976Hz and 0.195 Hz and so on. In most cases, you will not need such a high frequency resolution (eg having power every 0.0976Hz), and this is where you should the spectrum export undersampling feature. For example, if you set this factor to 8: Spectrum data points number will drop from the original 1024 down to 128, each point of the spectrum representing power within a frequency width of 0.78Hz. Similarly, you will very often have little interest for spectrum data in the high frequency range. Indeed, most studies in EEG do not assess any signal component higher than 40 to 60Hz. To avoid needlessly exporting spectrum data above some limit, use the spectrum export max frequency (Hz) setting.
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Exported spectrum data shows up in the epoch per epoch data zone (also called beat section) of the text file, to the right of any other exported data. If spectrum data from more than one channel is exported, they are appended further to the right. The first label line indicate channel (or raw data input or lead) index, followed by spectrum data index. The second label line indicates the frequency (Hz) at the beginning of the frequency zone of the current data column.
Spectrum export example. Spectrum of the first data channel is exported with an undersampling factor creating a frequency increment per column of 3.125 Hz and export is limited to frequencies below 40Hz. For example, the third column, labeled ch 1 cl 3 and sublabelled 6.25, contains the data power between frequency 6.250Hz and 9.275Hz 135
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Spectrum of the second data channel is exported with an undersampling factor creating a frequency increment per column of 0.781 Hz.
7.11 sleep scoring module (EEG)

Sleep in mammals and birds involves two main stages as measured by field potential recordings: slow-wave sleep, characterized by large-amplitude slow cortical rhythms REM (rapid eye movement) sleep, which is characterized by low-amplitude and faster cortical rhythms. This stage is also known as paradoxical sleep since the EEG patterns are similar to those present during the alert awake state. These two sleep stages alternate in a highly structured way during natural sleep. In sleep scoring, segments of the eeg trace are analyzed for the purpose of categorizing them into one of the stages. The sleep scoring scoring module of of four stages: active wake quiet wake slow wave sleep REM sleep Each segment is an epoch, whose length is defined by the user in the data strip length field. The sleep scoring module uses EEG signals and EMG signals to discriminate between sleep and non-sleep stages.
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eeg analyzer categorizes segments into one
7.11.1 Overview
The algorithm used by the sleep scoring module can be represented by a flow diagram (figure n92). Bolded text represents the user-adjustable settings available in the sleep scoring module (with the exception of the frequency bands, which are nevertheless defined in the eeg analyser settings). In this example we assume that the 3 parameters used as inputs are: Power from emg Energy from cortex Power in the 3-6hz band from hippocampus But of course any other combination of input parameters may also be used. 136 The software does not apply any check on the validity of the chosen parameters to assess sleep stage, nor on the pertinence of the values chosen for thresholds.
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sleep scoring module (EEG)
Is the power of the emg signal in the frequency band 15-33 Hz greater than 0.0010 V2/s? no Is the energy of the cortical eeg signal greater than 4400 V2? no Is the power of the hippocampal eeg signal in the frequency band 3-6 Hz greater than 720 V2? no quiet wake yes REM sleep
figure n92. sleep scoring algorithm
yes
active wake yes slow wave sleep
7.11.2 selecting inputs

To use the sleep scoring module, your configuration must have three inputs, all of which are linked to the EEG analyzer (figure n936).
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figure n93.
three inputs must be selected and EEG analyzer assigned to each
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7.11.3 sleep scoring settings

Sleep scoring settings are accessed in the EEG analyzer settings by: activating Fourrier analysis using the FFT toggle switch then, activating the sleep scoring module using the Sleep Scoring toggle switch; this displays a number of specific settings shown in the figure hereunder.
figure n94.
accessing the sleep scoring settings (circled in yellow)
The user-adjustable sleep scoring settings are those in bold in the algorithm flow diagram (with the exception of the frequency bands, which are nevertheless defined in the eeg analyser settings): lead (input) parameter threshold
condition 1 condition 2 condition 3 Is the power of the emg signal in the frequency band 15-33 Hz greater than 0.0010 V2/s? no Is the energy of the cortical eeg signal greater than 4400 V2? no Is the power of the hippocampal eeg signal in the frequency band 3-6 Hz greater than 720 V2? no quiet wake yes REM sleep yes slow wave sleep yes active wake
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figure n95. sleep scoring algorithm
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inputs Although all three inputs must be linked to an EEG analyzer, the signal may be a different type of biopotential (in the above example, input 3 is an EMG signal). In the above example, condition 1 uses lead 1, condition 2 uses lead 2, and condition 3 uses lead 3, but this is not compulsory. You may use any lead for each condition - it is your responsibility to ensure that your conditions will yield results that are scientifically meaningful. Sleep scoring analysis settings It is not possible to recommend a particular choice of parameters for effective sleep scoring. Different researchers seem to have different opinions; often, however, the following conidtions are used: condition 1: cortical EEG signal, usually power ratio within a specified frequency range condition 2: hippocampal EEG signal , usually power ratio within a specified frequency range condition 3: an EMG or activity signal, usually max value or total power thresholds As regards the thresholds, experts in the field of sleep scoring say that it is difficult or impossible to define threshold values that will produce reliable sleep scoring on different subjects. In general, researchers determine threshold values by trial and error. The Multitrend panel has a special feature for sleep scoring to help users determine optimal threshold values (see next section). multitrend panel provides a special feature in the Multitrend panel to allow you to determine the optimal threshold values. To make use of this feature:
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1. Open the Multitrend graph panel. 2. Set the panel to display 8 graphs. 3. For graphs 1-3, select the Sleep scoring condition (for your convenience, they have the __SLEEP suffix attached).
139 In traces 4-8, select sleep score, active wake, quiet wake, REM sleep and SW sleep: www.emka.fr
4. Trend graphs automatically appear - by default the bar graph display is used (overriding any other choice such as solid circle or small dots):
The current threshold of each input (graphs 1 to 3) is shown as a horizontal dotted red line and its numerical value displayed on the left edge of this line. Each input also has a black triangle at its right side whose tip is initially aligned with the threshold. Move the triangle up and down to adjust the threshold value. As you do so, the analysis results in the Multitrend graphs and the main data table are immediately updated. 140 Please note that manually adjusted threshold values are not automatically fed back into analyzer settings. Therefore, if you want to keep the new threshold values in the configuration for later use, you must return to the EEG analyzer settings panel and enter them manually.
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7.11.4 main panel with display options

figure n96 shows the main panel after sleep scoring analysis. In the data table, the sleep score column contains an integer from 1 to 4 and the columns to the right for each state of each input are either empty or contain 1.
figure n96.
main panel after sleep scoring analysis
In the graph settings panel (Graph Settings or rightclick anywhere in the data window), you can set specific colors to each state (figure n97). These colors are displayed below the first raw data trace of the main panel (figure n96).
figure n97.
assigning colors to each state
7.11.5 SLEEP score manual edition from main panel

Once SLEEP scoring analysis has been performed, the main table shows one line of data per epoch. 141
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Most researchers wish to perform a visual check of the sleep scores produced by the software and have the ability to edit these values. This is possible. SLEEP scores values take any 4 following values: 1, 2, 3, 4 To manually edit: On the main table click on the epoch line to edit; This displays the corresponding epoch in the center of graph, surrounded by a black rectangle. From the keyboard, type any number from 1 to 4 according to your new choice of sleep score. This action immediately: Enters the new value in the sleep score column and adapt the individual score columns accordingly Changes the color of the score display on the top trace Updates statistical step values
7.11.6 SLEEP manual scoring from main panel

Some researchers also wish to manually assign one of many different types of scores. They also prefer to customize the automated scores. The software provides the ability to have up to 18 manual scores. As an example, the settings as in the panel in next figure: Attribute custom labels aSW, bREM, cQW, dAW do automated scores; Allow the us of 2 custom scores; These 2 custom scores: Are labeled aaa and bbb Are assigned to the epoch by typing keys W and 6. In the present example: Typing keys 1 to 4, will assign score values of 1 to 4, with labels aSW etc 142 Typing key W, will assign score value 11 with label aaa Typing key 6, will assign score value 12 with label bbb
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Custom scores can only be assigned trigger keys in the following ranges: 5 to 9 a to z A to Z
Because it would take a long time the software to refresh all graphs and therefore create inconvenience in the ease of use, editions do not automatically trigger refresh of trend graph displays. This can be manually triggered from the multitrend graph panel from the Force plot all points icon. A soon as you perform at least one manual edition, the black cursors used on the multitrend graph panel to adjust sleep scoring threshold turn grey and become inactive. You may make these cursors active again from the Multi trend settings panel by clicking on the sleep_arrow on/of toggle button. When you do that you will be asked to confirm your action, since once the cursors become active again, any action on them will immediately update all sleep score computations, including those you have manually edited, which would be lost. To conclude on the proper sequence of actions to perform sleep scoring : Run automated analysis; From the multi trend graph, perform threshold adjustments with the cursors; Check the results and if required perform manual, epoch per epoch edition of sleep scores; Save the results.
7.11.7 Effect of score manual edition on multitrend graph

Once you start making manual edition of sleep scores, realize that any update of the automatic scoring would replace any manual edition you might have already made. To prevent from unwanted such loss of manual editions, as soon as at least one manual edition is performed, the black arrows of the multitrend panel used for adjustment of automated scoring threshold turn from black to grey and become inactive. 143
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If you agree to lose your manual edition and update automated scoring, you must reactivate the adjustment arrows. To do that, in the multitrend panel, open the settings panel and toggle the sleep arrow button from off to on. Below: Multi trend panel with inactivated adjustement arrows (notice their grey color). Multi trend settings panel, with the sleep arrow button in the centre of the upper section.
7.11.8 Using manual SLEEP scoring only

Some researchers may wish to manually score all epochs, eg make no use of automated scoring feature. To do that, it is best to run an analysis which create epochs, computes data and spectrums, but does not assign any sleep scores so that the score values remain blank until they have manually be assigned a value. 144
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7.11.9 Main trace display in case of epoch overlapping

Very often, the user will set up the software so that successive epochs overlap. This creates a practical difficulty in showing, on the main trace, color rectangles representing sleep scores and/or FFT spectrum. To overcome this, the displayed width of colored rectangles and spectrums is reduced from both ends so that they remain centered on epoch centers but do not expend left and right to the end of that epoch. Next figure shows example of such a situation. The current active epoch, in blue, with a light gray background and labelled bREM actually extends on the whole gray area, overlapping on the previous and following cQW orange epochs. Setting the display mode to only show marks on the active epoch, as in the next figure, makes this easier to understand.
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7.11.10
Main trace display in case of large number of epochs
When the number of epochs displayed on the main trace increases, some features are progressively removed: Numeric values of spectrum grid; Spectrum grid; Label of sleep scores; Spectrum; Zooming in again re establishes the displays of these features.
7.12 epilepsy seizure detection module (EEG)

The EEG analyzer can also be used to detect epileptic seizures from EEG traces. On EEG recordings, epileptic seizures usually show up as clearly marked events, lasting from a few seconds to a few minutes, during which the signal consistently shows higher amplitude variations and low frequency (3 to 8Hz) oscillations. The aim of this analysis is to report each seizure, together with its duration. The statistical tools that operate systematically in ecgAUTO analyzed data then provide values such as: Number of seizures within each analysis step Accumulated seizure duration within each analysis step. Manual edition is also possible.
7.12.1 Analyzer settings

Epilepsy seizure (epilepsy in the rest of this text) detection is tuned using controls at the foot of the EEG settings panel. Software performs the analysis in 2 stages: First step is to detect epochs (computed as described in the EEG analysis section at the beginning of this chapter) for which some parameters exceed a defined threshold. This detection can be performed using one parameter only, or using 2 parameters. In this second case detection can be performed using: OR logic (threshold must be exceeded for parameter 1 OR for parameter 2 for the epoch to be validated) or performed using a AND logic (threshold must be exceeded for both parameter 1 AND for parameter 2 for the epoch to be validated). This choice is defined in the Epilepsy detection setting.
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epilepsy seizure detection module (EEG)
In the example shown in the figure, one epoch will be detected as possible candidate to be part of a seizure if parameter power from channel 1hSO1+_EEG exceeds value 7.00 OR if parameter band_2_val from channel 1hSO1+_EEG exceeds value 0.6
Once the software has detected a number of epochs that satisfy the indicated criteria (parameters exceed thresholds) it sets the EPL_state parameter to 1 instead of not available. The second analysis step is to search for series of consecutive valid epilepsy epochs which are long enough to qualify as seizures. In the above example, a series is a seizure if: It the series it is at least 8 epochs long (minimum seizure length setting) And if it is separated from earlier and later seizures by an interruption being at least 3 epoch long (minimum break length setting). www.emka.fr 147
When a series of epochs has been qualified as a seizure, the software enters its length, both as epoch number and seconds, in 2 parameters named EPL_epoch and EPL_Length With these rules, any interruption in valid epochs which is only 1 epoch long (less than 2) leads to merging the 2 series into one single series. If the resulting series happens to be long enough to qualify for the minimum seizure length requirement, it becomes a valid epileptic seizure.
7.12.2 Analysis review

See in the figure hereunder the result of a seizure detection as shown in the main table. Valid epochs appear as 1 in the EPL_state column. The series of consecutive epochs ends with a value in the EPL_epoch# and EPL_length column. When you click on the line indicating the seizure: You see the last epoch of the seizure sequence highlighted in the middle of the screen (here it is epoch 153) A green rectangle surrounding the complete seizure.
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By using menu item View Epilepsy table, you open the Epilepsy panel (figure below). This panel has 3 lists and one graph.
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List_1, to the left, contains one line per detected seizure. Each line contains: Seizure index Step # to which the seizure belongs Index of last epoch constituting the seizure Site time of this last epoch Length, in epoch number, of the seizure Length in seconds of the seizure Number of seizures in the analysis step to which the seizure belongs
List_2, in the middle, contains one line per analysis epoch for the current seizure active in list 1. Epoch index Step # to which the seizure belongs Index of each epoch constituting the seizure, within that seizure (starts at 1) Index of each epoch constituting the seizure, within global analysis index. This List_2 also contains a defined number of epochs prior and after the seizure. These have a local epoch index reported as (-1), (-2) etc for those before the seizure and (+1), (+2) for those after the seizure. The number of such surrounding epochs is defined as epoch extra number, set to 5 in the printed example above. List_3, to the right, contains one line per analysis step. It shows: Step index Number of seizures per step Total seizure length per step www.emka.fr 149
Lists _1 and _3 are, by default, shown in chronological order, with the first seizure of the file shown first. Two list boxes let you choose to also display according to: increasing or decreasing seizure lengths (List_1) increasing or decreasing seizure number in the step, o increasing or decreasing total seizure length in the step (List_3) These lists are interactive. For example when you click on List_1, List_2 updates to show the relevant epoch list. When you click on List_1 you also see the corresponding seizure in the graph. When you click on List_2 you see the corresponding epoch in the graph as well as the status of condition set in the tuning panel for automated detection of the seizures. For example, in the figure below, on List_2 in the liddle, the active line is that of epoch (-3) that is the third epoch before the beginning of the seizure, and the line above indicates that only condition is used for the automated detection (since only one such line is displayed) and thet the condition is that power should be greater than 12, and that this condition is not presently since power = 1.46, which is why the background is pink.
7.12.3 Seizure edition

Invalidation: Seizure can be invalidated by clicking on the seizure table to select, then pressing suppress or delete. Invalid seizure appears in pink in the list, and as dotted rectangle on the graph. If the active seizure is invalid it shows in red. The invalidated seizure remains in the list but with a null length (s) value. 150 Revalidation: Pressing delete or suppress on an invalidated seizure toggles it back to valid state.
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Editing seizure limits: It will happen that you wish to adjust the beginning and/or the start of a seizure. To do that: From the list, select the seizure you wish to edit; On the Epilepsy_panel graph, position the cursor where you want to indicate the modified seizure beginning, and press f2 (function key f2) to record this position. On the Epilepsy_panel graph, position the cursor where you want to indicate the modified seizure end, and press f3 (function key f3) to record this position. Press f5 to validate and update seizure data. Edited seizure shows in blue in the list and as current seizure on graph. On an edited seizure you will notice that the vertical dotted green lines that indicate the original limits as found by the software are different from the present limits indicated by the blue rectangle. See figure below.
Zooming on seizure graph: If you need to zoom on the seizure graph: Right_click on the zone which should be at the center of the zooming action. Right_click again is higher zoom is needed. Double_click to return to initial display.
7.12.4 Seizure manual addition

It may happen that you want to manually add a seizure that was not detected by the software during the initial automated analysis phase. 151
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To do this: From the main panel graph (and not from the epilepsy panel graph), drag the mouse on the area containing the seizure to create. This creates a red rectangle (figure).
Press Ctrl a (simultaneously the Ctrl and the a keys) to open the beat edition panel.
When the panel appears, the graph shows the seizure start and stop corresponding to where you made your selection with the mouse on the main graph. If you are satisfied with seizure limits, simply press >>Save_beat menu item. If not move the cursor to what you think should be the beginning of the seizure, then click on the epl_start button. Do the same for the seizure end. Click on menu item >>Save_beat. On the Epilepsy panel, the newly created seizure is inserted in the seizure list and shown in yellow. When active it also shows in yellow on the graph (figure below). 152 The newly created seizure is arbitrarily attached to one of the epochs closest to its end. It is also assigned an arbitrary value for its length measured in epochs. What is important is the actual length in seconds which the one corresponding to your manual selection of seizure start and stop.
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You cannot cancel or erase a manually created seizure, but, like for any other seizure, you can invalidate it.
7.12.5 Splitting a seizure in multiple shorter seizures

If the software has produced a long seizure event which you think should be considered as multiple shorter events you may edit doing the following: shorten this seizure, ending it where the first of the shorter seizures should end. use the manual edition possibility to create the other seizure events.
7.12.6 Automatic trimming of beginning and end of seizure events beginning and end
It often happens that automatically detected seizure events are marked as starting a little too early and ending a little too late. This is due to the fact that the first epoch satisfying the validation criteria happens to cover an area with non seizure data and seizure data. The last setting parameter for EPL detection ( extreme_epochs_truncating (%) )at the bottom of the setting panel (see figure above)allows you to say that: Seizure events starts at X% of epoch length within the first valid epoch; Seizure events stop at X% of epoch length prior to the end of the last valid epoch; This feature usually allows you to reduce the number of seizure events that you find necessary to edit manually. If you do not want this feature to function, set the setting value to 0 (zero). When you use it, for example with a 30% value, see that the vertical green dotted line showing the beginning of the first valid epoch comes earlier than the actual reported seizure events in the Epilepsy panel graph: www.emka.fr 153
Also, in the main graph, you see that the green rectangle showing the current seizure event starts at 30% of the current epoch shown in red dotted lines:
7.12.7 Necessary protocol settings

When you run a continuous seizure detection analysis, it is best to run the protocol in continuous mode (see earlier in the ecgAuto manual details about analysis protocol settings). See figure of a protocol instruction sit the continuous_analysis_feature set to on.
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If you need to perform non continuous analysis, for example one analysis step fo 5mn every hour, you will deactivate the continuous mode. In such case, make sure that the max # of beats per step value exceeds the number of epoch you will have in each step, or you will see that analysis has stopped midway into the step, when the number of epochs reaches the indicated value. For example with 5mn steps and epochs which are 2s long with a 50% overlap, you will have a 301 epochs per step, so you need to enter a number higher than 301 in the max # of beats per step setting to obtain full analysis.
7.12.8 Seizure events that occur at the junction of analysis protocol steps
When you run an analysis made of contiguous analysis steps software is able to properly detect and report seizure evnts which happen to be at the junction of 2 consecutive steps. When this happens, the seizure event is reported in the second step (eg the setp that contains the last epoch of the seizure event) regardless of respective seizure length on either step. In other words, even if a seizure event happens to have 90% of its length in step 3 and the remaining 10% on step 4, it is reported in step 4.
7.12.9 Seizure report into text file

Seizures appear in the main table as data lines irregularly distributed within the global lists of all analysis epochs. If you want to export a list that only contains the detected seizures, you may do as follows: Perform the analysis and all the edition you might find necessary; In the List_display_and_text_export_settings panel, open the section->txt tab and make sure that your selection includes the epilepsy table. 155
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The resulting epilepsy table exported to the text file is as shown below in the figure. step# indicates in which analysis step the epileptic seizure was found; abs# indicates the index of the seizure event within the epileptic seizure table. The only parameter reported here is the seizure length in seconds, according to the selection made in the beat->txt tab settings (figure below).
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Seizure report statistics into text file
It is also often interesting to report the number of seizures as well as their total length, for each analysis step. To do that, also include the step section in the export settings, and, in the statistics tab, select the average, number and sum types (figure below).
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The exported text file will then include, for each step, one column with the average length of seizures of the step, one column with the number of seizures, one column with the total length of seizures (figure below).
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building a library
chapter 8. libraries (for ecg analysis)

A library is a group of waveforms used as reference waveforms during ecg analysis. It is saved as part of the configuration; however libraries can also be manipulated as separate items.
ecgAUTO does not add waveforms to the library automatically. In other words, all the waveforms in any
library were originally added by a human. If you are a beginner, you can use a library that has already been created, e.g. a library supplied by emkaTECHNOLOGIES. If you are an advanced user with the necessary user privileges, you can build and edit a library freely. Building a library means adding waveforms to it; typically, reference waveforms are selected from waveforms in the raw data trace (if the waveforms are noisy, you may use an average waveform, which is the average of several beats). Whenever a user adds a waveform to the library, he must position markers for key points such as onset of P wave, R wave peak, end of T wave. Editing a library means adding and removing waveforms, and modifying the position of markers. There is no limit to the number of waveforms in a library - but typically, a library contains 10 to 30 waveforms. Also there is also no limit to the number of separate libraries that you can create. It is common practice to build one library for each species. However, in some cases, there are good reasons to create one library per subject. A library must be loaded for ecgAUTO to be able to perform analysis. Nevertheless, analysis will fail if the reference waveforms in the library are not sufficiently similar to the ecg data. In this case, you must edit the library. This chapter describes how to build your own library to use for analysis. In chronological order, the key steps are: 1. load existing library waveforms (section 8.1) 2. add waveforms to library (if waveforms are noisy you can use the averaging function) 3. edit marks on library waveforms manually; you may use the prepositioning feature to save time 4. delete, disable, enable library waveforms Over time, you can repeat any of these steps as often as necessary, to refine the library for example.
8.1 building a library

When you load raw data into automatically loaded.
ecgAUTO, the library in the configuration (if one exists) is
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You can continue building this library or start from zero. The following options are available:
Library View & edit Library New & replace
This option will delete all waveforms from the loaded library.
Library Load library Load & replace
You must select a library file, which will necessarily be in the format *.ecg.lib After selection, the currently loaded library is closed - any unsaved changes are lost - then the selected library is loaded.
Library Load library Load & append
You must select a library file, which will necessarily be in the format *.ecg.lib After selection, the waveforms of the selected library file are added to the currently loaded library.
Library Import library Import from config & replace
You must select a configuration file, which will necessarily be in the format
*.ecg.cfg
After selection, the waveforms in the currently loaded library are replaced by those in the library in the configuration file.
Library Import library Import from config & append
You must select a configuration file, which will necessarily be in the format
*.ecg.cfg
After selection, the waveforms of the library in the configuration file are added to the currently loaded library.
Library Import library Import from .z results & replace
You must select a .z results file. After selection, the waveforms in the currently loaded library are replaced by those in the results file.
Library Import library Import from .z results & append
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You must select a .z results file. After selection, the waveforms in the results file are added to the currently loaded library.
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Library Load version 1 library Load & replace
You must select a library file produced by ecgAUTOversion 1. After selection, the waveforms in the currently loaded library are replaced by those in the selected library file.
Library Load version 1 library Load & append
You must select a library file produced by ecgAUTOversion 1. After selection, the waveforms in the selected library file are added to the currently loaded library.
Library Save as *.ecg.lib file
Select to save the current librarty as an ecg.lib. file.
8.1.1 adding waveforms to a library

It is assumed that you have already loaded ecg data into ecgAUTO.
8.1.1.1 creating a library waveform from a single waveform

In the main screen, select a portion of the signal from slightly before the onset of the P wave to slightly after the end of the T wave, as follows: click a point in the data window to designate one side of a selection box while keeping the left mouse button pressed, move the cursor to another point release the mouse button to designate the other side of the selection box. Please note that the entire signal between the left and right sides of the selection box is actually selected (there will be no cropping at the top and bottom).
figure n98. main screen with red selection box
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Press the space bar to send the selected portion of the signal to the library panel.
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8.1.1.2 the library panel

We presently suppose that prepositioning is switched off. The information in the librarypanel is divided into several sections (figure n99):
averaging mode section
1 Button to activate or deactivate the waveform averaging mode (described further down in this section).
waveform origin
This section contains: path and name of raw data file, and input from which waveform is derived index of currently displayed waveform (in view field) total number of waveforms in the library (in total# field) active status of the current waveform, indicating whether the waveform is currently enabled or disabled authors name creation date label of selected waveform sample rate of raw data file site-time of R peak mark within the file
mark and cursor data
3 The first column contains information about certain time intervals. The values are updated dynamically as marks are repositioned (or 0 if the mark is not present). Wavelength is given in ms. The start and end are indicated by the square brackets. Capture length is the duration of the signal in the waveform window (corresponding to the duration of signal that you selected in the main screen). As you move the cursor: cur-R(ms) shows the value between between the cursor and R peak mark (in ms) f(cur) shows the voltage of the signal at the time point of the cursor
mark list
4 See list of marks in parameter settings, page 67 for an explanation of the marks. 162
waveform window
5 The portion of signal that you selected is displayed in the waveform window. In some case, ecgAUTO will display more of the original signal at the start or end.
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The square bracks indicate the start and end of the waveform (ecgAUTO attempts to locate these points itself, but you may need to edit them). The signal is red inside the brackets and black outside.
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2 5
figure n99. library panel
8.1.1.3 selecting correct portion of signal for reference waveforms

It is essential that the waveforms in the library are of the correct length. Ideally you should select the signal from slightly before the onset of the P wave to slightly after the end of the T wave (see figure n100).
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waveform of correct length
waveform starts too early and ends too late
waveform is too long (more than one complex selected!)
figure n100. selecting part of signal for use as a library waveform
8.1.1.4 creating a library waveform from an average waveform

allows you to create a library waveform by taking the average of two or more waveforms.
ecgAUTO
This is particularly useful when you have a noisy signal. Compared with a non-averaged waveform, the averaged waveform will - in most cases - be less noisy and a better representation of the true ecg complex. 164 The averaging function uses the waveforms which are currently displayed in the data panel of the main screen (either all of these or a subset of these).
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procedure 1. By default, averaging will be done on the segment of signal data that is currently displayed in the data panel of the main screen. If you accept this default, select Library View&Edit in the main screen. If you want to average only part of the segment showing in the data panel: select a portion of signal (using the standard method). then press Ctrl-W to open the library panel. 2. In the library panel, click or select Waveform Average to open the Average
figure n101. average Waveform panel (before data loaded)
3. Click Load data! to load the signal data (part or all of the signal currently displayed in the data panel of the main screen).
Display 1 (signal from data panel in main screen)
Display 2 (reference waveform)
Display 3 reference waveform average waveform figure n102. Average Waveform panel (after data loaded)
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There are three displays in the Average Waveform data panel. Display 1 contains a portion of the signal (specifically the portion that is currently displayed in the data panel of the main screen). will calculate the average waveform using waveforms (data waveforms) in this portion of signal. In the next step, you define criteria to allow ecgAUTO to select which data waveforms to use in this calculation.
ecgAUTO
Each data waveform is associated with a bar. The height of the bar indicates the similarity with the reference waveform, from 0 (no resemblance) to 1 (identical). The bar is grey for data waveforms included in the averaging calculation and green those not included in the averaging calculation. Display 2 contains the reference waveform. Display 3 contains the reference waveform and the average waveform. 4. Define the criterion to allow ecgAUTO to select which data waveforms to use in the averaging calculation. You must use one of two methods, by selecting from the dropdown list: min correl. In this method, ecgAUTO will select data waveforms that are at least x% similar to the reference waveform, where x is the value in minimum correlation (between 0.8 and 1). The red horizontal line in Display 1 reflects this value. best n waves - ecgAUTO will select the x most similar data waveforms, where x is the value in wave number. As you modify the criteria, you can see instantly which waveforms are included or not (display 1) and the resulting average waveform (display 3). 5. To use a new set of data waveforms: move along the data in the main screen select Load data! Then select Get wave to update the resulting average waveform. 6. When you are satisfied, click Save wave to transfer the average waveform to the Library panel. 7. Enter a name for the average waveform in the wave label field. 8. Save the ecg configuration, by selecting File Save as or File Save in the main screen. automatic application of averaging By default, you must apply averaging to every reference waveform. However, you can tell ecgAUTO to apply averaging automatically. In this case, every time you select a portion of signal from the main screen, ecgAUTO opens the Library panel containing the average waveform. It remains possible to go into the Average Waveform panel and adjust the settings manually. 166 In the toggle switch, located on the top left of the Library panel (figure n103), select whether you want ecgAUTO to always or never apply averating automatically. for
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figure n103. averaging toggle switch
position marks During analysis, ecgAUTO uses the marks in the reference waveforms to position marks in the ecg data. You do not have to position all the marks on every reference waveform (except R which is compulsory). For example, if you only want to perform QT measurements, you only need to position marks R, <Q (start of Q wave) and >T (end of T wave). This also speeds up data processing. Prepositioning is an ecgAUTO function that automatically positions markers. However, this process is not 100% effective. As the name implies, you should manually position marks after prepositioning. Nevertheless, it can save time. The next sections describe how to position marks manually and how to activate prepositioning.
8.1.1.5 positioning marks

In this section, it is assumed that prepositioning is not active. Only one mark should be present on the waveform (R) (figure n104).
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figure n104. positioning marks (start)
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The procedure to position a mark is as follows: 1. Select Waverform Edit or click on the icon available (figure n105). the toolbar. The mark list becoms
The left column contains a list of marks as well as the start and stop marks for the selected waveform. The number in the right column is an index for acquisition points (from the left of the data window, not the start of the waveform). 0 indicate that the mark is not available. Marks which are required to calculate the current parameters are highlighted in yellow.
figure n105. mark
2. To position a mark: position the cursor at the correct time by clicking on a point within the data window (the cursor does not have to be on the signal) click the corresponding mark in the left column. For example, if you are positioning the <P mark, click the <P button to position the mark. When you click, a mark appears on the signal (as a short vertical line) with a label, and the acquisition point index number is updated Repeat the procedure as many times as necessary to correctly position the mark. For more precision, position the cursor on the area of interest, then right-click to zoom in. Each right-click cycles through 5 different zoom levels. To remove a mark, double-click it on the left column. To remove all marks at once, click clear. The software does not perform any checks on the appropriateness of the marks from an ecg point of view. The only checks performed are for the correct chronological order of marks (for example <P should be before P). 168
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To return to the main screen without saving your modifications, select Cancel. 3. When you have positioned all required marks (as in figure below), click Save then Close.
figure n106. positioning marks (end)
prepositioning To switch prepositioning on or off, select Settings in the Library panel then set the preposition marks feature ON or OFF as desired. . When prepositioning is activated, ecgAUTO immediately prepositions markers on a waveform as soon as you have selected one from the main screen (as in figure below).
figure n107. library panel with prepositioning activated
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You can activate/deactivate prepositioning for individual marks by double-clicking in its field in the second column. Marks for which prepositioning is activated have a green background. www.emka.fr
Of course, prepositioned marks remain fully editable. note regarding prepositioning Please be aware that prepositioning is a feature designed to save time when building up a library. It should be used in addition to, and not instead of, manual mark positioning. The algorithm used for prepositioning is quite simple. In particular, it presently only operates on complexes with a clearly positive peak. It will therefore never work on negative peaks, found on some ecg leads. In some situations, this algorithm will fail, either returning no marks at all, or returning slightly or totally wrong positions. Of course, the algorithm used for prepositioning marks is completely different to the sophisticated algorithm used during ecg analysis. If you notice that marks are poorly positioned during prepositioning, this does not mean that marks will be poorly positioned during ecg analysis (unless of course, you do not manually edit the prepositioned marks in the library waveforms!).
8.1.1.6 finish defining the waveform

When all marks are positioned, give a name to the waveform in the wave label field(1). Waveform labels do not have to be unique. If you want to give the same label to more than one waveform, use the drop-down list next to the wave label field containing all used labels. Save the ecg configuration, by selecting File Save configuration as or File Save configuration in the main screen, or by clicking on the icon At any time, you can exit the library panel without saving your changes by selecting Edit
Close
8.1.2 other waveform operations

After adding a waveform to the library, if you want to access it again (to edit, to delete, to disable/enable), you must pass by the MultiLibDisplay panel, which can display more than one waveform at once. MultiLibDisplay panel To open the MultiLibDisplay panel (figure n108), click on the icon or select Edit Multiview from the Library panel.The MultiLibDisplay panel displays waveforms in a matrix in order of their index number.
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(1) This wave label is just a label - its only purpose it to allow you to remember the type or origin of the waveform.
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index number/ total number of waveforms
enabled disabled
figure n108. MultiLibDisplay panel (left) displays several waveforms (right)
The icons in the tool bar, from left to right are as follows: pin window enable / disable all waveforms change table size. In the example shown, the table is set to 3 x 3 (3 columns x 3 rows). The drop-down menu has different table sizes. all automatically selects the option permitting display of all waveforms print current page print all pages shift the waveforms so waveform 1 is in the top left position shift the waveforms back 1 screen / 1 waveform shift the waveforms forward 1 screen /1 waveform zoom in / cancel zoom / zoom out show/hide mark names / marks / waveform label / used Click on a waveform to load it into the main Library panel. to delete a waveform In the Library panel, click on the icon form (currently displayed) from the library. to disable/enable a waveform All waveforms are either disabled or enabled (by default they are enabled, when you create them). When you perform an ecg analysis, only enabled waveforms are taken into account. 171 or select Waveform Erase to remove the wave-
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So, for example, if you have built a library of 20 waveforms, and want to run an ecg analysis using only 5 of the 20 waveforms, you can disable the 15 waveforms rather than delete them. Within the MultiLIbDisplay panel, double-click on a waveform to toggle between the enabled and disabled states. You can disable/enable all waveforms at once, by using the icons in the MultiLIbDisplay tool bar. The enabled/disabled state of each waveform is part of the waveform data; thus, when you load a library, you also load the enabled/disabled state for each beat.
8.2 display settings

Select Library Edit Settings in the Library panel to open the Library settings panel (figure n109):
figure n109. Library settings panel
The available options are:

save config when saving wave
When you select Save in the Library panel, ecgAUTO saves the changes that you have made in that panel since you launched ecgAUTO. If you want to use those changes the next time you launch ecgAUTO, you must save the configuration as well. If this option is on, every time you select Save in the Library panel to save the changed you have made in that panel since you ecgAUTO is open, ecgAUTO also saves the configuration. 172
show wave used for beat
If this option is on, when you click on an analysed beat in the main table, the Library panel (if open) will automatically show the wave used for the analysis of this beat.
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display settings
propose wave label as
If this option is on, you can define the default waveform label propsed by ecgAUTO: file name, lead name, file + lead name, lead + file name. In all cases, the label can be edited before the waveform is saved.
grid on wave graph
Set this option to on to display vertical gridlines.You must then select: the spacing (5, 10, 20 ms) in the grid centred on option that appears, whether the zero point of the grid is aligned with the R peak or positioned wherever you click on the graph Please note, if an R peak is not defined, no grid is visible, whatever the setting.
cursor style
Select from small point, vertical line, long cross.

preposition marks
Described in section 8.1.1 .

display horizontal line / display derivative
As with the main screen, you can display a horizontal line or the signal derivative.
graph background color assign created wave to lead
In multilead ecg analysis, by default, all waves are tested on all leads. To save time, not testing waves that obviously correspond to another lead, or avoid poor analysis, it is possible to assign created waves to lead.
show sampling points
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building a protocol
chapter 9. defining and running protocols

A protocol is a set of instructions which defines one or more segments of data on which ecg analysis will be performed. Each segment is called a step. A protocol contains one or more instructions. Each instruction defines a series - or a train - of steps. Many instructions are used to define a more complex protocol. An example of a simple protocol with one instruction, expressed in plain English words, is: Perform this operation 24 times: analyze 30 seconds of data, then move forward 4 minutes and 30 seconds
9.1 building a protocol

9.1.1 Marks and protocols window
From the main screen, select Analysis Marks and protocol or click on the icon open the window of the same name (figure n110). 1 2 to
figure n110. Marks and protocol window
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The different parts of this screen are: tool bar 1
From items in this tool bar, from left to right are as follows: pin window Edit instructions supress mark protocol analysis step-list shift the schema to the beginning shift the back 1 or screen backwards zoom in / cancel zoom / zoom out shift the schema back 1 or screen forwards shift the schema to the end update the study schema print full panel help list of marks 2
Including comments and Zones. If you have done non-continuous streaming, a stream-start and a stream-stop mark will be added to each streaming segment. Streaming segments are automatically indexed. In the marks table, the marks [n and n] indicate the start and end, respectively, of the streaming segment with index number n. Furthermore, the duration of the segment and the duration of the previous data gap are shown.
figure n111. streaming segments are automatically indexed
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list of protocol instructions
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study schema
The study schema provides a graphical overview of your experiment. The lowest row contains the time line of the whole study (in site-time). Above this line are plotted the time point or period corresponding to periods, experimental marks (i.e. comments and Zones), streaming bar (green where streaming data are available; otherwise blank); one row for each instruction defined in a protocol (filled where steps are defined; otherwise blank).
periods comment timepoint zone
marks
streaming bar instruction rows site-time steps figure n112. study schema
Use the vertical slides on the left side of the window to redimension the vertical space or optimize how much space is devoted to the 3 possible displays
9.1.2 defining instructions

Choose on Protocol Edit instruction or click on the icon instruction list to open the Edit protocol panel (figure n113). or double-click the protocol
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2
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figure n113. Edit protocol panel (left) and sections for different steps in defining instructions (right)
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define the train start and reference period (step 1) Choose a type of reference period from among: stream-start (a streaming segment), range, range named, comment, comment named, zone, zone named, or CPU time. The named options allow you to choose from among all the ranges, comments or zones (as the case may be). For all reference period types except CPU time, there are several fields to define where the train potentially starts and which periods are potentially included in the train: The first reference period (e.g. the first range, the first comment, first zone) or a specific occurrence of the reference period (if you chose a named option) is used to define the start of the train (i.e. where the first step starts). If [ is selected,the train starts at the start of the reference period. If ] is selected,the train starts at the end of the reference period. If 1/1 and all are selected, all periods are potentially included in the train. To exclude some periods at the start or end, select from first+ until last- from the drop-down menu. Then define: how many periods to exclude from the start (from first+) how many periods to exclude from end (until last-)
To only include one in every n periods, enter the value of n e.g. 1/2 or 1/3 If you select CPU time, the time you enter is the time of day at which the train starts.You can also: define an offset in number of days (day+ field), force the train to end at midnight by entering -1 in the day+ field.
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Examples of train start definitions potential steps (further refined by train-stop settings)
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refine the train characteristics and define the train end (step 2 infigure n113) In the train stop field, you define how the train will stop. The available options for: stream stop: the instruction fits as many steps as possible until the next streamstop mark period stop: the instruction fits as many steps as possible until the next period-stop mark zone start: the instruction fits as many steps as possible until the next zone start mark zone stop: the instruction fits as many steps as possible until the next zone stop mark comment: the instruction fits as many steps as possible until the next comment max step number: the instruction consists of the maximum number of steps as defined in the max step number field. The value in the step length field defines either the minimum duration of each step (if continuous analysis is off) A step will not be created if there are not enough streamed data to meet this criterion. The limit is 1 hour although we recommend much shorter steps, in the range of 20 s to 2 min. the maximum duration of each step (if continuous analysis is off). The offset time field defines an offset of the whole train. It may be positive or negative or 0 (for no offset). The continuous analysis setting works as follows (we assume here that streaming is on throughout the recording): if continuous analysis is on, ecgAUTO creates a train of steps of equal length. First, it creates steps with a length as specified in the step length field. Second, it slightly extends the end of each step to achieve overlap. In this way, complexes that lie across two adjacent steps are not missed (ecgAUTO makes sure not to report the same complex twice). if continuous analysis is off (default setting), ecgAUTO creates a train of steps, where the length of each step is determined by other settings (e.g. Max # of beats). If continuous analysis is off (default setting) and train stop field is max step number You must also define: the time interval between the start of two successive steps in the Step increment field. So, for example, if step length is 30s and step increment is 2 min, then 30 s of data will be analyzed, then 1 min 30s of data skipped, then 30 s of data analysed, etc. maximum number of complexes which will be analyzed on each step, in the Max # of beats per step field. This number may not be reached if the step is too short, or complexes cannot be processed.
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Tip: If you want to almost certainly obtain an identical number of analyzed complexes for each step, specify a step length well in excess of what is strictly needed to theoretically find the request number.
max step number: maximum number of steps in a train (this option is only available when train
stop is set to max step number).

max # of beats per step: maximum
analysis is on).
number of beats for each step (not avaiable if continuous
min # of beats per step:
minimum number of beats required for each step. If this minimum number is not reached, ecgAUTO stops and issues an explanatory warning. If this value is set to 0, the analysis will not stop, regardless of the number of steps, if any, found in each step.
min success rate: when the analysis of a given step is completed, a success rate is computed.
If this success rate is below the required minimum, no values are reported for the entire step - just as if no beats had been detected in the whole step.
The keep beats with less noise function takes into account user-specified values for minimum (MinN) or maximum (MaxN) number of beats: if keep beats with less noise is off, ecgAUTO keeps the first MaxN beats that it can process then moves to the next step if keep beats with less noise is on, ecgAUTO analyzes as many beats as possible within the step, then, if there are more than MinN processed beats, it keeps the MinN beats with the lowest noise. note: activating the option Keep beats with less noise may lead to longer processing time and increases the proportion of non-consecutive beats in the results. The consecutive beats setting is only available in intervals search mode when continuous analysis is off. When it is active, you must provide criteria to define a specific sequence of consecutive beats - the target sequence. Only beats from the target sequence are kept; if a target sequence cannot be found, no beats are kept. There are four modes of action: off step beginning: The target sequence is the earliest sequence of at least n consecutive beats, where n is the entered value. If the target sequence has more than n beats, only the first n beats are kept. note: other settings influencing the number of beats in one step are ignored step center: The target sequence is the series of n consecutive beats whose middle beat is closest to the middle of the step (n is the entered value).
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An example illustrates this mode: you enter a value of 13 the protocol instruction defines steps of duration 1 minute the target sequence for each step is the sequence whose middle beat (i.e. seventh beat) is closest to the time point of 30 seconds. Please bear in mind that in this mode, the length of sequences is fixed. So, to continue the example, ecgAUTO will consider 15 consecutive beats to be 3 sequences of 13 beats each (1st to 13th beat, 2nd to 14th beat, 3rd to 15th beat). longest: The target sequence is the longest sequence of consecutive beats - if there are two or more sequences of this length, the earliest one is used. No beats are kept if the target sequence has fewer beats than specified in min # of
beats per step.
The max # of beats per step setting is also respected (excess steps are excluded). The allow step-start shift functionality is a very useful functionality for certain types of experiments. Suppose that you are performing telemetry experiments: you have used a protocol in which streaming occurred for 1 min every 10 min.Your data file thus contains 1 minute of ecg data every 10 minutes. you entered event markers such as treatment, feeding etc. When creating these markers, you probably did not, or could not, wait until the acquisition software was effectively acquiring data to create the event marker. As a result, most of the event markers are positioned at times where no data are available. you want to create a protocol to start analysing at the treatment mark. It is probable that no data will be associated with the step so analysis will fail. In situations like this one, the solution is to activate allow step start shift. Essentially, this features provides ecgAUTO with flexibility to adjust where each step starts. Specifically,ecgAUTO behaves as follows: if the whole step is inside the streaming segment, nothing happens. if the step-start is not outside a streaming segment, it is moved forward to the start of the next streaming segment. if the step-start is within a streaming segment but too close to its end, it is moved backword to try to fit the required analysis length inside the streaming segment. Some examples are given overleaf. 182
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building a protocol
A C B D
The train will not go beyond the zone-stop (A). Steps ( ) are continuous (B). Each step is around 15 seconds long (C) and has at least 3 beats (D).
A C B D E
The train will not go beyond the zone-stop (A). Steps ( ) are continuous (B). Each step is no longer than 15 seconds (C) and has between 3 (D) and 6 beats (E) inclusive.
other settings In Step color & label, select the step color and a label for each instruction. This color will show on the study schema, in the beat and report tables, as well as (if required), in the average beat display of the Report panel. Two other options (step 3) s are useful when building up a protocol: n/t n is the current instruction being edited, t is the total number of instructions. Enter a value for n to go directly to that instruction. on/off button This button is a toggle switch to disable/enable instructions individually. This function is useful when you are building a long protocol.
9.1.3 setting protocol-wide settings

In the bottom left (step 4 in figure), you make protocol-wide settings (settings that apply to all instructions). If include invalid steps is on, the protocol will take into account invalid steps. If stop if success or beat # < min is on, a protocol-based analysis will stop if the success rate or number of beats per step is less than the specified minimum. 183
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9.1.3.1 exclusion zone

It is possible to exclude Zones from the analysis. To do so, set the switch to on. The zone exclusion panel appears (figure n114). Zone exclusion panel (visible when option is activated)
figure n114. Zone exclusion activated in Edit protocol panel
In the upper field select a Zone from the drop-down list. Click on field to transfer the selected Zone to the list of excluded zones. To remove a Zone from the list, double-click on it within the list.
or double-click in the
In the experimental shema of the Edit Protocol window, the Exclusion zones appear as dark green rectanges in the light green streaming row (figure n115). note: if any part of a step falls in an exclusion Zone, the whole step is excluded from the analysis.
excluded Zone
figure n115. Zones excluded from analysis are visible in the Edit Protocol window
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example protocol
9.1.4 transfer instruction to protocol

There are several menu options for transferring the instruction on display in the Edit protocol panel to the list in the Marks and protocol panel. to add the instruction to the end of the list, click Append to insert an instruction before an existing instruction in the list, first click on the existing instruction in the list, then click Insert to replace an existing instruction, first click on the existing instruction in the list then click Replace . to delete an existing instruction, first click on it in the list then click Suppress As soon as a protocol instruction is added to the list, its effect (if any) is shown in the study schema. Each instruction has its own row. Steps display as filled rectangles (red by default). An index is shown next to the first step of each each train. Sometimes analysis will not occur for some of the steps that you define, for example when there are no streaming data available, or when it overlaps with another step. Such steps appear as unfilled rectangles (see figure n116).
figure n116. step information provided in Marks and protocol panel
9.2 example protocol

You have a streaming segment lasting several hours and you want to perform the analysis: In the first hour, analyze segments of 30 seconds, every 5 minutes. Then, analyze segments of 15 seconds, every 15 minutes. This can be achieved with the following instructions (the main parameters are circled):
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figure n117. example of a protocol
9.3 behaviour of protocol-based analysis

It is useful to highlight some points about protocol-based analysis, to help you understand what you see. Trains are not allowed to overlap. If your protocol defines trains that overlap, ecgAUTO ignores all overlapping steps of the train defined earlier in the protocol. figure 80 shows how overlapping is handled in a protocol with these two instructions Starting at 10 minutes before the first streaming segment, go through every streaming segment and analyze 120 seconds of data every 3 minutes. Only use 10 segments of data (steps) in each train. (Instruction 1). Starting at the first streaming segment, go through every streaming segment and analyze 120 seconds of data every 3 minutes.Only use 2 segments of data (steps) in each train. (Instruction 2). The user probably entered an excessive number of steps (10) to cover the first segment, knowing that the steps in excess would be superceded by the second train .
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behaviour of protocol-based analysis
figure n118. example of overlapping protocol
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ecgAUTO version 3.0 user manual
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local analysis
chapter 10. analysis

In ecgAUTO you can perform a local analysis or a protocol-based analysis. In a local analysis, ecgAUTO analyses a short continuous sequence of ecg data. Local analysis is useful for testing the efficacy of a library - when you are building or refining it. Protocol-based analysis is the standard analysis mode, which uses the currently loaded protocol. If no protocol is defined, protocol-based analysis cannot proceed. This chapter describes how to perform each type of analysis, and settings for each.
10.1 local analysis

It is assumed that data and a library are loaded. Before analysis, the main screen appears as in figure n119.
figure n119. main screen before local analysis
In the secs fields of the toolbar, you can define the width of the data panel. The local analysis is an analysis performed on the data showing in the data panel (as described below, in some cases, the analysis is stopped before the end is reached). In the adjacent beats field, you define a maximum number of fully analyzed beats for the local analysis.
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ecgAUTO version 3.0 user manual analysis
For example, with these settings:
The local analysis will continue until either 10 beats or 3000 ms data have been analysed whichever occurs first. To launch local analysis, select Analysis Local Analysis or click on one of following three buttons of the toolbar:
the middle button launches local analysis on the data currently displayed in the data panel. the left/right buttons scroll the data panel backwards/forwards by one panel width then perform the local analysis. For example, if the data panel has a width of 5 seconds and is currently displaying data between 10 s and 15 s, clicking the right button will scroll the panel forwards to display data between 15 s and 20 s then perform the local analysis.
At the end of the analysis, the results are displayed automatically (figure n120):
parameters have been added to the table
figure n120. main screen after local analysis
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The table (figure n121) contains a line for header information, every fully processed beat and comments. The different columns of the table are as follows:
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local analysis
cpu-date / cpu-time:
date and time when the complex was recorded (in the iox acquisition software). This makes it possible to know, for example, that the complex was recorded on December 5, 2001 at 08 h 30 m 10s. This information is based on the time of the acquisition PC, more specifically its central processing unit (CPU).
site-time: time position of the complex (measured at the R peak) within the data file. The start
point (time=0) is taken at the first mark.

period-time:
time position of the complex within the current period; If the complex is not inside a period, no value is available.
step #:
index number of step.
step-label: label for step (if defined). rel#, abs#: index
number of the waveform within the step (relative) and within the complete analysis (absolute).
wf#: index
number of the library waveform used to analyze the complex. of the library waveform used to analyze the complex..
wfName: label
Following columns contain parameter labels. Typically, users will se standard labels such as PR duration, QRS duration and QT duration.
Edit-comment (not in figure): this column is automatically added to the table whenever beat
measurements are manually edited.
figure n121. table after local analysis
Click on one of the analyzed beats in the table to zoom in on a waveform, as shown in figure n122. Display options are adjustable (see next section). In the toolbar you can adjust the width of the zoomed view by changing the value in the ms field.
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parameter labels (blue guidelines show calculations)

width of data panel
mark labels and tick line
Rn where n is index number of complex
index number and label of the library waveform used
pink zone = active complex

figure n122. data panel after local analysis
blue zone = parts of the data that could not be analyzed
10.1.1 local analysis via slider or F12 key

It is also possible to perform a local analysis using the horizontal slider or F12 key. To use the horizontal slider: you must first activate the slider by right-clicking in the colored part, which becomes pink when active (figure n123).
right-click on the coloured part of the slider to switch between active and non-active state figure n123. activate/deactivate the slider (for local analyis)
When the slider is activated, click anywhere on the slider to scroll the data panel then perform a local analysis from that point. F12 key: 192 Press F12 to trigger local analysis from the cursor position in the main screen.
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local analysis
10.1.2 display options

You can adjust display settings for the data panel and the table. data panel display option Right-click anywhere in the data panel to open the graph settings panel (figure n124). You can also open this panel by selecting Graph Settings from the main panel.
figure n124. display options for data panel
In the left and middle columns, use the toggle buttons to show/hide certain marks and parameters. As a reminder, R is the R peak of the previous complex and RR is computed from R to R. These buttons are always present, regardless of whether the corresponding parameter is compute or available. The switches in the right column are for the following: mark labels - show/hide mark labels. If the horizontal scale is insufficient to display all labels, some or all are hidden. In this case, zoom in to see them all. R index - show/hide the index number of the complexes. waveform index - show/hide the index number of the library waveform used select the background color for: active beat, invalid beat, edited beat, added beat, gaps marks on active only - only display the markers and parameters for the active complex (ie the complex selected from the beat table). show extra R peaks - to show position of all detected R peaks. This option is only relevant when extra beat detection is active.
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table display options Right-click anywhere in the data panel to open the main table tab of the List display and text export graph settings panel (figure n125). This panel can also be accessed by selecting Tune
Parameters to list/file
figure n125. table display options
The left list shows all available items, and the right list show selected items (which will be displayed in the table). Double-click on an item in the left list to move it to the right list. Double-click on an item in the right list to remove it. Click Apply ! or OK! to apply your settings.
10.2 using a protocol to perform an analysis

It is assumed that data and library are loaded and a protocol has been created. Different stages described below are: select steps to be analyzed (this is an optional step; by default all steps are analyzed) (section 10.1) launch the analysis (section10.2.2) assess the effectiveness of your analysis in the Frozen Success rate panel (this is also an optional step, but useful to refine your library) (section 10.2.3).
10.2.1 select steps to be analyzed

194 By default, all steps are analyzed. However ecgAUTO gives you the possibility to select which steps to analyze.
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using a protocol to perform an analysis
This functionality is typically used in the following way: user defines a protocol that produces a number of (usually consecutive) steps around the theoretical time points where analysis needs to be performed, user selects the step to be analyzed from among each series of steps around each theoretical time point. The selection is usually a compromise between signal quality and proximity from the time point. For example, if measurements are required at 1 hour after treatment, the protocol may define 5 steps starting at 2mn, -1mn, 0mn, +1mn and 2mn around the time point. The user may then decide that the best signal quality is obtained for the step from +1mn and select that one even though it is not exactly at the theoretical time point. The procedure is as follows. 1. Open the Step control and export selection window (figure n126), by selecting Step list in the Marks and protocol window, (Analysis Marks and protocol) or clicking on the icon . The upper window contains all the steps, while the lower window contains all selected steps. 2. Select steps defined from protocol in the drop-down menu. 3. Under reference marks, you can select up to 4 reference marks from all marks. 4. Click on a step to highlight it. When a step is highlighted, the step time from reference marks fields displays the difference between the step and the respective reference mark. In the upper window, double-click on a step or press the space bar to select/deselect a highlighted step (your changes are instantly applied in the lower window). In the lower window, press the space bar to deselect a highlighted step . If you want, ecgAUTO can provide a visual indication of which reference marks are within a specific time from the highlighted step. To activate this functionality, set step label from reference mark to ON then enter the desired time period in max time to mark. The reference marks within the range are highlighted pink. 5. When you have made your selection (an example is shown infigure n127), select
Close!
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figure n126. step control and selection tab (when opened)
figure n127. step control and selection tab (after selection of steps)
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10.2.2 launch analysis

To launch a protocol-based analysis, select Analysis Protocol-analysis in the main screen or the Mark and protocol window. or click on the icon
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using a protocol to perform an analysis
Progress can be followed in several ways: in the main screen: the time displays are updated and the horizontal slider moves accordingly. Each data trace, markers, and data table entries are updated on the fly. in the Marks and protocol window, the red cursor moves in the Analysis report panel, calculated parameters values appear as soon as available the specific Run information panel (figure n128), provides real-time information during analysis. The green bar show progress within each step, while the the blue bar shows progress within the whole protocol. There is a vertical red bar for each step. The height of this bar indicates: (if Continuous analysis is on) the number of beats in each step (the scale is automatically adjusted) (if Continuous analysis is off) a percentage of number of analysed beats in the step, with 100% representing the max beat number specified in the protocol ( Max # of beats per step field.
figure n128. run information panel
You may terminate an analysis in progress by pressing esc. The software will stop after completing analysis on the current step. A panel asks you to confirm the termination or resume the analysis. At the end of the analysis, the results are displayed automatically (just as they are after a local search (figure n120). Information about the effectiveness of your protocol is available in the Frozen success rate panel, described next.
10.2.3 frozen success rate panel

When a protocol-based analysis has been performed, select View Success frozen view, or click on the icon to open the Frozen success rate panel . 197
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The six bar graphs are blank the first time you open the panel within a work session. Select load data! to load data (figure n129).
figure n129. frozen success rate panel after protocol analysis
The 6 bar graphs display parameters to allow you to evaluate the effectiveness of your analysis. Each bar represents a step. The parameters are:
beat number:
number of beats of gaps
gap number: number
analyzed zone length (s): time from R of first analyzed complex to end of T of last analyzed
complex
success % (time based): sum
of RR of all analyzed complexes divided by analyzed zone length
success % (beat based): number max consecutive number:
of analyzed complexes divided by total number of R peaks detected by the extra beat detection feature. the current step. maximum number of consecutive fully analyzed complexes within
If you click on one of the bars, the data and the table on the main screen are centred on the corresponding data. The bar graphs are updated when you click load data. In other words, they are not automatically updated when you perform a new local or protocol-based analysis (this features allows you to use this panels local analysis feature to see the effect of library modifications on efficiency of analysis).
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reviewing and processing results
the Frozen success rate panel in practice Suppose you have performed a long protocol analysis. Opening this panel might show you some steps for which the analysis was not very effective (e.g. there are fewer detected complexes than otherwise achieved or expected). If there are areas in which analysis was not very effective, it may be possible to remedy this by refining the library. Proceed as follows: click on one of the poorly analysed steps if the signal is acceptable, add a library waveform based on the signal make sure that local analysis is activated (use the local analysis toggle switch )
local analysis is activated
with local analysis activated, when you click on a bar, ecgAUTO perform an analysis limited to the step to which that bar belongs, then updates the Frozen success rate panel. This allows you do see the effect of your your waveform modifications on the analysis. repeat the process for other poorly analysed steps
10.3 reviewing and processing results

10.3.1 raw data display
Select View Raw data traces to display the raw data window (figure n130). 199
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figure n130. Raw data panel
navigation toolbar
From left to right, the items in this tool bar are as follows: pin window perform a local analysis (more specifically, the data in panel are loaded into the main screen data panel, then a local analysis is done) adjust traces: see section on settings. transfer to main panel: filters the displayed zone and sends it to the main screen. scroll to the beginning of the data scroll 1 or screen backwards scroll 1 or screen forward scroll to the end of the data zoom in / zoom out time width (in sec) of displayed data create comment: covered in section 10.3.7 comment function key: Opens a panel allowing you to enter a label which becomes a comment positioned at the time where the active cursor is positioned. After validation, the label appears on the data panel. Print: prints raw data cursor toolbar 200 site-time of the two cursors time between the cursors
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time toolbar
From left to right: Site time in day, hour, min, sec Period time (in hour, min, sec) and the color, name, concentration and concentration unit of the period (these items only visible if the data are already positioned within a period) CPU time and date. note: the middle of the data is used as the reference time point slider The site-time of the start and end of the displayed data are shown. memorize a time point
ecgAUTO
time.
can memorize a time point in your data so that you can return to it instantly at any
To do so, left-click to position the cursor at the point of interest, then right-click to move the point of interest to the middle of the screen and to memorize the time point. From now on, a doube-click will move the data to the point of interest (which will be centred in the data panel). Of course, another left-click/right-click will memorize a new time point. browse using marks The Marks and protocol window and the raw data panel are dynamically related: as you move along the data in the raw data panel, the red cursor moves in the schema of the Marks and protocol window (with enough magnification, you can see that the cursor is actually a red rectangle) when you select a mark in the Marks and protocols window, the displayed data in the raw data panel are also updated.
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figure n131. Marks & protocol and the raw data panels are dynamically related
display settings Click on or select Raw data Adjust traces to open the Trace display settings panel.
This panel contains one line for each input in the loaded data file. As you modify settings, there are immediately applied in the raw data panel (figure n132). From left to right the available settings for each input are: two horizontal slides, to specify the Y offset and Y dynamic of each trace (by default, each trace is assigned an identical proportion of the vertical space) trace color in the on column, click on the button to show/hide the trace. in the scale column, click to select the trace to be used as the Y scale. input label, measuring units, sampling rate (as defined during the initial calibration, non-editable). value of the trace at each cursor point, and slope of invisible straight line joining the two cursor points (in calibration units/second). Y scaling mode; options are: 202
auto:
autoscale
dyn: in this mode the dynamic (the range of the Y axis) is constant, but the
offset varies. So for example, if the minimum and maximum Y values are 5 and 19, respectively, the difference between the high and low value of the Y
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scale will always be 14 (=19 5) and the trace will automatically be centered on Y. This mode allows you to evaluate amplitude variations when the data have a fluctuating baseline.
man:
low and high values are manually set.
baseline button: if ON, the trace is displayed after subtraction of the baseline. In this case, the absolute values read from the scale or from the cursors are no longer physiologically valid since the trace is now vertically centered around Y=0. Y unit/cm: to impose a vertical scale. line 1 / line 2: used to draw 1 or 2 horizontal lines when perfoming calibrated print-outs.
figure n132. changes to Trace display settings panel (bottom) immedialely visible in raw data panel (above)
It is possible to apply the settings simultaneously to all inputs, using the first line (apply to all) Menu items of the the Trace display settings panel:
Spread !
to reset traces to their default Y position setting (regular vertical spread). to superimpose all traces (ie one above the other).
Superpose !
Graph scale ! / No graph scale: to hide / show the graph scales; the Y scale uses calibration
units; the X scale is in acquisition points.
Graph Number: to display the traces in more than one graph, stacked one above the other. For
example, if the display width is set to show 30 seconds, splitting the display into 3 graphs will produce contiguous strips of 10 s each (figure n133). The time reference point is centred in the central graph (red triangle).
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figure n133. raw data panel with 3 graphs displaying
10.3.2 report window

Select View Stat table & Trend graph or click on the icon (figure n134). to open the Report window
figure n134. report window
This report window has four panels. The respective size of each panel can be adjusted via the vertical sliders on the left side of the window.You can hide a panel by moving the slider all the way. 204 The different panels are described below.
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waterfall display
figure n135. waterfall display
The panel is a waterfall display of synthetic ecg waveforms. There is one waveform per step. Each waveform is obtained by summing all waveforms of analyzed complexes within a given step. Waveforms are synchronized on the R peak before being added up. The different settings are as follows: select the colour mode in the first drop-down list. Options are:
no coloring (default active beat: the
mode).
waveform corresponding to the active line in the step table (panel be low) has a thick red line.
period color: the
waveform colour is that of the period from which it is derived (If a step spreads over one or more periods, it is colored according to the period corre sponding to the beginning of the step).
period and active beat: a protocol color:
combination of the previous two settings.
thatstep.
the waveform colour is that of the protocol instruction that created a combination.
protocol and active beat:
in the drop-down list, you can hide or show vertical gridlines spaced 5 ms, 10 ms or 20 ms apart. The zero point of the grid is on the mark specified in the upper center of the Adjust step beat display panel. in x > and y > , specify the x and y offset between successive waveforms. in the ms field, specify the time width of each trace. In some cases, changing this display triggers a complete recalculation of all waveforms and might require a few seconds of processing time. you do not have to display a waveform for every step. Enter values in the first, last and incr(increment) fields to determine which waveforms to display. For example, if you enter 10 in first, 30 in last and 5 in incr, the panel will display a waveform for steps 10, 15, 20, 25 and 30. 205
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step table
figure n136. step table
There is one line for each step. Display of information can be customized as follows. select statistical function By default the average of calculated parameters is shown. However you can use the dropdown list in the top left to display other values (table 1). label aver min max med std sem numb std/aver disp (med) disp (aver) [10%] [25%] [75%] [90%] sum description statistical mean minimum maximum median standard deviation standard error of the mean number of values standard deviation divided by the average (max - min) / median (max - min) / average 10% percentile 25% percentile 75% percentile 90% percentile sum of all values
table 1. list of statistics available in average waveform
You can select several percentages. If you click on 10% and 25%, you will get the parameters values for the first 10% and also for the first 25% of the sorted data. select columns to display You can select what information to display in the step table as follows. Select Tune Parameters to list/file then the report table tab (figure n137). The left panel shows a list of available items; the right panel shows the items that will be displayed in the report table. Click on an item in the left panel to add it to the right panel. Click on an item in the right panel to remove it.
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The columns are as follows: cpu-date / cpu-time: date and time of the start of the step. site-time: time position of the start of the step within the data file. per-time mark-type, mark-label, mark-value, mark-unit step#: index number of step step-label (if defined) start# :index number of the first complex of the step. length(s): duration in seconds from the first to the last analyzed complex in the step. all beats, val beats are respectively, number of analyzed complexes and number of valid complexes in the step. The values are different only if some complexes have been invalidated by the user. gaps#: number of analysis gaps within the step. There is a gap each time two analyzed complexes are separated by a zone (short or long) of non-analyzed signal. success(time) and succes(beat) are indicators of analysis effectiveness. Success (time) is calculated as sum of all valid RR intervals time between the first R and the last R This value is simply an indicator. You cannot use it as a perfect and unique tool to how many complexes have been ignored. HR_all_RR, all_R#, max_consecut#
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The remaining items are calculated ecg parameters.
figure n137. selecting information to display in the report table
trend panel As you make changes to the settings, the display is updated in real time. There are basically two settings: parameter (this is where you select the calculated parameter to display). stat/all toggle switch In all mode (default mode) (figure n138, A), there is one point for each analyzed ecg complex. If the switch is set to stat, each point represents a statistical value calculated for all analyzed ecg complexes in each step.The different available statistical values are as shown in table 1.You can also combine certain statistics. For example, you can show the averages (statistical mean) and standard deviatons (figure n138, B). Or, you can show the median with deciles & quartiles (10%, 25%, 75%, 90% percentiles, as shown in figure n138, C).
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figure n138. trend panel with 3 different display settings
In all mode, you can easily see which ecg complex produced a specific data point. Click anywhere on the panel to select the nearest point. On selection, the point turns green and the corresponding ecg waveform is displayed in the main screen. Use the navigation icons to shift the Y axis up or down, to zoom in, to cancel zoom and to zoom out. snapshot study schema This is a copy of the study schema in the Mark and protocol panel (see section 9.1.1). The copy is not dynamic - it is a snapshot of the study schema in the Marks and protocol panel. It is only updated when you run an anaylsis.
10.3.3 multiple trend panel

As the name implies, the multiple trend allows you to display more than one trend panel at once. Open the panel by selecting View Multiple trend graphs or click on the icon
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figure n139. Multi trend panel
Right-click in the left margin or select Settings! to open the Multi-trend settings panel (figure n140).
figure n140. Multi trend settings panel
Most settings are identical to those in the trend panel of the report window. Other settings are described below. Select how many graphs to display in the Multitrend panel by selecting the number of columns (column#) and rows (line#). For example, if you select 2 columns and 3 rows, 2x3=6 graphs will be displayed. If you set the apply toggle switch to ON, ecgAUTO will remember the row and column settings. The other settings on the first line concern the colored density plot:
density colours
- click on a color to be able to modify it
pixel# (x,y) - the x and y dimensions of the density blocks, in pixels
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If you select all display, a drop-down menu allows you to select how data are plotted: as a solid circle scatterplot, a small dot scatterplot or a color density graph.
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Any changes you make to the first line labelled apply to alll are automatically applied to all graphs. There is dynamic interaction between the points in the graph and other displays in ecgAUTO. For example, clicking on a data point selects the corresponding line in the table and displays the data in the main screen. The settings in figure n140 correspond to the multipanel visible in figure n141
figure n141. Multi trend panel
10.3.4 captures
There are two ways to capture points: select them visually select them using criteria visual selection In the multi trend graph in all mode, drag-click in the graphs to draw a red selection box containing data points of interest. You may draw up to four boxes (figure n142). When you press the space bar, all the selected data points are captured. They appear in a capture list (figure n143).
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capture boxes
figure n142. capture boxes in multi trend graph (settings panel)
figure n143. capture list
You can capture more points if you desire. The new points are added to the capture list (the first point of each capture is highlighted in yellow) (figure n144).
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figure n144. extending capture list
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criterion-based selection From the report window or the multiple trend window, select Criteria! to open the Selection criteria panel (figure n145).
figure n145. selection criteria panel
In this panel, you select criteria for the selection of points (beats). Typically it is used to rapidly examine all outlying points, i.e. beats for which one or more parameters have an extreme value. The different steps are: select parameter Select the parameter or the parameters using the on/off toggle switch on each parameter line. define the range
(low and high cut-off values, range or percentage, inside or outside)
The Low, High and the mode drop-down list work together in the following way. If Low and High are the values entered in the low and high fields, ecgAUTO will select: all points lying inside the range Low -High ) (inside lo hi val mode) all points lying outside the range Low - High (outside lo hi val mode) all points inside the range defined by Low and High (inside lo hi % mode) all points outside the range defined by Low and High (outside lo hi % mode) note: points lying on cut-off values are considered to be inside the range 213
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With the percentage criterion, the cut-off values are calculated on the basis of the number of values, n. The low cut-off value, LowCutOff, is the (Low% x n) th value in the sorted list, while the high cut-off value, HighCutOff, is the (High% x n) th value in the sorted list. For example, if the values are 1, 2, 2, 2, 2, 2, 2, 2, 3, 3, 4, 4 (n=12), and you enter 30 is the low field and 80 in the high field, and select outside lo hi % mode: Low% x n = 30% x 12 = 3.6 LowCutOff is the 4th value, i.e. 2 (there is no such thing as the 3.6th value so the closest integer is taken) High% x n = 80% x 12 = 9.6 HighCutOff is the 10th value, i.e. 3 (10 is closest integer 9.6) selected values: 1,4,4 The high cut-off point is calculated in a similar fashion. select scope In the applied field, select whether to apply criteria to each step individually or to all steps together. define Boolean operators If you select more than one parameter, you must tell ecgAUTO how to combine the selection criteria for each. Select a OR or AND in the logical mode field. Once you have selected your criteria, select Count! to see many beats correspond to your selection criteria. Click on Capture! to select the beats and transfer them to the Caption list .
10.3.5 capture list

From the capture list (figure n103), click on a line to see the correspondign beat in the main screen.
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figure n146. capture list
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To invalidate a beat or beats, press delete to open the invalidation panel (figure n147). From this panel, you can invalidate and revalidate the current beat (ie beat selected when you called the panel), the current capture (ie the capture to which the current beat belongs), or the entire capture list .
figure n147. invalidation panel
10.3.6 xy plots
xy plots are used to look for possible relationships between 2 sets of data. In the field of ecg analysis, xy plots are most often used to examine how the relationship between QT and RR develops over time. In ecgAUTO, you can create customised xy plots then fit curves using one of several different methods. An example will illustrate how to use this functionality. A protocol-based analysis must be performed first. We will use the protocol: Analyse segments of 10 minute (10 steps of 60 seconds each) in the ranges named: baseline / treatment / treatment + 1 / treatment + 4h Ffigure n148 shows how this protocol appears in the Marks and protocol window.
figure n148. sample protocol and study schema
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After performing the analysis, select View XY plot graph or click on the icon to open the xy trends graphs panel. figure n149 shows an example of an xy plot using our analysis data. Each point of the graph corresponds to one analyzed ecg complex. Colors are those of the protocol instructions. It can be seen that the treatment has an effect on the QT-RR relationship. Settings are described below.
figure n149. xy plot of QT-RR relationship from 4 periods X
and Y fields: select the x and y variables
type field: select to display all points or only point per step. In the latter case, you must choose
the statistic to display for each step (see table 1).
fitting type field, select an equation to be used to fit a curve to each set of points. Options are
as follows (if none is selected, no curve is fitted).
display section: the toggle switches allow you to show/hide the points from each protocol
instruction. The second field shows the number of points for each instruction. 216 Click Graph! to access the graph tab of the xy settings panel.
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Click Fitting! to access the curve fitting tab of the xy settings panel. display settings Clicking Graph! in the XY trends graph panel opens the xy settings panel, with the graph tab selected.
figure n150. display settings in XY settings panel
From here you can: switch autoscale on or off (in autoscale off mode) select minimum and maximum values for the x and y axes show or not horizontal and vertical gridlines (if gridlines are showing) select the number of divisions for each axis and the color of gridlines fitted curve information Clicking Fitting! in the XY trends graph panel opens the xy settings panel, with the Curve fitting tab selected.
part 1
part 2
part 3
figure n151. fitted curve information in XY settings panel
In part 1: The chosen X and Y variables and the selected fitting type.
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In part 2: For each set of points, are shown: the calculated coefficients of the fitted curve . the mean squared error r2 coefficient (this is a value between 0 and 1; the closer to 1, the better the fit). In part 3: When you double-click on the label of a particular set of points, part 3 of the window displays three different formulas for that set of points: (1) the regression formula of Y on X This is expressed as Y = f (X) where f is the function corresponding to the fitting type: (2) formula for calculating residuals A residual is the difference between actual and theoretical values (as defined by the regression formula). The formula for calculating each residual is: residual = Ym f(X) where Ym is an observed value of the Y variable. A set of data provides a non zero residual if it does not behave as the original set which produced the fitting curve. For example, if the fitting formula is computed between QT and RR on points from baseline, any later data with non zero average means a change in QT. (3) correction formula The formula for the corrected value includes a reference value (Yref ), which itself is based on a reference value of X (Xref): corrected value = Ym + Yref f(Xref). Xref is the value entered in the reference X input field. The calculated Yref appears in the the reference Y input field. In figure n131, in the context of the QT-RR relationship, it was decided that the correction formula should correct QT calculated for RR values different from 800ms. For an RR value of 800 ms, the regression formula provides a reference QT of 231.34.
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regression formulas to create custom parameters (e.g. for QTc) Select the formula text string and copy it to the clipboard (Control-C). Create an ecg custom parameter, and paste (Control-V) the copied text into the field of the formula editor panel.
10.3.7 comments and zones

It is possible to attach Comments and Zones to your data. A Comment is associated with a single point of time, while a Zone is associated with a period of time. However, ecgAUTO considers a Zone to be a special type of Comment. This section describes different operations related to Comments and Zones: create a Comment or Zone using cursor time create a Comment using time panel define keyboard shortcuts view Comment or Zone information erase a Comment or Zone As is apparent from the list, there are two methods of entering a comment: the cursor time method requires that the Comment is attached to a time point within a streaming period. use the time panel method when you want to attach the Comment to a time point outside of a streaming period
10.3.7.1create a Comment or Zone using cursor time

F key shortcuts only work if the particular shortcut is active (see below). To create a comment: make sure that the raw data display is open and that it is the active window click on the point where you want to add the Comment (screenshot C1, figure n131) select Comment Create or press F2 to open the Comment panel (screenshot C2, figure n131) enter the text for your Comment and select its colour. Click OK to proceed the Comment immediately appears in the raw data display (screenshot C3, figure n131). 219
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To create a Zone: make sure that the raw data display is open and that it is the active window click on the point where you want to start the Zone (screenshot Z1, figure n131) select Comment Create or press F2 to open the Comment panel (screenshot Z2, figure n131) enter the text for your Zone and select its colour. Click OK to proceed. click on the zone where you want to end the Zone and press F3 the Zone immediately appears in the raw data display (screenshot Z3, figure n131). Zone are usefull to mark not only local events but full time zones (like, for example, the duration a fibrillation episode). Comments and Zones also appear in the table of the main screen (bottom of figure n131).
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figure n152. adding Comment and Zones

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10.3.7.2 create a Comment using the time panel

From the main screen or the raw data panel, press Ctrl-5 to open the time comment panel:
figure n153. time comment panel
On the first line of this panel, you can enter a label for your comment and modify its colour. The panel provides information about the loaded data file; this information is on a grey background and is non-modifiable: start date and time (file start date line) stop date and time (file stop date line) length of file (maximum site-time line) You select a time point by entering: either the actual date and time (selected date line) or time from the start of the file (selected site-time line) The default selected time point corresponds to the position of the cursor in the Study Schema part of the Marks and protocol window (see section 9.1.1 ). The relationship between the different lines of the time panel is shown in figure n154 (the values correspond to those in figure figure n153).
1day and 1s 7h 44m 42s maximum site-time data file time file start date 05/12/2002 08:55:07 selected date 05/12/2002 16:39:49 file stop date 06/12/2002 08:55:08
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figure n154. information shown in time panel
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If the time point you select lies outside of the file, the line containing the faulty value is highlighted in pink, and the exceeded limit is highlighted in yellow. Example 1
The selected date (07 November 2003) is beyond the file stop date limit (06 December 2002). Therefore, the selected date fields are highlighted pink and the file stop date fields are highlighted in yellow. Example 2
The selected site-time (1day 7 hours 44min 42s) is beyond the maximum site-time (1 day and 1s). Therefore, the selected site-time fields are highlighted in pink and the maximum site-time fields are highlighted in yellow.
10.3.7.3 define keyboard shortcuts

The following function keys have a predefined action: F2 open the Comment panel for the>comment>>create menu item F3 define the end of a Zone F4 erase a Comment 222 Function keys F5 to F10 may be used as shortcuts for adding comments. The procedure to assign a comment to a function key is described below. To use the predefined keys F5 to F10 they must first be activated.
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To activate/deactivate a function key or to assign a comment to a function key, open the Assign comment to keys panel (figure n155) by selecting Comment Comment function keys in the raw data display or by clicking on the icon
figure n155. function key assignment panel
Use the ON/OFF button to activate/deactivate each key. For keys in F5 to F10, you can enter text and a colour. When the key is activated, pressing the key will add the comment where the cursor is .
10.3.7.4 view Comment or Zone information

In the table of the main screen, press the space bar while a mark (Comment or Zone) is highlighted to open the Mark information panel.
figure n156. Comment and Zone information
erase a Comment or Zone Provided that the F4 key is activated (see previous section), pressing F4 in the main screen or the raw data display will bring the closest Comment, Zone-start or Zone-stop mark to the center of the graph, and open the information panel with an erase option (figure n157). 223
figure n157. confirmation panel before erasing a mark
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Click erase to erase the mark, or cancel to cancel the operation. Erasing a Zone-stop marks transforms the corresponding Zone-start to a Comment mark. However, erasing a Zone-start mark also erases the corresponding Zone-stop mark If a function key is activated, the key is only effective when the raw data display is itself active, i.e. it is open and the active.
10.3.8 editing markers on beats

It is possible to edit the position of markers after analysis. This provides users the possibility to make any corrections. To edit a beat, first highlight it in the table of the main screen, then press the space bar. The beat is opened in the Beat marks editing window (figure n139). This window is very similar to the window used to position markers of library waveforms (section 0). There are some differences:
automatic edit comment
(1): see below.
beat information (2): The absolute and relative (within step) index number of the beat, and the
index number of the step in which it occurs.

beat editing history
(3): see below.
interval information (4):The duration (in ms) of certain interval parameters is given (unless the
corresponding markers have not been positioned).
1 2
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figure n158. Marks edition panel
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Reposition the markers as you like (in the same way as you did when editing markers of library waveforms). When positioning markers, it is sometimes useful to simultaneously see other leads or inputs. To do so, select Display leads! to open the Display auxiliary leads panel (figure n159).You can then select the other leads or inputs to display at the same time, as well as their color.
figure n159. selecting lead display during beat editing
You may enter a comment. Validate your modifications by selecting Save beat! effect of a beat edition Once a beat has been edited, the following happen: intervals and other parameters for that beat are recomputed and the new results appear in the main table as well as in the trend graphs. statistical values for the step to which that beat belongs are also recomputed, and the statistical values on trend graphs modified accordingly. creates a comment then attaches it to the edited beat. This automatic edit comment includes: date, time and author of the beat edit; description of the edit (which marker was moved, by how many milliseconds in which direction). This comment appears in the table of the main screen (the example in figure n160 informs us that the beat has been edited twice).
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figure n160. beat editing information in table
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beat edition history It is possible that a beat will undergo successive edits or invalidation/revalidation (the user changes his mind, the study director wants to edit changes already made by others, etc). This is how ecgAUTO helps you to keep track of successive beat edits: the comment attached to the beat contains the index number of the edit (1, 2, 3 etc). in the Beat marks editing window: the second modif field displays the total number of edits performed. in the same window, the first modif field contains the index number of the waveform edit (0 is the unedited waveform). Enter a number to view the results of that waveform edit the automatic edit comment is provided (from software for the unedited beat). for each edit, the markers on the graph are shown as they were after the edit currently under examination. you can only edit the last state of the beat. In the example of figure n161, the user is viewing edit 1.There are 2 edits in total so the editing functionality is not available.
figure n161. viewing beat edit history
10.3.9 validating / invalidating analyzed ecg complexes

226 There might be cases where ecgAUTO has produced questionable analysis results. For example, a segment of data may be so noisy that you decide that no measurements at all should be done. In this case you can choose to invalidate these beats rather than correct them. You cannot delete beats.You may consider invalidated beats as deleted beats. The difference is that invalidation is reversible.
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to invalidate a complex In the table of the main screen, select the line of the beat to be invalidated. Press delete to open the invalidate/revalidate panel figure n162.
figure n162. invalidate/revalidate panel
Comments are optional (unless you have made them mandatory - see below). If you enter an invalidation comment, ecgAUTO proposes to make it a default comment for complex invalidation. You can reuse a comment already defined in the current session by using the drop-down menu( ) Then: select Invalidate beat! to invalidate the beat. Alternatively, if the panel has remained active (you have not done anything else on another with the keyboard or mouse), you can press delete . select Invalidate step! to invalidate all beats of the step. When a complex is invalidated: the beat parameters in the table are replaced by inv a Comment is automatically inserted the complex has a blue background in the main screen display ().
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figure n163. main window after beat invalidation
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to revalidate a complex To revalidate a complex (i.e. to restore it the to its original state of valid beat), select the line of the beat to be revalidated in the table of the main screen, then press delete to open the invalidate/revalidate panel. Proceed as for validation (the appropriate options are now available). mandatory comments (GLP) If you work in a full GLP environment, your rules may require that a specific comment is attached to any invalidation or revalidation operation. In the General settings (section 3.3), you can make such comment mandatory. If the option is activated, pressing delete twice will not automatically invalidate or revalidate a beat.You will have to enter a comment before being able to complete the operation.
10.4 recompute function

Recompute
used.
is a menu item of the Analysis settings panel. Here is why and when it can be
When you run an ecg analysis, the most time consuming part of the process is the detection of the markers on the signal trace. This takes up about 80% to 95% of the processing time. Once a long analysis has been completed, you may wish to modify some analysis settings, for example by adding new interval parameters, or a different types of QT correction, or custom parameters based on already defined parameters. In this case, if you press recompute, ecgAUTO will perform another full analysis in a shorter time because it will only calculate parameters based on the new settings (and use the previously detected markers). An example of the recompute function: The first analysis has parameters RR, HR, PR and QT, which require positioning of markers <P, <Q, R and T>. After the first analysis, settings are changed by adding more parameters: TP (end of previous T to start of P), P duration ( from start of P until end of P), QTcFridericia. Pressing Recompute will produce values for TP and QTc (since marks required to compute those 2 new parameters are available from the first analysis). However, P duration will not return any values (because >P was not included in the first analysis).
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notes about display of data
10.5 notes about display of data

10.5.1 null values
It happens that some or all values in the result tables are null. Here are some possible causes and remedies: This is primarily caused by the fact that some of markers were not found, because the software used a waveform library which did not contain this marker. Then, if a given parameter is not computed, any other parameter which uses it as reference parameter will also not be computed. For example, if QT is defined as interval from <Q to T>, and if <Q is not marked on the waveform used to analyze a given ecg complex, QT will not be available. Then in turn, any parameter using QT as input (for example, QTc) is also unavailable.
10.5.2 non-continuous raw data

When acquiring data with iox, It is often justified to perform non-continuous raw data recording - for example, when we are only interested in certain time zones in the experiment or when we want to limit file size. In this case, the raw data are segmented. Each streaming segment starts with a stream-start mark and ends with a stream-stop mark. When segmented data are displayed in graphs either on the main screen (figure n164) or in the Marks and protocol window (figure n165), the border between the streaming segments show as vertical black lines with green color at either end. Streaming segments are automatically indexed, and this index is shown next to the limiting black line as [n and n] to indicate the start and end, respectively, of the nth streaming segment. In the mark tables, the index is shown as well as the duration of the segment and the duration of the previous data gap. When you use the horizontal slider to move within the data file, the slider ignores nonstreaming segments . In other words, it behaves as if streaming segment are joined together.
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getting started
chapter 11. HRV studies (variability module)

The variability module, available as an add-on option with ecgAUTO, analyses the variability of values of parameters generated during analysis. The most common application is the study of heart rate variability (hrv), through analysis of RR or HR parameters. For this reason, the module is often known as the hrv module. Nevertheless, it remains possible to analyze tables of QT or QTc, systolic pressure, dp/dt maxprovided that these data were generated by a previous analysis. This chapter assumes that you will be using the module for HRV studies.
11.1 epochs in hrv studies

hrv analysis is performed on one or more epochs, each epoch being a set of data within a delimited time zone. It is usually logical, in order to produce meaningful results, to make sure that each epoch contains a continuous set of data. Typically, an epoch contains all RR values produced over 5 minutes of ecg recording. However, the hrv module does not prevent you from defining epochs with discontinuous data. Therefore, you can define, for example, an epoch of 15 minutes containing RR values at 0-5 minutes and 10-15 minutes, but no data at 5-10 minutes. When you use epochs with discontinuous data, you must ensure that the results you obtain will be meaningful. Great caution must be exercised because in many situations the data will be of limited scientific value, since missing data will adversely effect, for example, all parameters produced by the fft analysis.
11.2 getting started

After performing an ecg analysis (or loading the results file), select View hrv analysis or click on the icon to open the hrv panel with the data tab selected (figure n166) . It is impossible to open the hrv module if no results are available - an error message appears if you attempt this.
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ecgAUTO version 3.0 user manual - HRV studies (variability module)
figure n166.
hrv panel
The following sections describe the different parts of the hrv panel, and the functionalties available from each. The different tabs are: data histo cumul histo histo_std Poincar colored Poincar delta delta_histo delta vs data FFT trends
11.3 general information header

The general information header at the top of the hrv panel provides general information about the hrv analysis, and has some user-adjustable settings.
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settings
The first line contains: name of the raw data file and full file path start: start date of experiment stop: stop date of experiment length: duration of experiment data: cumulative duration of recorded data (this value is lower than length if streaming was not continuous) In the second line, the first three fields are user-defined. Use them to select: the parameter to be analysed the epoch to load (all epochs are given an index). the epoch definition mode: this setting defines how epochs are created. There are three modes:
one per step(1) (1/step): in this case, there are as many epochs as there are analysis
steps defined by the analysis protocol used to produce the data
one per train (1/train): in this mode, the data contained in all steps of one train are
pooled into one epoch
one per analysis (1/ analysis): in this mode, all data available in all steps of all trains
are pooled into one epoch
The rest of the second line contains information related to the current epoch (i.e. the epoch currently loaded): start date start site-time data length: duration of the epoch input point #: the number of values within the epoch resampled #: how many resampled data points are produced (see fft section)
11.4 settings
Click on Settings in the HRV panel to open the Settings panel. There are four tabs (figure n167). Only Graph settings are described in this section; other settings are described under relevant tabs.
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As a reminder, each instruction of a protocol define a series of steps (a train).
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figure n167.
settings of HRV panel
Throughout the hrv module, changes to settings have immediate effect. You do not need to validate the change first. All graphs and calculations are updated as soon as the change is made. When there are many data points (> 50,000), there may be a short delay before changes to settings are taken into account. hrv graphs settings
figure n168.
graph settings
In this panel, you can select between automatic or manual scaling. Be aware that in autoscaling mode, an outlying point on one epoch affects the scale on all graphs (to avoid such issues, use manual scaling). 234 The data settings are applied to all axes displaying data values. For example, the Y axis when showing data vs epoch time, but both the X & Y axes when displaying Poincar plots. The delta settings are applied to all axes displaying data delta values.
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panels
note: the same axes are applied to all graphs from all epochs. This makes it easier to assess changes from one epoch to another. X axes displaying time within the epoch are in automated scaling mode across all epochs. If epochs are of different lengths, all will be displayed using the longest epoch as reference and the shorter epochs will have a blue zone after the end of the epoch (figure n169).
figure n169.
blue zone at the end of a shorter epoch
11.5 panels
11.5.1 Data panel
The Data panel shows the data points (parameter values) plotted according to their time within the epoch. The red line is the mean value, and the two blue lines show mean 1 standard deviation.
mean + 1 s.d. mean mean - 1 s.d 235

figure n170. Data panel
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It is possible to exclude data points from the epoch - these points are not deleted but are not involved in the calculation of variability parameters. Excluded points are shown as red on the graph. The Filtered data of a current epoch refers to the original data minus any excluded data points. In the top-left is information about the points. Calculated time domain parameters are shown in the lower left corner of the data panel (all parameters are relative to the filtered data of the current epoch).
Mean: mean SDNN: standard RMSSD: square
deviation
root of the mean of the sum of the squares of differences between consecutive data points.
Triangular index: total
number of data points divided by the maximum value of the data histogram (highest number of data points across all bins). This value is of course influenced by the bin width. When working on human ecg, it is customary to use a bin width of 1/128 seconds, or 7.8125 ms.
NNnn & pNNnn parameters (where nn user-defined time interval in ms)
These parameters are based on a specific time interval, specified in the NNnn, pNNnn interval field of the Data limits tab of the HRV settings panel. When studying RR data on humans, it is customary to produce evaluations of the NN50 and pNN50 values. When working on data other than RR, or on animal data, values other than 50 ms might be required. The labels on the panel are based on an interval of 50 ms. With this interval the parameters are as follows:
NN+50: number of data points X(n) for which X(n)-X(n-1)> 50
NN - 50: number of data points X(n) for which X(n)-X(n-1)<-50

NNabs(50): number of data points X(n) for which |X(n)-X(n-1)|> 50
Therefore, NNabs(50) = NN+50 + NN-50

pNN+50: (NN+50) / (total data points within current epoch) pNN 50: (NN+50) / (total data points within current epoch) pNNabs(50): NNabs(50) / (total data points within current epoch)
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panels
excluding data points The graph has three cursors: two grey line cursors a blue cross-hair curser. These cursors allow you to exclude data points, either individually (cross-hair cursor) or in groups (line cursor). At any one time, only one of the cursors is active (ie able to be moved). Right-clicking anywhere on the graphs causes the active status to cycle between the three cursors.The grey line cursors are yellow when active. to exclude individual data points Make sure that the cross-hair cursor is active. When you click on the graph, the cross-hair cursor automatically snaps to the closest data point and the corresponding complex is shown in the main screen. Press Delete, and then proceed as you would for invalidating an ecg complex (section 10.3.9).. to exclude groups of data points You can also exclude groups of data points in one operation. Essentially, you tell ecgAUTO to exclude all data points above or below threshold values. Threshold exclusion is often too crude since data points should only be excluded if they are clearly not physiological - for example, data points due to artefact, analysis errors etc. In the field of HRV analysis, threshold exclusion became established because many systems have difficulties returning reliable sets of RR data. One easy way to exclude outliers was to simply decide that anything above or below certain thresholds must be artefactual outliers. caution! clearly, if not used very carefully, threshold exclusion will lead to the exclusion of valuable data. We thus recommend that (i) excluded points are examined case by case, and (ii) if threshold exclusion is inadequate, that beats should be individually excluded. You can exclude groups of data points using the line cursors or via the Settings panel. To exclude data points using the line cursors, make sure that the appropriate line cursor is active then move the cursors vertically to the desired position. Exclusion is immediate: all data points below the lower line cursor and above the upper line cursor are excluded. To exclude data points using the Settings panel, enter the desired minimum and maximum values in the data low exclusion and data high exclusion fields, respectively. 237
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line cursor
figure n171.
hrv data panel with excluded points (in red)
11.5.2 Histo panel

The Histo tab shows the histogram of data points of the current epoch. The histogram is calculated and displayed using values in the Settings tab: low RR value (histo low value field) high RR value (histo high value field) bin width (histo bin width field). This is the size of each interval. An example of a histogram and its settings is shown in figure n172.
figure n172.
histogram settings (left) and histogram (right)
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If there is more than one epoch, you can view the histograms for all epochs by setting multi graph button to ON. By default, all histograms are superimposed, making it difficult to evaluate them. Enter values in the y offset % and x offset % fields to show a waterfall display (as shown infigure n173). The current epoch is colored in blue, and its index number is colored with a red background.The scale is automatically adjusted as to be relevant to the active trace.
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panels
figure n173.
waterfall display of epoch histograms settings are circled
11.5.3 Cumul histo panel

The Cumul histo panel shows the cumulative histogram of data points of each epoch. The Y axis is a percentage of total number of epoch data points. Given that epochs do not have the same number of data points, this allows you to compare epochs visually. In other respects, the Cumul histo tab is identical to the Histo panel. figure n174 and figure n175 show, respectively, a single histogram and a waterfall display of several histograms.
figure n174.
cumulative histogram
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figure n175.
waterfall display of cumulative histograms
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11.5.4 Histo std panel (standard deviation histogram)

The Histo std panel displays a histogram of the standard deviation of each bin of data points in the epoch. A standard deviation becomes meaningless if it is based on a very low number of values. In the Settings panel, you can define the minimum number of values that each bin should contain for a standard error to be calculated (in the field). If there are not enough data points for a particular bin, 0 is returned. figure n176 and figure n177 show, respectively, a single standard deviation histogram and a waterfall display of several standard deviation histograms.
figure n176.
standard deviation histogram
figure n177.
waterfall display of standard deviation histograms
11.5.5 poincar panel

The Poincar panel shows a Poincar plot for which the X-axis is the RR interval of the current data point and the Y-axis is the RR interval of the previous data point (figure 206). 240 By default, a scatter plot is shown (this corresponds to the point option in the drop-down menu).
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panels
When you click on the graph, the cross-hair cursor snaps to the closest point, and the cooresponding complex is shown in the main screen. Given that more than one data point may have the same co-ordinates, cursor snaps to the data point with the earliest time. The interaction is two-way: when you highlight a beat in the table of the main screen, the cursor moves to the corresponding point of the Poincar plot. Point information apppears in the top of the left side-bar: index number within total analysis; index number within current epoch; x and y co-ordinates.
information about selected data point
figure n178.
poincar plot
joined-up plots When you select segment points in the drop-down menu, lines are plotted between successive points (figure n179). According to published literature, this type of display provides an estimate of heart rate turbulence.
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figure n179.
joined-up poincar plot
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selection polygons It is sometimes useful to quantify data in one particular area of a Poincar plot. In ecgAUTO, this is made possible by the use of polygons. You can draw up to 6 polygons on the graph; all data points lying within each polygon are selected as a data set, giving up to 6 data sets. To draw selection polygons: switch ON the draw polygon button switch ON one of the six polygon buttons drag the mouse on the graph to draw a polygon. In figure n180, the user is currently drawing polygon 2. As shown, polygons can have any shape, including intersecting or overlapping boundaries. To erase a polygon, switch ON the corresponding polygon button then click anywhere on the graph.
figure n180.
poincar plot with 2 polygons drawn
When you have created all your polygons, select Polygon data! to open the polygon data panel (figure n181, corresponding to polygons shown in figure n180). 242 This panel contains as many lists as there are polygons. Within a list, each line corresponds to one epoch.
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panels
The columns are as follows:

epoch: index minX maxX percent: number averY: average Y
of epoch number. of points within th polygon.
number: number
of points in polygon as percentage of total number of points in graph. co-ordinate of points within the polygon. co-ordinate of points within the polygon.
averX: average X co-ordinate of points within the polygon. medianX: median X co-ordinate of points within the polygon. medianY: median Y dist_aver: dist_med: median
average of orthogonal distance from points in polygon to y = x line (bisecting line). of orthogonal distance from points in polygon to y = x line. of points within the polygon which are above the y = x line.
%_above: percentage
figure n181.
polygon data panel
Polygons are saved with the configuration. You can therefore perform different analyses with the same polygons. density plots The standard Poincar plot sometimes include areas where a large number of points overlap. In such situations, it is difficult to assess the density of points. The colored density Poincar plot(2) allows better assessment of point density (figure 210). It uses small rectanges instead of points. The colour of the rectangle indicates the density of points beneath it. Up to 10 density levels can be used. To view the density plot, selected colored density in the drop-down menu to the left. 243
(2) In older versions of ecgAUTO, the colored density Poincar plot is accessed via a tab and there are fewer density levels.
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Settings for the colored density Poincar plot: size of each colored rectangle (or its pixel resolution) This is defined in the colored Poincar width setting of the Settings panel. If you select a high resolution, the calculation time will increase (as there are a large number of rectangles). There is a built-in limit to the number of rectangles the number density levels (2 to 10) the colors of each density level (except the lowest density color, which is always white). Please bear in mind that the thresholds between density levels are calculated on a graph-bygraph basis. On this particular type of display, there is no dynamic interaction between the graph and the table of the main screen.
10 density levels are used in this plot
figure n182.
colored density poincar plot
11.5.6 delta panel

The Delta panel shows a scatter plot of data points of the current epoch for which. x-axis is time of current data point within the epoch y-axis is difference (the delta) between RR of current data point and RR of previous data point. As for the Poincar plot, there is interaction between this graph and the table of the main screen.
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panels
If the plot is not centered around 0, this indicates that fluctuations are faster in one direction. For example, if there are more points above 0, this indicates that RR increases suddenly across one beat, but returns to the average slowly, across several successive beats.
figure n183.
delta vs data plot
11.5.7 delta histo panel

The Delta histo panel displays a histogram of the current epoch for which: x-axis is the time difference (the delta) between RR of current data point and RR of previous data point y-axis is the number of points figure n184 and figure n185 show, respectively, a single histogram and a waterfall display of several histograms.
figure n184.
single delta histogram
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figure n185.
waterfall display of several delta histograms
11.6 delta vs data panel

The Delta vs Data panel displays a scatter plot of data points of the current epoch for which: x-axis is the RR of current data point y-axis is the difference (the delta) between RR of current data point and RR of previous data point. As with the Poincar plot: there is dynamic interaction between the HRV panel and other screens (e.g. selecting a point on the graph causes the selction of the corresponding beat in the table of the main screen). information about the selected point is shown in the top-left of the panel.
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fft panel (fast Fourier transform)
figure n186.
delta vs data plot
11.7 fft panel (fast Fourier transform)

The fft (fast Fourier transform) module computes power spectrum and power within specific frequency bands. It is used to detect any periodic fluctuations of a parameter and analyze them. For example, suppose we are analyzing the parameter systolic blood pressure (SBP). Now, SBP often fluctuates with breathing. If the breathing rate is 10 bpm, the fft spectrum from the SBP parameter will exhibit a peak at around 0.16Hz (which corresponds to 10 bpm). The stronger this fluctuation, the higher the peak and the higher the power in the frequency band which includes the 0.16 Hz peak. The results of fft analysis are displayed in the fft panel.
11.7.1 fft process overview

Data points must be resampled before being fed into the fft module. The fft algorithm uses resampled data to compute a spectrum for each defined fft epoch(3) (each spectrum produced this way is called an fft spectrum). The fft panel displays the fft single-sided power spectrum of resampled data (this spectrum is called the epoch spectrum). This spectrum, corresponding to one epoch, is obtained by averaging all the fft spectra of that epoch. Resampling and fft epochs are described in more detail below.
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(3) fft epoch is distinct from epoch - do not confuse the two terms
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resampling The algorithm used by the fft module can only process data points that are evenly spaced, i.e. succssive points having the same time intervals. Of course, the data points of physiological data are usually not evenly spaced in time. For example, when analyzing ecg data produced from dog ecg, the RR data points are separated by anything from 250 ms to 3000 ms since dog heart rate varies greatly physiologically. Resampling is the process by which the data points are processed so that they become evenly spaced. It is performed according to a user-defined sampling step, and by one of two modes (the user selects which mode to use): by simple interpolation between the first point to the left and the first point to the right. If the gap between two original points is large, resampling will create a string of points on the straight line joining the two original points on either side of that zone (clearly visible on the data panel with discontinuous data above) by 3rd degree spline interpolation (which creates a smooth curve with no sharp angles at any junction, across all original points, and then picks the resampled points at proper time points on the smooth curve). This a usually better choice but it may lead to some overshoot (a hump in the smooth curve, produced to avoid a sharp bend) fft epochs The number of data points in each fft epoch must be a power of 2, e.g. 256, 512, 1024 (this is required by the fft algorithm).You must specify the number of points to be used. Another user setting determines whether successive fft epochs are overlapping, contiguous or non-contiguous.
11.7.2 performing a fast fourier transform

The settings and the results display are described below. Please note that once the fft module is switched on, the fft runs automatically every time you modify the settings. settings Settings are made under the FFT tab of the HRV settings panel (figure 215) To switch on the fft module, set compute FFT button to ON.
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resampling step (ms): as already explained, to produce evenly time
spaced data to feed the fft algorithm.

resampling max point #: the
maximum number of resampling points
resampling max length (min): this is a non-editable field showing the
duration corresponding to the maximum number of resampling points

Interpolation mode:
choose whether to use linear or 3rd degree spline interpolation during resampling . The next four fields concern processing of data points (mainly resampling) before they are fed into the fft algorithm:
start offset shift (%):
the time shift between the start of successive FFT epochs in an epoch, as a percentage of the duration of the FFT epoch (if <100%, fft epochs overlap; if 100%, fft epochs are contiguous).
figure n187. FTT settings point number: the number of points in each FFT epoch (and there-
fore used to compute individual spectrums).

windowing type:
windowing is process by which data at the edges of each fft epoch are smoothened. Select from one of three windowing types: triangle, Hanning, Hamming. No windowing is performed if you select rectangle.
remove average: this is an optional step of processing after resampling and before the data are
fed into the fft algorithm. Settings are:
none: the processing step is not done. of full epoch: the average of the data over the full epoch is subtracted from the filtered data. of each fft data: the average of the data over each fft epoch is subtracted from the filtered data.
Removing average values, which by definition are constant over the data strip, has the effect of removing normally useless power in the the low end of the spectrum (frequencies close to 0, i.e. representing a constant offset).
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The next fields concern the final epoch spectrum:

ignore freq < (Hz), ignore freq > (Hz)
You can define a frequency range by setting low and high thresholds. The frequencies outside the range are ignored when computing the final epoch spectrum, or when calculating the total power or band power. Often, frequencies lower than, for example, 0.003 Hz are ignored (thereby avoiding the disturbing effect of high spectrum values generated for very low frequencies).
ULF (ultralow frequency), VLF (very low frequency), LF (low frequency), HF (high frequency)
You can define up to four frequency bands by entering the low and high frequency on the appropriate lines. Power is computed for each band you define. You can also select a colour of each. There is no software control of the validity of your choice of band limits: for example, bands can overlap, and ULF band can be of higher frequency than the HF band. save band settings It is often usefull to be able to change from one set of band limits to another. For example, if you use ecgAUTO to perform hrv on different animal species, you will want the spectrum bands to be different when you analyze dog or mouse heart rate. You can save up to 6 sets of frequency limits, each set consisting of the limits for the frequency range and ther 4 bands. To save the limits as a new set, choose one of the six slots in the frequency set-up list, then right-click on the list to give a name to your set. You can use the list to go from one set to the another - when you do so, ecgAUTO will automatically recompute and display the new power spectrums and associated powers. displays Useful information are shown in the Data panel as well as the FFT panel. When the fft module is switched on, resampled data points are shown on the data graph as tiny black point. Set the show resampled only to ON to only show resampled data only. The resampled data points are then blue (figure n188).
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The red sloping lines at the bottom of the Data panel show the start and end of each fft epoch. resampled points shown only
there are 2 (overlapping) fft epochs
figure n188. FFT information in Data panel
The fft panel displays either one spectrum (of the current epoch) or several spectra (of all epochs). ecgAUTO automatically selects the most appropriate formatting, as follows: single epoch spectrum, non-overlaping custom frequency bands (figure n189, A): area under the curve is colored according to user-defined band colors. several epoch spectrums, non-overlaping custom frequency bands (figure n189, B): traces have band color. overlapping custom frequency bands, with one or several epoch spectrums (figure n189, C): band limits are shown as colored rectangles on top of the graph .
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figure n189. different formatting for spectrum displays
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A B C
figure n190.
spectrum display in fft panel
The different parts of the fft display are as follows:

multigraph button
(A)
to switch between displaying single and several epoch spectrum

cursor section
(B)
When you click on the graph, a red point automatically appears on the first available point to the left of where you click. Because spectra are mare of discontinuous data, there might be a significant gap along the horizontal axis between the click point and the red point. The cursor part contains: x co-ordinate of the red point in the (Hz) field. the frequency expressed in bpm and seconds. the power
power section (C)
The full spectrum field is the total spectrum power(4), obtained by adding up all data, including those outside of the user-defined frequency range. 252
(4) a power spectrum is made of a number of discrete values, each one corresponding to a specific frequency. When producing a value for power within frequency limits the software adds all spectrum data for frequencies >= low limit and < high limit
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In the two columns are power values for up to 5 ranges: the user-defined frequency range (left is % of total power, right is power) up to 4 custom bands (left is % of total power within user-defined frequency range; right is power)
reminder
section (D)
This includes: band limits: the current band limits. fft: current fft settings. spectrum #: number of individual spectrums used to build the spectrum of the current epoch (same as number of red tiles shown in the lower graph of the data tab). resolution (hz): frequency spacing between consecutive spectrum values (is a function of both the number of points used to perform the fft and of the data resampling step). spectrum max frequency (hz): max frequency value for which the spectrum returns a known value. Is a function of the resampling data step.
11.7.3 important points

Please read the following points, to help you use the hrv module optimally. settings are specific to your goal Before making settings, you must be clear about what sort of phenomenon you are looking for. If you are looking for events that occur across time spans of, say, 15s, your fft spectrums must be at least twice this length and preferably somewhat even longer (40 s to 60 s). This implies that you must choose spectrums having a number of points covering such durations. In turn, this requires that your epoch is long enough so that a full spectrum will fit inside it. When you adjust the number of points used for each spectrum computation, you will see that this automatically produces a change in the frequency resolution of the spectrum (the higher the number of points, the higher the resolution) With regard to the resampling step, typically this should be 50% to 80% of the average time difference between two consecutive data points, so as not to lose too much resolution in resampling. For example, if your RR intervals are between 250 ms and 3000 ms range, a resampling step of 200ms may be a good choice. Please bear in mind that no epoch spectrum will be produced if, for at least one epoch, there are not enough data points to produce at least one fft spectrum,. example of settings Lets suppose that the epoch contains 1000 resampled points. 253
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You can adjust the resampling step, the fft point number and the fft epoch shift settings, and see their effect on the number, length and relative position of the individual fft epochs. Two examples of settings are shown in the figures. Example 1 1000 resampled points 512 points in fft spectrums. fft epoch shift: 100% Data panel shows that only one spectrum is computed (figure n191)
figure n191.
example 1 (hrv analysis)
Example 2 1000 resampled points 256 points in fft spectrums. fft epoch shift: 50% Data panel shows that 3 (overlapping) spectra are computed (figure n192)
Sloping lines indicating individual spectrum data range.
figure n192.
example 2 (hrv analysis)
further reading 254 A full discussion of fft analysis is beyond the scope of this manual. For a full understanding of the fft technique and to help you obtain valuable results, we strongly recommend that you do further reading. Several good manuals are readily available.
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hrv test signal
A good understanding of how fft works is all the more essential since it is easy to produce data of poor scientific value by using improper settings.
11.7.4 trends panel

For each epoch a number of parameters are computed: time-domain parameters fft derived parameters The Trends panel displays one or more parameters across all epochs (figure n193). You can select: how many trend graphs are displayed (graph# field) the parameter the type of horizontal scale (X scale field): epoch or, if epochs are irregularly spaced in time, time
figure n193.
trend panel
11.8 hrv test signal

It can sometime be useful, in particular for test and validation purposes, to be able to inject a known signal as input for the variability module. By doing so, it will, for example, be possible to check that the power spectrum correctly shows the frequency peak associated with the injected test signal.
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To perform a test signal, go to the Test signal tab of the settings panel. The three modes in the test function tab are: none added to data replaces datal With the last two options, you can define the paramters of the test signal (figure n194): f(timeS) = A + B X sin (C X timeS) + B X sin ( E x (timeS + F) ) where A, B, C, D, E, F are user-defined constants, and the variable is time, ie time within the epoch expressed in seconds.
figure n194.
hrv test signal settings
figure n195 shows the graph (resampled points only) after addition of a test signal made of a single sine wave.
figure n195.
sine wave added original signal
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caution! keep in mind that forgetting to remove test signal will produce results that of course do not correspond to the original input data.
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viewing video signal
chapter 12. advanced features

12.1 viewing video signal
iox2,
emka TECHNOLOGIES acquisition software, allows for the simultaneous recording of physiological signal and video. The video signal may be saved within the mkt file or as a separate file. For integrated video signals, you just need to load the mkt subject file and signal traces as well as video will be available for review and analysis. You know thet you open a file which contains video because: the raw data file info panel indicates the total video data as well as the number of recording sections (if video was split in more than one continuous recording) the mark tables and the mark graph show video indications. See the next 2 figures.
Information on video recordings present in this file.
figure n196.
raw data info when video is present
Marks indicating video starts and stops. Colored zones where video is available.
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figure n197.
Marks table and graph when video is present
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ecgAUTO version 3.0 user manual - advanced features
To view video signal, go to the Raw data traces panel. Use the video control ring to decide how to view video: Short loop: video is played in a continuous loop covering 10% of displayed data length and centered on the displayed zone. Full loop: video is played in a continuous loop covering the full displayed zone. Continuous play: video is played and when the image reaches the end of the data zone, data automatically moves to the next window. The time point of the current image is shown as a green cursor.
video control ring
Cursor showing time position of current image
Zone covered when in short loop mode. Zone covered when in full loop mode.
figure n198.
Raw data trace panel and video features
figure n199.
video recording of dog in tox study
A right-click on the video image brings up a popup menu where it is possible to resize the image, speed up or slow down the video replay speed, see information on format, resolution.
12.2 performing batch analysis

258 This option is useful to load a number of raw data files and let the software automatically perform ecg analysis on all of them.
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performing batch analysis
To access this option, select Analysis Batch Analysis or click on It brings up the Multi-file batch analysis panel (figure n200). The first three menu items of this panel are used to produce the list of raw data files to analyze (Add, Remove, Clear). When the list is built, the software assumes that analysis will be performed using the currently active configuration. In cases where you want to impose a specific configuration for analysis of some files, click on the data line containing the file. A directory select window pops up; select the configuration then validate. The new choice appears in the list. When the selection is complete, click on Batch Analysis! to start the analysis procedure.
figure n200. batch analysis file selection panel
12.2.1 rules applying to multi-file analysis

The multifile search only operates if a viable protocol exists. If no protocol at all is defined (no protocol instruction exists) a warning message is issued and the analysis aborts. At the end of each analysis, text and binary data are automatically stored to disk. If HRV analysis button is pressed on, at the end of the ecg analysis, the HRV analysis is automatically performed before moving on to the next file. In manual mode, the user is invited to enter a message when data are saved to file. In the case of multi-file analysis no such message is required. During analysis, press on esc to stop. A dialog box proposes three choices: abort the whole procedure, abort the analysis on the curent file but move to the next file and analyze it, cancel. As soon as one file has been completely analyzed, the number of beats produced is added to the total beat indicator. www.emka.fr
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12.2.2 lower list of analyzed files

The lower list of the panel only displays the analyzed data files for which the number of detected beats is inferior to the number specified in Show if beat # < setting. Indeed, when you batch process a very large number of files (for example 100 files or more), this provides an easy way to immediately see which analyses provided less than what you estimate to be an acceptable minimum number of beats. If you want this list to display all files, simply set Show if beat # < to a very hugh value.
12.2.3 accessing analyzed files

If you wish to look at the results of an analysis, you may use the File Load result file menu, as explained in the chapter about data review. You can also right click on the lower list of the Multi file batch analysis panel, and the corresponding raw data file will be proposed for reloading.
12.3 reading the key events log-book

produces a log-book which keeps track of a limited number of key events. This is designed as a tool to help the user have a summary of what is has done with the software.
ecgAUTO
This is no substitute for the complete Audit-Trail module, which may be installed along with ecgAUTO and which keeps a very extensive track of all events. Click on View log book display in the main menu or click on panel. to open the log-book
figure n201.
log-book panel
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reading the key events log-book
The log-book is automatically created and lists all important actions from the users. Actions which trigger an entry in the log-book are the following: Starting and leaving the software (log-in, log-out) Saving results data. Some actions create more than one entry; in the example above, the action of saving results, performed at 11:43:04, created lines 37 to 40, all listed as belonging to action n38. The four entries are: - Information that this was a new analysis (not a review) and specifying which raw data file is used - Specifying file name and directory for all saved result files
Included in the entry line about the binary data file, extra information is provided: How many steps were performed out of the theoretical number requested (here 10 out of 10. If you had for instance 8 out of 10, this would mean that the software was either stopped manually during analysis, or automatically stopped for failing to analyze a sufficient number of beats in one step).
Number of analyzed beats:
The step index which generated the smallest number of beats (here obviously, it is step 1). This can be helpful to locate possible areas in a file where the analysis was less successful).
Multi-file analysis:
analysis starts.
A specific Multi-file analysis entry is added in the log-book when such
The log-book is automatically incremented as in manual mode, for entries concerning raw data file and saved data files.
Stored file presence: It can be useful to know if results files are still present in the directory
where they were originally stored.
Click on the update file presence button in the log-book panel. Any file which is still where originally stored will be highlighted by a bright yellow or blue dot.
list selection: It can be useful , when looking at the log-book, to only see lines that correspond
to one type of action. For instance, find analysis already done and saved, only display those lines, and get rid of the other lines about startying the software, exiting the software etc.
Loading result files from the log-book:If a binary file is present in its original directory (bright
blue color dot in from of its name), you may position the cursor on its entry line and right click, to immediately load it for review.
Archiving log-book data:The
log-book keeps expanding every time the user utilizes the software. To archive all but the latest entries, choose how many entries you want to archive using the send nn log-book actions to archive numeric display; you are at most allowed to archive all but the last two entries (you can archive fewer). www.emka.fr
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Then click on Archive menu item. Panel as in figure below appears.
figure n202.
Log-book archiving
You are proposed the choice between Appending to an already existing archive file, or archiving to a new archive file. Archive files are sent to the program\logbook-directory\ directory, where program is whatever directory you chose to install the program. The logbookdirectory is automatically created when the program runs for the first time (see corresponding message issued during installation procedure). Archive files are automatically created and named log-book-archive.xn where n is automatically incremented when the user chooses to Archive into new archive file. Archive file is a read-only text file.
figure n203.
Successful archiving message
12.4 summary of keyboard shortcuts

A number of keyboard shortcuts are available within ecgAUTO. They are primarily designed to make software easier and more efficient. They are not always traditional Windows conventions since the requirements from such an advanced analysis tool are most of the time very different from other office type applications. Shortcuts are context-dependent and may have different effects depending on the currently active panel. The active panel is the last panel on which the user has clicked or used. The active control is the last control on which the user has clicked. Shortcuts from main panel graph is active 262
mousewheel:
moves signal traces page by page graph: signal traces page by page graph: in or out on graph centered on cur-
left, right arrows: moves up, down arrows: zooms
sor position:
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summary of keyboard shortcuts
right-click: opens panel for marks, parameters and graph display settings. double-click: if witin an analyzed beat, positions the table on that beat.
F keys (when activated)

F2: creates F3: creates F4: erases F12:
a custom comment. a zone (starting from comment just created and ending at cursor position).
closest mark.
F5 to F10: places a predefined mark at the cursor point.
analyzes data from cursor point. create rectangle.
mouse -drag on traces:
ctrl-X produces an XML file of selected data in ecg interval analysis mode (rectangle is red) space bar: collects data and proposes it a new library waveform ctrl-space bar: collects data and proposes it as averaged new library waveform (if proper setting in library panel) ctrl A collects data and proposes it as a manually added beat: table is active
single-click:
show corresponding beat on graph: up and down within the table and shows beats; table content left or right:
mousewheel: moves right-click: opens
left, right arrows: shifts
table and export content selection panel.
space bar: if on a line with beat data, opens beat edition panel. delete key: if on a line with beat data, opens invalidation panel.
Shortcuts from library panel (graph is active)

simple click:
positions cursor ready for transfer as mark on cursor point (5-step zooming cycle).
position.
left/right click: zooms
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Shortcuts from Multiple library panel (graph is active)

single-click:
panel.
shows corresponding waveform in library
double-click: toggles waveform status (enable/disabled).
Shortcuts from report panel graph is active:

single-click: right-click:
detects closest average beat and positions step table on it. opens panel for adjustments on average beat display settings. table is active:
single-click: show mousewheel:
corresponding step on graph.
hows beats.
right-click:
moves up and down within the table and table content left or right.
left, right arrows: shifts
panel. Trend graph is active:

single-click: show
opens table and exports content selection
corresponding beat or step step on graph. up and down within the table and shows beats;
mousewheel: moves
Protocol graph is active:

single-click: shows
corresponding absolute time and site time.
Shortcuts from raw data traces panel (graph is active)

single-click: updates
point.
info about time at cursor
moves the corresponding point in graph center.

left-click, right click: mouse-wheel:
back or forth. 264

single-click: shows
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moves graph by a single page
F keys: as
for main panel graph (see above).
Shortcuts from multi trend panel (graph is active) corresponding beat (or step if in stat display mode).
summary of keyboard shortcuts
left-click,mouse-drag: creates
selection rectangle.
space-bar: if selection rectangle exists, send captured beats to capture list. simple-click: if selection rectangle exists, erase oldest rectangle. right-click-left margin: opens
settings panel.
Shortcuts from capture list panel (table is active)

simple click: shows
corresponding beat.
delete key: if on a line with beat data, opens in-
validation panel.
Shortcuts from XY trends graphs panel (graph is active) shows corresponding beat (or step if in stat display mode).
single-click:
Shortcuts from Success frozen view panel (graph is active)

single-click: shows corresponding step, or if button is
on, performs local analysis.
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chapter 13. results files

As described in chapter 5 , ecgAUTO analyses files generated by iox or files generated by non-iox software and converted to an iox-compatible format. In all cases, the analyzed file is one of two formats, corresponding to different versions of iox. version 2 of iox produces files of format subject.mkt where subject is the user-defined subject name. Every time this file is replayed, a file of format subject_mmm.mkt will be created where mmm is a unique number computed from the date and time version 1 of iox produces files of format subject.dmm where subject is the user-defined subject name and mm is initially 00 then, incremented on every replay.
When you save the results of an analysis done in ecgAUTO, 2 or 3 files are created: .z file (also called a binary file) The .z file contains calculation configuration settings (including the library), software display settings, and co-ordinates of all marks produced by the analysis. It does not contain the raw data signal. The .z file is a binary file and is created every time you save analysis results. .x file (also called a text file) This is the end product of ecgAUTO, i.e. the file containing the results for further processing, and archiving. The .x file is created every time you save analysis results. The contents of this file are highly customisable: apart from the core information contained in every .x file, you can choose whether to include other types of information. The .x file is an ASCII-encoded text file so can be directly loaded by third-party software such as Excel or other spreadsheet programs. .xx file (also called an archive text file) The .xx file is created on request. It is the same type of file as an .x file but its contents cannot be customized (in fact, it is identical to an .x file for which all types of information are saved).
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ecgAUTO version 3.0 user manual results files
13.1 creating results files

The different stages are described in sections below. make text file settings select steps to be saved in .x and .z files (by default all steps are saved) save results
13.2 make text file settings

The text file settings are made under five tabs of the List display and text export settings window (figure n204). These tabs are described in the following sections.
figure n204. accessing text file settings
To open the window, select Tune Parameters in list / to file from the main screen or rightclick on a data table. sections -> txt
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figure n205. sections -> txt tab (text file settings)

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creating results files
The left box contains a list of available items and the right box contains the items that you have selected. Click on an item in the left box to select it; click on an item in the right box to deselect it. Each item represents a particular section of a text file.
main-header
(This section is always selected - and therefore included in every text file). Contains: name, full path and creation date of raw data file; name, full path and creation date of the text file itself;
IOX file headers
When starting an acquisition with iox, the user has the option to enter comments relating to the whole experiments and to each subject. This section contains the comments.
file-story
As explained elsewhere, it is possible to load a results file, edit beats and/or marks and then save the new file. This operation can be repeated as many times as needed so that a text file can be the product of successive work sessions: an initial automated ecg analysis session, followed by a number of review sessions. This section contains the tracking information.
software
Version and release of iox and ecgAUTO

leads
List of all inputs recorded during the experiment, including labels, sampling rate. Specifies which individual input was used for ecg analysis.
calculation
List of all calculation settings used to produce the automated ecg analysis.
library
Name, path and number of waveforms of the library used in the analysis.
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library-all
A list of all library waveforms and the number of times each was used in the current analysis. Specifies raw data file from which each waveform was extracted, as well as waveform author, last modification date.
library-use
Same as Library-all, but does not say how many times each waveform was used in the current analysis.
protocol
Not implemented in the current version.

comments
There is one line per comment label or Zone label. For each label, specifies how many times the comment/Zone appears in each period. Provides the the total duration of all Zones in each period. Labels reported here are only those selected in the Comments graph & text file panel.
mark-table
Table of all marks in the data file including stream-start/stop, period-start/stop, comment, Zones. This table provides a useful summary of the whole experiment protocol.
steps
Table of results, with one line per step. The contents of each line are defined under the step -> txt tab.
beats
Table of results, with one line of data per analysed ecg complex. The contents of each line are defined under the beats -> txt tab.
invalidated beats
List of beats invalidated manually. 270

variability
HRV results.
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selected beat end of report text file
Always included. Inserts an indication showing the end of the results text file.
datanalyst fmt
A button is available, in the upper right, to indicate whethre the text data file format should be made compatible with emka TECHNOLOGIES Datanalyst postprocessing software. When you use it, you may find that the file includes information or parameters that you did not specifically decide to include, but are included anyhow, since they are essential fo compatibility with Datanalyst. This option also has an effect on the order in which some columns appear.
site-time
Site-time can be displayed in two formats: days+hh:mm:ss.sss or hhhh:mm:ss.sss For example, 1 day, 1 hour, 6 minutes and 04.630 seconds can be written 1d+ 01:06:04.630 or 25:06:04.630.
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steps -> txt
figure n206. steps -> txt tab (text file settings)
The left box contains a list of available items and the right box contains the items that you have selected. The items are identical to those available for the report table.Click on an item in the left box to select it; click on an item in the right box to deselect it. If the boxes are not accessible (in this case they are dimmed), first select the steps item in the sections->txt file tab. In the check boxes, you can select whether you want: marks (stream-start, etc) to be included in the step report. missing values to be reported as na (otherwise they are 0) whether to analyze selected steps If unchecked, all analyzed steps are included in the text file. If checked, those steps that you have manually selected using the Step control and export selection panel are included.
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beats -> txt
figure n207. beats -> txt tab (text file settings)
The left box contains a list of available items and the right box contains the items that you have selected. Click on an item in the left box to select it; click on an item in the right box to deselect it. If the boxes are not accessible (in this case they are dimmed), first select the beats item in the sections->txt file tab. Each item represents a column of information in the beat report. In this report, there is one line per analyzed ecg complex. Items are identical to those available for the main screen table. The check boxes provide the following options: marks included If checked, marks (stream-start, etc) are included in the beat report. This feature allows you to understand where a step is within the experiment, but it creates a special type of data line among step data lines. missing values as na If checked, a missing value is reported as na or 0 - inv is reported for invalidated beats
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invalidated beats included If checked, invalidated complexes are included in the table. If you wish to see the list of invalidated beats, you may still see it by selecting invalidated beats from the sections -> txt tab. Datanalyst format To be able to successfully import the text file into Datanalyst, you must check this box. To ensure compatibility with Datanalyst, some parameter columns are forced to the right, and other parameters permanently selected. whether to analyze selected steps If unchecked, all steps are included in the text file. If checked, only steps that you have manually selected using the Step control and export selection panel (section 13.3). statistics Under this tab, select which statistical values to include. Refer to list of statistics available in average waveform, page 206 for detailed description of each statistic parameter. Please bear in mind that regardless of your choices under this tab, statistical values are always computed.
figure n208. statistics tab (text file settings)
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select steps to be saved
precision Under the export column of the precision tab, select the precision of the data (number of digits after the decimal point) in the exported table
figure n209. precision tab (text file settings)
13.3 select steps to be saved

By default, all steps are exported. However, in some situations, users only want to export some of the steps. The choice of steps to export is usually based on proximity to a time point and quality of analysis. Selection of steps to be exported is done in the Step control and export selection window (figure n210), accessed by selecting Step selection! in the Report window (View Stat table & Trend graph) The upper window contains all the steps, while the lower window contains all selected steps. Select steps from analysis results mode in the drop-down menu. Under reference marks, you can select up to 4 reference marks from all marks. Click on a step to highlight it. When a step is highlighted, the step time from reference marks fields displays the difference between the step and the respective reference mark. In the upper window, double-click on a step or press the space bar to select/deselect a highlighted step (your changes are instantly applied in the lower window). When you have made your selection (an example is shown in figure n211), select Close!
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figure n210. step control and selection tab (first time opened)
figure n211. step control and selection tab (after selection of steps)
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13.4 saving
In the main window, select File Save results files or click on the icon
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saving
In the next panel (figure n212), you may: enter a comment to be attached to the results file customize the file name of the .z file text (entered text is appended to the file name defined by default options). Enter your desired options if any then select OK to proceed. A popup panel invites you to enter an optional comment which will be included in the data file.
figure n212. save options for results files
The following panel appears when results files have been created. It provides information about the file and folder names. Excel file can be opened from this panel, ckicking on Open.
figure n213. successful creation of results files
If the save folder for any of the files is not suitable (e.g. it does not exist or it cannot be written in, as is usually the case for CD or DVD), ecgAUTO informs you and gives you the opportunity to select another folder:
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figure n214. impossible to write on target folder (message)
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will create none or all of the requested result files. In other words, if it will not be able to create at least one file, the other ones will not be created (in this situation, a message informs you that no files will be created).
ecgAUTO
13.5 notes
lifetime of results During a session, ecgAUTO remembers only the results of the most recently performed analysis (whether a protocol-based analysis or a local analysis). As a consequence, when you start a new analysis (protocol-based or local analysis), the results of the most recent analysis are erased. This is why it is so important to save the results as described above. The created files can then be loaded at any time. To minimize the risk of losing results in this way, ecgAUTO provides a warning message/reminder when you close ecgAUTO. (figure n204). .
figure n215. warning of imminent loss of analysis results
If while in Review mode (described in next section), you decide to switch to analysis mode and run an analysis, the currently loaded analysis results will be discarded. Of course, since they were already stored on disk, they can be reloaded for Review again if needed. file naming By default, ecgAUTO names the result files subject. xmm, subject. xxmm or subject. ymm where: subject is the subject name defined by the user in iox and mm is a two-digit index number (00, 01, 02). If you have selected the option Results file name appended with lead label in the General settings (section 6.3.1), the files will be named subject_leadname.xmm, subject_leadname. xxmm or subject_leadname. ymm where leadname is the name of the input in iox.
ecgAUTO will use the same index number for all files that it creates in one operation. So, supposing you want to create all 3 types of results files, ecgAUTO will check whether subject. x00,
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subject. xx00 or subject. y00 already exist on their respective target folders. If any one file already exists, ecgAUTO performs the same check with file names subject. x01, subject. xx01 or subject. y01. In fact, ecgAUTO continues increasing the index number until it finds one for
which all 3 file names are available.
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loading results files (Review mode)
file renaming Data files are not supposed to be renamed. If a file has been renamed, a warning message will appear the next time you try to open it with an emka TECHNOLOGIES program. This message will inform you that the file has been renamed and remind you of its original name. You will not be able to load the file until it is given its original name again.
13.6 loading results files (Review mode)

As a reminder: the binary file (.z) and text file (.x) are always created when you save the analysis results; the archive text file (.xx) is only created on request. by default, the results files are saved in the same folder as the raw data file you used the storage folder of each type of result can be specified by the user in General settings) To load results files, select File Load results file from the main screen or click on the icon . A file explorer window appears from where you must select a binary file.
When you selected the binary file, ecgAUTO will attempt to locate the corresponding raw data file (.mkt) and load that too. It proceeds as follows: first, ecgAUTO looks in the original location (the folder in which the raw data file was located when the binary file was created). second, if you defined a secondary folder in the field seek .mkt file or .d file in secondary directory from .z file in General settings, see (0),ecgAUTO will look there too If the file is not found, a message appears with a file explorer, from where you can look in another folder. When the file is found, it is loaded and ecgAUTO switches to review mode. In review mode: analysis icons in the toolbar are dimmed - see figure n216).
ecgAUTOyou cannot perform analysis (all analysis options are unavailable, e..g. the ecgAUTOyou can edit some calculations, add comments or periods.
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If you make modifications, you can save the results as normal.
figure n216. main panel in Review mode
To return to analysis mode, select File switch to analysis mode or click on the icon .
13.7 file story

When in review, you can open the file story panel (figure 142) by selecting View File analysis history or by clicking on the icon .
figure n217. file history panel
If you invalidate then revalidate the same complex within the same session, this is still counted as 1 invalidation and 1 revalidation, even though the overall effect is zero.
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types of print-outs
chapter 14. presenting your data

In ecgAUTO, it is possible to print out the raw signal trace and other study-related information. Several options are available to allow you to print documents that contain the information you want and look as you want them to look. You can also produce electronic documents to share with other people (fellow researchers, experts) who do not have ecgAUTO The created document are files in the XML file format and can be viewed in any browser such as Internet Explorer (of course they remain non-editable). This chapter describes: the two basic types of print-outs customisation options how to customize your print-outs how to create xml documents
14.1 types of print-outs

In ecgAUTO, you can create one of two basic types of print-outs: current view print-out The print-out is based on the data currently shown in the raw data display. It consists of 1 page only. The mid-point of the data on this page is the same as the mid-point of the raw data display (however, depending on your settings, not all of the raw data display will be printed). protocol steps print-out The print-out is based on steps defined by a protocol. There will be as many printed pages as necessary to show all the analyzed data. The two types of print-out are shown, with examples, in figure n218.
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ecgAUTO version 3.0 user manual - presenting your data
Raw data window
current view print-out #1

Print size is 20 cm x 10 cm ; X axis scale is 100 mm/s 2 sec of data shown in print-out
Protocol defines 5 steps of 5 seconds each.
current view print-out #2

Print size is 20 cm x 10 cm ; X axis scale is 50 mm/s 4 sec of data shown in print-out
2 lines
protocol steps print-out

Print size is 20 cm x 10 cm ; X axis scale is 50 mm/s; 2 lines per page 8 sec of data shown in each print-out page
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1 page required for each step, so 5 pages in total (page 1 for step 1, page 2 for step 2, etc).
figure n218.
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two types of print-outs
types of print-outs
Each page of a print-out is made up of three or four sections (one is optional). section 1: text section with file and study information section 2: contains one or more lines. a 'line' is one width of data containing all the selected data traces section 3 (optional): protocol graph section 4: a text section with information about scales, page numbers, etc. A sample print-out is shown in figure n219. Your print-out will not necessarily have the same appearance - it depends on your settings (described in the next section). section 1
section 2
section 3 section 4
figure n219. sample print-out
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14.2 settings
From the Raw data display (View raw data trace in the main screen), select Print Adjust Print Settings to open the Raw data print settings window (figure n220).
figure n220.
raw data print settings window
The settings in this window allow you to customize the contents of your print-out. Settings in the left column specify which information is included in the text sections (sections 1 and 4) and whether a protocol graph (section 3) is included. Settings in the right column concern the data trace (section 2) and printable area settings. Settings labelled PS only apply to previews or print-outs of protocol steps.
with user-defined header: if ON, a user-defined comment (as specified in the raw data print out-out header field) is included. with iox exper. header / with iox site header: if ON, the corresponding experiment / site header,
specified in iox, is included.
with CPU date and time / with site time / with period time: if ON, the corresponding time is in-
cluded. Please note that the times refer to the mid-point of the data (indicated by the two small red triangles). 284
with step and beat index: if ON, the index number of the beat and its steps are included. with time span info: if ON, the total duration of displayed signal is included (in seconds). Please
note that this value does not take into account any signal interruptions.
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settings
with input info: if ON, the input index and label is included on the traces. with protocol graph (height in pixel): to include a protocol graph, select ON then enter its
height. Typically, a readable graph is between 20 and 60 pixels high.
with analysis markers: if ON, the markers resulting from analysis are included on the data
traces.
always print when saving data: if ON, a print-out is produced automatically when you save
binary and text data to files.
This is an important issue from the the GLP point of view. Because it is possible to edit markers, the automatic and simultaneous production of electronic files and paper print-outs ensures that both contain the same data under different representation. Print-outs automatically generated in this way have a special label indicating that they correspond to a specific binary and text file.
send print-out to printer: font size:
in the current implementation of ecgAUTO, this setting is always ON.
overlap.
specify text font size; choosing too large a font might cause text sections to
step print rhythm (s/10): in preview mode, print-out is displayed on screen for a limited amount
of time. Specify (in tenth of a second) the display duration.

print from step indexPS / print until step indexPS
if OFF, all steps are included in the protocol steps print-out if ON, you can select a range of steps to include, by speciying the index number of the first and last step.
line number / page: specify
the number of lines per printed page. This number can be different from the present current number of data lines.
with grid (spacing mm) PS: if ON, grids are made of dots and solid lines (every 5 dots) are in-
cluded with the data traces.You can choose between 1 dot / 1 mm or 1 dot / 2 mm.
simple grid PS
(This option is only available if grid spacing is ON) 285
If ON, only the solid lines of the grid are printed (the dots are not).
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The previous two options concern the grid on the printouts; you can independently control whether the grid is also displayed on-screen by setting the grid also in raw data display toggle on or off.
time scale mark (ms): if ON, a square wave of the user-defined time length is included in the
lower left corner of the graph.
input label: if ON, input lndex and label are included. Y scale label PS: if ON, the Y scale (in calibration unit/cm) is included print as landscape:
if ON, pages will be in landscape format ; if OFF, pages will be in portrait format :
print width (cm) / print height (cm) PS
if ON, you can enter the dimensions of the print area. For A4 sized paper (29.7 x 21 cm), a print area with a width of 25cm and a height of 19 cm gives good results. if OFF, the print area is the same size as the paper size.
print X scale (mm/s) PS: specify the horizontal scale in mm (paper) /second (of data). print X scale (s/line) / print X scale (s/page): These fields are for information only (non-editable).
They tell you how many seconds of data will fit on the line and page (they are identical if you have 1 line per page).
14.3 customizing print-outs

You must adjust several parameters in order to obtain satisfactory print-outs. This process is usually a matter of trial and error. It therefore requires patience but also luck, because, unfortunately, some printers behave in unexpected ways. However optimization probably only needs to be done once! Below is a methodical step-by-step procedure explaining how to customize your print-out settings. 286 1. What is the size of your paper? 2. Do you want to print as landscape or portrait?
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customizing print-outs
The most common case is printing in landscape format (width greater than height) on A4 paper (21 cm x 29.7 cm). In this case, set Print as landscape to ON, and specify print width of 25 cm and print height of 19cm (these dimensions allow for margin space). Remember that you must have specified a value for print width and height, to also be able to print a grid and to impose a X or Y scale. If no paper size is defined, ecgAUTO does not know physical dimension so cannot apply scaling. 3. Do you want a background grid ? If yes, set with grid to ON and specify the distance in mm between dots (1 mm is usually used). Set simple grid to ON if desired. 4. Specify the X axis scale (also referred to as paper speed) Enter your desired scale in Print X scale (mm/s). As an example, if you chose a paper width of 25 cm and a paper speed of 50 mm/sec, then each line of data will contain 5 sec of signal (value in the print X scale (S/line) field). 5. Specify vertical scale(s) Your print-out might contain the signal trace of more than one input. In this case, it is obvious that the vertical scale will be different for each input (for example, an ecg input will have a scale of 1 mV/cm, pressure will have a scale of 20 mmHg/cm) To set vertical scale(s), click on Adjust traces in the Raw data display to open the Trace display settings panel (figure n221).
figure n221.
Trace display settings panel
When you are making print settings, the Y offset and Y dynamic slides as well as the scale settings on the left of the panel have no effect Click on the appropriate on buttons to choose which trace to display and print. Suppose now that you intend to have three inputs printed, and that you only want one line of data per page.You should now consider that the whole rectangular graph area is horizontally divided into three equal sized areas for each trace. 287
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On the middle slide (auto, dyn, man): set on dyn if you are only interested in the vertical amplitude of your signal. The vertical scale is then as specified as Y unit/cm, and the signal strip will automatically be vertically centered on its rectangle (in our example, one of the three rectangles). The min Y and max Y values have no influence. set on man if you want to impose the vertical position of your trace. Then, the minY value is the signal value on the lower of its rectangle (one out of three in our example), the vertical scale being again as specified as Y unit/cm. The max Y value setting still has no influence. 6. preview to check At this stage, in the Raw data trace window, choose Print Print current view. A preview of the print-out appears as well as a small pop-up (figure n222).
figure n222.
preview panel pop-up
The options at this stage are: print (click left icon) send a bitmap image to the clipbopard (click right icon) close the preview (press esc key, or close the pop-up). 7. print data zone This step depends on whether you will print: a current view (7A) protocol steps (7B) 7A. print current view Press the print icon in the pop-up menu. 7B. print protocol steps. As mentioned in section 14.1, when you print out protocol steps, there will be as many printed pages as necessary to show all the analyzed data. Each step starts on a new page - the first point on the printed page correspond to the start of the step.
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customizing print-outs
Two examples illustrated these principles: example 1: Settings are such that 5 s of data will be printed on each page. Every protocol step is less than 5 s. Printed page 1 contains all of step 1, page 2 contains all of step 2, etc. example 2: Settings are print width of 18 cm, paper speed is 50 mm/s and 1 line/page. Therefore, 180/50 = 3.6 sec of data will be printed on each page. The protocol defines continguous steps of 5s each. Printed pages 1 and 2 will contains step 1 (page 1 has data from 0.0s to 3.6s ; page 2 has data from 3.6s to 7.2s) Printed pages 3 and 4 will contains step 2 (page 3 has data from 5.0 s to 8.6 s; page 4 has data from 8.6 s to 12.2 s) 7B1. preview protocol steps print-out: To access this preview, choose Print Preview all steps from the Raw data display window. If a protocol is present (regardless of whether analysis has been perfomed or not), the preview opens along with a small Preview panel (figure n223):
figure n223.
preview of protocol steps print-out
At this stage, you must perform one of the following actions in the panel: browse among the page previews print a specific page (click the printer icon) Press escor click the panel close button to exit the preview mode and return to the Raw data display window. 289
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7B2. print protocol steps print-out To print the protocol steps, select Print Print all steps from the Raw data display window. If the print from step index or print until step index settings are active, print-out will be produced only for those steps between the sepcified limits. 8. optimizing printer settings In an ideal world, paper print-outs would look exactly like the on-screen preview. In reality, they often do not. Here are a few hints on how to change the settings of your printer to solve any problems that arise. The most common problems encountered are the following: the print area size you impose is not taken into consideration or cause the printer to stop functioning. some printers invert landscape and portrait. some printers refuse to print the grid dots . Hints at solving those problems: when the grid dots do not show, the solution is often to decrease the printer resolution (contrary to what common sense suggests), for example to 300 dpi or less. if such settings are not accessible with your driver, use a generic driver instead (HP LaserJet for example). activate the point mode, rather than the vector graph mode do not activate the resolution enhancement options (RET and similar). see if switching to black and white rather than color improves things.
14.4 export text files

The export text file function produces a text file containing the raw data. This function is useful in the following situations: you want to use third-party software to modify and annotate the signal waveforms, with a view to include samples of the graphs in a report or a publication. The solution is to export the data as a text file, then directly load this file into your spreadsheet or graphing software you want to perform your own calculations, test some algorithm, and thus need access to the raw data in an easily usable format 290
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export text files
Key characteristics: Data to be exported must lie within Zones (section 9.3.7 describes how to creates Zones). It is possible to export several zones into the same text file. The created text file is tab delimited The procedure is as follows: In the raw data display panel, select Export Export as text file or click on the icon open the Raw data export as text file panel: to
Select the period, zones or comments you want to export. The top window shows all available zones. The bottom window show selected zones. Click on a zone in the top window (anywhere on the line) to select or unselect a zone. Select all to select all zones or none to unselect all zones
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Changes you make in the Raw data export as text file panel are saved instantly.
The data max freq (Hz) fields shows the default sampling rate of the created text file. The default sampling rate is the highest sampling rate across all inputs. So, if there is one input at 1000Hz and another at 100Hz, the default sampling rate is 1000Hz (for the 100Hz input, ecgAUTO will generate new values based on extrapolation). If you do not want to use the default sampling rate, you may undersample your data by changing the value in the under sample field. For example, if you enter 2, only one in every 2 data points will be exported. Undersampling is useful to reduce the number of data lines produced. For no undersampling, leave the default value of 1. The print freq (Hz) shows the sampling rate of the created text file (taking into account any undersampling applied)
total signal duration shows est.total data line number
the total duration of selected zones.
shows an estiamtion of the total number of data lines to be produced. This is absed on the total duration of selected zones, the default sampling rate and the undersampling if appied. In comment, you may if you wish enter a comment that will appear in the text file. If you want to avoid exporting more than a certain number of data lines, enter the limit in the max line number field. This is useful when, for example, you want to be able to load the clipboard or text file into a software program that has a limitation.
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export text files
Click preview to display the data to be exported as a graph. From the displayed graph press print to print out this graph.
The final step is to create the text file, by clicking on send to file or send to clipboard. If you choose to create a file, a panel prompts you to confirm or modify the file name and storage folder. The proposed file name is of the format subjectname_ZoneLabel(s)type where subjectname is the .mkt file name,followed by the labels of the zones selected for export.
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When you click on Save, the file is exported. Progress is indicated by a progress bar;
If you press escape to interrupt the process, a text file or clipboard is still created but limited to the amount of data that had already been transferred when you interruped the process. A confirmatory message appears at the end of the export:
The text file may then be directly loaded into your graphing or spreadsheet program, such as Excel (figure n224):
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figure n224. text file opened in Excel
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export xls files
14.5 export xml files

From the Raw data traces panel: 1. drag the mouse to select a zone of data (with or without analysis markers) 2. create a zone , see chapter 10.3.7) 3. press ctrl-X. or select Export Export data as XML file. This action open the
Export data as XML file panel.
4. Select the required zone and click send to file. It creates and displays an XML file (with an .svgz extension). The XML file is created in the folder where the data were originally stored. The name of the XML file includes the subject name and times and dates of the data period. So if the orginal file was named subject.mkt or subject.d01, the XML is file named subject_ july_4_2000_09h_.8mn_28s_18.611.svgz meaning that the XML file contains data from 09:08:28 on 4 July 2000 and is 18.611 seconds long. The file is then displayed in Internet Explorer. (Firefox should not be use) In most cases, a security module of Internet Exporer asks for confirmation before it allows the display of the XML file (.figure n225).
figure n225. Internet Explorer requires user confirmation to display XML files
After you confirm, the .XML is displayed (figure 192). This is what your colleagues will see when they open the XML file in their browser.
14.6 export xls files

During file saving, Excel file can be opened from this panel, ckicking on Open.
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figure n226. successful creation of results files
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uninstall with the installer
chapter 15. uninstalling ecgAUTO

There are two methods for uninstalling ecgAUTO: via the Windows control panel using the installer Each method is described below.
important! please note that to uninstall ecgAUTO, it is not sufficient to simply erase the folder where thesoftware is installed. Follow one of the described methods.
15.1 uninstall via the control panel

In the Start Menu, select the control panel, then Add/Remove Programs (figure n227).
figure n227.
Windows tool to add or delete installed programs
15.2 uninstall with the installer

Insert the ecgAUTO installation CD-Rom in the CD drive Double-click on the file ECG-Install.exe. The following panel is displayed:
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ecgAUTO version 3.0 user manual - uninstalling ecgAUTO
figure n228.
ecg uninstall: step 1
Select Remove, then Next.
figure n229.
Click next to confirm that you want to remove ecgAUTO.
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figure n230.
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uninstall with the installer
figure n231.
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overview
chapter 16. usersMANAGEMENT

This chapter is divided into the following sections: overview of usersMANAGEMENT how to make usersMANAGEMENT settings how users interact with usersMANAGEMENT
16.1 overview
If users management is activated for a particular emka TECHNOLOGIES program, then every time a user attempts to launch that program, the usersMANAGEMENT module reads the users base in order to decide whether to allow the user access to the program and, if access is provided, which functionalities are available. It is the responsibility of the users base administrator to create users choose which software each user is able to access (Authorized software) set the user logins (the password is defined by the user at first use of the software so only he/she knows it) select the login mode for each user select which functionalities are available for authorized software for each user Users bases are named users.umb by default. A users base can be local or distant . Although usersMANAGEMENT gives you the choice of using more than one users base, we recommend that you use only one users base for all software. During configuration of each emka TECHNOLOGIES program on each PC, you will therefore have to create a link to this user base. Furthermore, in a network, this user base must be shared and administrator users must have full control (read/write access/available offline) of the folder containing the users base. Other users should have a read access.
usersMANAGEMENT
runs in one of two login modes: 301
emka login mode passwords are managed by usersMANAGEMENT. Logins and passwords are defined for each emka TECHNOLOGIES program. Windows login mode www.emka.fr
ecgAUTO version 3.0 user manual - usersMANAGEMENT
passwords are managed by Windows. uusersMANAGEMENT retrieves the logins and passwords from the Windows password database. Each user only has to remember one login and password.
16.2 make settings

Below are described more in details the users account settings. You can reach the users base via the users identification panel, which is displayed: immediately after you activate usersMANAGEMENT in the first run (GLP configuration) panel, and then every time you launch an ecgAUTO for which usersMANAGEMENT is activated. when ecgAUTO is launched, selecting Files GLP tools... Edit users The following panel is displayed:
Click on Users . The access control panel is displayed:
302
figure n233.
access control panel
Log in as an administrator (the default Password is userscontrol, although we strongly recommend that you change this at the earliest opportunity.) If the selected base doesnt exist yet, the following warning message appears:
emka TECHNOLOGIES
make settings
figure n234. users edition login panel
Click on OK. The users base editing panel appears.
figure n235.
users base edition panel
From this window, the users base administrator can: add a user remove a user add/remove programs from the list of authorized programs for each user modify a users privileges for each of his authorized programs reset a users password activate/deactivate other glp modules for authorized programs To validate these modifications, click OK. add a user To add a user to the list of users (on the left): click on Add Users specify a login name and a user name choose login mode When you select a user from the list of users, the list of authorized software for this user is displayed on the right (programs must have been launched at least once to appear in this list). 303
www.emka.fr
Each users password is only known by that user. add/remove programs from list of authorized programs for each user To add a program to the list of authorized software: click Add under the list of authorized software choose the selected program in the scroll-down list of the Name column.
note: if you are using a users base on a network, you will have to add the same program repeatedly if the program is not stored on the same path on each computer (for example if it is E:\EMKA\ ecgAUTO on some computers and C:\EMKA\ecgAUTO on others).
important! users must have read/write access to the folder containing the users base. To delete a program from the list of authorized software: select the program click Del Make the following settings for each program in Authorized software:
Status: determines whether the user has access (active) or does not have access (revoked,
expired) to the program. Active and revoked can be manually set, while expired appears automatically when the expiration date has been reached.
Expiration: the
user has access to the program up to this date only.
Use level: determines which functionalities the user can access in the program. There are five
user levels for each program. There are five user levels. From the most to least powerful, these user levels are Administrator, Expert, Super User, User and Mini-User (these are the default names).
Log again if no activity after: defines the duration of inactivity beyond which the user will have
to log in again.
modify a users privileges for each of his authorized programs Click Edit user levels to edit user levels. activate/deactivate usersMANAGEMENT In the Miscellaneous section, the Users must login check box allows you to activate or deactivate usersMANAGEMENT for the program which called the users base editing panel.
304
emka TECHNOLOGIES
user interaction
reset a users password For emka login mode only: if a user forgets his password, the users base administrator can reset that users password by: selecting the user from the list of users clicking Reset pswd. The next time the user launches the software, he will be invited to define a new password.
16.3 user interaction

Users other than users base administrators can interact with different ways: to define a password to log in to a program using their login and password to change their password
usersMANAGEMENT
in three
16.3.1 define a password

The user identification screen appears when you launch an emka TECHNOLOGIES program:
If this is your first login attempt or if the administrator has reset your password (if you lost it), it means that no password has been defined for your login. Enter your Login name and click Password to proceed to the Password edition screen. If you whish to change the default Administrator password (userscontrol), click first on Users and then on Password. If no password is defined for your account and you attempt to log in, the following message will appear: 305
www.emka.fr
In the Password edition screen, define a new password by entering it in the New password and Confirm new password fields.
Click OK to return to the access control screen where you can log in to the program.
306
emka TECHNOLOGIES
chapter 17. troubleshooting

Some possible problems and suggested solutions: The start analysis icons, and protocol analysis ! menu items are not accessible: No library waveform exists; You are still in review mode. If you indeed want to produce an analysis, switch back to analysis mode. ecg analysis produces no results: The waveform library is not adapted (comes from another species, or from the same species but does not contain the appropriate shapes); The expected bpm setting is not correct; Some or all of the beats in the library are in disabled state; Precision level is set too high. Go back to medium setting. One or more required parameters are sometimes or always null: Check how the parameters is supposed to be calculated. For example, if QT is null, check how QT is supposed to be computed (from <Q to T>, or from other setting). Then check that the markers required for QT are present in all the waveforms making up the library. If the null parameter is an amplitude, or an area or a ST elevation, make sure that the information required to produce a base value is available. For areas, the base is either the isoelectric line or the junction between area limits. You are unable to add a new waveform into the library: Make sure you are actually in ecg intervals mode and rhythm and stability mode. A waveform, newly included in the library, fails to analyze the exact area from which it was extracted: Even though the complex is (probably) detected, the software failed to validate the corrsponding RR, either because of the specific characteristics of the previous complex, or because an artefact or signal flucatuation of sufficient amplitude exists on the previous RR. In the latter case, the solution is to increase the value of the artefac amp (%) setting; The waveform was extracted from a complex too close to the beginning of the data zone and no previous R peak is available to complete its analysis. 307
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ecgAUTO version 3.0 user manual - troubleshooting
Following a software crash you have a new crash as soon as you restart the software: The problem is now present in the configuration file, which is automatically loaded at every new start, and again causes the crash; Solution: from the Windows explorer, go to the directory where the program is installed, erase the lastrun.cfg and noname.ecg.cfg files. Start the software again. When you print, you obtain a white page Select use bitmap printing in the print panel. I still cannot resolve the problem Contact us by phone, while sitting in front of your PC, for trouble-shooting. If the problem is more difficult to describe, record the following files on a CD: subject.dnn raw data file, ecgAUTO configuration files, and, if the problem occurs in reloading an already analyzed file, binary and results file. Send it to us with some written description of where to see the problem. I get the error -143 In case of such error panel showing a -143 code
figure n237.
error-143
1. Uninstall Microsoft Visual C++ 2005 Redistributable 2. Install Microsoft Visual C++ 2005 SP1 Redistributable Package (x86) found at https://www.microsoft.com/download/en/details.aspx?id=5638
308
emka TECHNOLOGIES
... end of user manual
www.emka.fr
europe
emka TECHNOLOGIES SA
59, bd. Gnral Martial Valin 75015 Paris - France tel: +33 (0)1 40 60 76 00 fax: +33 (0)1 40 60 65 55 emka@emka.fr
north america
emka TECHNOLOGIES Inc
307 Annandale Road, suite 203 Falls Church, VA 22042 - USA tel: +1 (703) 237-9001 fax: +1 (703) 237-9006 emkatech@emkatech.com
hong kong
emka BIOTECH Hong Kong Co Ltd
Rms 1318-20, Hollywood Plaza, 610 Nathan Road, Monkok, Kowloon, HK tel: 00852-27108200-3296 or 00852-35000568 fax: 00852-27810816 emkabiotech@yahoo.com www.emkabiotech.cn
distributor for japan

Physio-Tech Co Ltd
6-3, Iwamoto Cho 1-Chome Chiyoda-Ku, T okyo 101-0032 tel: +81 3 3864 2781 fax: +81 3 3864 2787 emka@physio-tech.co.jp www.physio-tech.co.jp
distributor for china

Beijing GYD Labtech Co Ltd
office in Beijing:
Rm 935 Laho Studio, No.15-A1 East Jianguo Road Chaoyang District, Beijing 100024 tel: 010-85376382 or 13031151180 or 1301151181 fax: 0086-10-58208944 info@bjgyd.com
office in Shanghai:
Rm 401 Unit No15 169 street, East Guilin Road, Xuhui District, Shanghai tel: 021-33685303 or 18917745303 zhoujinjun0410@gmail.com www.bjgyd.com
All contents Copyright July 2011 emka TECHNOLOGIES SA. All rights reserved. Because emka TECHNOLOGIES has a policy of continuous product improvement, we reserve theright to change design and specifications without notice.

User Manual - EcgAUTO v3.0 Rev1 - April 2012

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User Manual - EcgAUTO v3.0 Rev1 - April 2012

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ecgAUTO v 3.

0 software for automated ecg analysis

chapter 3. general information

chapter 4. quick start chapter 5. loading data

chapter 6. ecg analysis settings

chapter 7. non-ecg analysis

ecgAUTO version 3.0 user manual

99 101 103 107 109 110 122 136 146

chapter 8. libraries (for ecg analysis)

chapter 9. defining and running protocols

chapter 10. analysis

chapter 11. HRV studies (variability module)

chapter 12. advanced features

chapter 13. results files

chapter 14. presenting your data

chapter 15. uninstalling ecgAUTO

chapter 16. usersMANAGEMENT

chapter 17. troubleshooting

can also analyze non-ecg signals1, namely:

corresponding data into objects called studies. electronic signature module

audit trail software (either auditCENTRAL or auditSERVER)

2.1 supplied items

2.2 minimum configuration

2.3 user privileges

ecgAUTO version 3.0 user manual installation

2.4 release notes

figure n1. install .exe file icon

figure n2. install welcome panel

Then the user information panel displays.

figure n3. install - personal information

In the destination folder panel, a default installation folder is proposed:

figure n4. install - installation folder

ecgAUTO version 3.0 user manual installation

figure n5. install - installation type

figure n6. install - ready to install

A message confirms successful installation.

configuring the users management

Click on Finish. When prompted, click Yes to restart the computer.

figure n8. install - restart system

2.5 configuring the users management

their login name and password.

ecgAUTO version 3.0 user manual installation

2.5.2 first run of ecgAUTO software

can be run with a number of options :

figure n9. 1st run of ecgAUTO software panel

check box and go directly to

configuring the users management

figure n10. users identification panel

access control panel

ecgAUTO version 3.0 user manual installation

2.6 running ecgAUTO for the first time

chapter 3. general information

toolbar customization and panels display

General settings tab Configuration files Precision tab

3.1 toolbar customization

figure n13. moving a module

ecgAUTO version 3.0 user manual general information

3.2 panels display

3.3 general setting tab

figure n15. general settings panel

The different settings are as follows:

general setting tab