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7. USE OF BATTERIES7.USE OF BATTERIESOpen the recorder. Insert the battery in the battery compartment (9), respecting the polarityas marked in the compartment.7.1.BATTERIESSpiderView is powered by one AA 1.5 V battery (lithium or alkaline).A new lithium battery will last between one and seven consecutive days of recording,depending on the brand of battery, the recording quality mode, and the number of channels.A new alkaline battery will last between one and four consecutive days of recording,depending on the brand of battery, the recording quality mode, and the number of channels.After using the device for one recording, it is recommended to keep the battery inside thedevice for the next usage. If the voltage is not sufficient for another 24h recording, a warningmessage will appear after switching on the device.NOTE: If SpiderView is switched on when the battery is low, the duration of the recordingwill be one day only (24h), regardless of the programmed time.7.2.RECHARGEABLE BATTERIESFor 24-hour recordings SpiderView may also be powered by a re-chargeable battery with aminimum capacity of 1500 mA/h.We recommend that you read carefully through the instructions that came with the batteries.NOTE: Use a suitable charging device to recharge the batteries and follow the batterymanufacturer's instructions.7.3.INTERNAL MEMORY BATTERYSpiderView contains an internal battery that ensures the maintenance of the system’s dateand time and other parameters (contrast, recording quality mode) for about a week.The internal battery recharges automatically during the daily usage of the recorder.WARNING:When the recorder is not used, it is recommended that the 1.5 V battery power supply notbe removed, in order to constantly guarantee the recharge of the internal memory battery. Ifthe internal memory battery is completely charged, the system’s parameters will bemaintained without the 1.5 V battery power supply for approximately one week.14SpiderView – UA10709B

8. POSITIONING THE ELECTRODES8.POSITIONING THE ELECTRODESWARNING: Connect the patient to the SpiderView only when the back of the SpiderView isin place.Electrodes supplied with SpiderView have been designed to withstand long-term ambulatoryrecording while ensuring patient comfort. Nevertheless, other ECG electrodes may be used.To ensure a good quality ECG recording, special care must be taken when preparing thepatient’s skin, positioning the electrodes and connecting the leads. Clean the patient’s skinwith soapy solution, cleanse it and dry the skin to reduce impedance and obtain a goodelectrode-skin contact.Electrodes must be firmly attached to avoid air bubbles which could impede proper contact.A loop should be made in each lead and the lead then attached with adhesive strips close tothe electrode. Pressure on an electrode could produce artifacts.The proposed electrode placements are an example. It is essential to ensure that the QRScomplex amplitude is sufficient in at least one lead, to make automatic data analysis possible.The user can verify electrode placement using the ECG preview.RightWrongWARNING: Conductive parts of electrodes (including the neutral electrode), should not beput in contact with conductive parts or grounded parts.8.1.TWO-CHANNEL RECORDING (3 ELECTRODES)8.1.1.ELECTRODESChannel: poleCommon – poleA2: red (112 cm)1: white (122 cm)B3: brown (112 cm)1: white (122 cm)SpiderView – UA10709B15

8. POSITIONING THE ELECTRODESCable length: 122 cm8.1.2.ELECTRODE PLACEMENTThis electrode configuration allows you to obtain the maximal number of independent ECGchannels with the smallest possible number of electrodes.Place the red electrode ( ) over a rib at V5, the brown electrode ( ) on the xiphoid muscle atthe bottom of the sternum and the white electrode (common – pole) on the sternum over themanubrium.Positioning of electrodes for this configuration is shown in the figure below.1328.2.TWO CHANNEL RECORDING (5 ELECTRODES)8.2.1.ELECTRODESChannel: poleCommon – poleA1: white2: redB3: black4: brownGround5: green5: greenCable length: 122 cm8.2.2.ELECTRODE PLACEMENTThe CMV5 lead ( 60 axis) detects identifiable P waves and high-amplitude QRS complexes.It is also acknowledged as being sensitive in detecting myocardial ischemia during exercisetesting. Place the white (-) electrode on the sternum, over the manubrium and the red ( )electrode over a rib at V5.The CMAVF2 lead ( 90 axis) provides high-amplitude P waves. The black electrode is alsoplaced on the manubrium as close as possible to the white electrode but not on top of it. Thebrown electrode is placed on the xiphoid muscle at the bottom of the sternum.The ground electrode is placed on a rib on the right side of the chest.Positioning of electrodes for CMV5, CMAVF2 is shown in the figure below:16SpiderView – UA10709B

8. POSITIONING THE ELECTRODES314258.3.THREE CHANNEL RECORDING (7 ELECTRODES)8.3.1.ELECTRODESChannel: poleCommon – poleA1: white2: redB3: black4: brownC5: blue6: orangeGround7: green7: greenCable length: 152 cm8.3.2.ELECTRODE PLACEMENTGenerally, it is recommended that a completely different lead be used in addition to the twoleads used for a two-channel recording. CBV2 is an anteroposterior lead close to the Z axisthat allows thorough study of changes in the ST segment related to the left coronary artery,as well as the LAD artery and circumflex artery.The blue electrode lies posteriorly and paravertebrally facing V2. The orange electrode isplaced in V2.The ground electrode is placed on a rib on the right side of the chest.31647SpiderView – UA10709B5217

8. POSITIONING THE ELECTRODES8.4.XYZ CHANNEL RECORDING (7 ELECTRODES)8.4.1.ELECTRODESThis electrode configuration is suggested for:― Derived 12 channel ambulatory recordings*.― High Resolution 20min recordings for late potential analysis; for this application ashielded cable is recommended to reduce noise level.WhiteX-Fourth intercostal space in right midaxillary lineRedX Fourth intercostal space in left midaxillary lineBlackY-Superior aspect of the manubriumBrownY Lower ribsBlueZ-Directly posterior to V2OrangeZ Standard V2 positionGreenrefOver 8th rib in right midclavicular lineCable length: 152 cm* Available with SyneScope Holter software.8.4.2.ELECTRODE PLACEMENTFor an ambulatory orthogonal ECG recording close to the XYZ late potential configuration,the following hook-up is recommended. However, due to constraints of daily activities, someminor variations may be introduced, provided that polarity of electrodes and axis orientationsare maintained.YZ Z-Xref18X Y 8.5.TWELVE-LEAD RECORDING* (10 ELECTRODES)8.5.1.ELECTRODES1YellowLALeft Anterior acromium2RedRARight Anterior acromium3GreenLLLeft Interior iliac crest10BlackGNDRight Interior iliac crest4PurpleV1V1 positionSpiderView – UA10709B

8. POSITIONING THE ELECTRODES5PurpleV2V2 position6PurpleV3V3 position7PurpleV4V4 position8PurpleV5V5 position9PurpleV6V6 positionCable length: 150 cm* Available with SyneScope Holter Software.8.5.2.ELECTRODE PLACEMENTRALAV1V2V3V4 V5GNDThis configuration is intended to provide astandard 12 lead recording similar to thatobtained from a resting ECG:―Lead I, II, III (Einthoven leads)―Leads avR, avL, avF (augmented limbleads)―Leads V1 to V6 (precordial leads)V6LLThe central terminal of Wilson is automatically calculated by SpiderView.Because of ambulatory conditions we recommend placing electrodes on the roots of the limbs(Mason-Likkar configuration), often used in exercise testing.NOTE: Due to the positioning of peripheral leads on the upper extremity of the limbs,ambulatory recordings obtained in this configuration are more likely to contain movementartifacts than other bipolar configurations previously described in this manual.SpiderView – UA10709B19

9. USING THE PROGRAMMING BUTTONS9.USING THE PROGRAMMING BUTTONS9.1.USER INTERFACE STRUCTUREThe user interface is structured as a sequence of several screens, which allow you to set theparameters of the device and of the recording. The programming keypad contains 7 buttons(the numbers refer to the “general description” section):These buttons (2) are used to move from one screen to another.These buttons (3) are used to move the cursor inside one screen and to modify the parameters of the screen.This button (4) is used for final confirmation to start a recording. During therecording it is also used as an event button by the patient.The ON/OFF button (1) is placed on the back of the device under the back cover.NOTE: The event button has a flat surface in order to avoid accidental activation of thebutton and causing false patient events in the report.After switching on the recorder and inserting a flash card, the device displays the name ofthe last patient recorded on it. Moving to the left allows access to the device’s parameters(date, time, voltage, contrast ). Moving to the right allows you to set the recording’sparameters and to begin the recording. The following chapters will explain the details aboutthe SpiderView screens.9.2.STARTING THE DEVICE9.2.1.SWITCHING ONIn order to insert the battery, please refer to section 6.2 “Opening the battery cover”.After inserting a battery and connecting the patient cable, press the On/Off button (1).20SpiderView – UA10709B

9. USING THE PROGRAMMING BUTTONSA beep indicates the start-up of the recorder. The LCD screen lights up and the deviceperforms a number of automatic tests to check that all of its components are functioningproperly and carries out various initialization procedures.If the display remains blocked on an AUTOTEST number, this indicates that a problem hasbeen detected. Contact MicroPort After-Sales Service.If all tests are normal, the message INSERT CARD is displayed.If no operations are performed within 5 minutes, SpiderView beeps and then automaticallyswitches off.9.2.2.INSERTING THE SD CARD1. Insert the card into the slot (8), as shown in the illustration, with the front of the card facingup. The card has a beveled edge in one corner, which should be at the top right-handside when inserting the card.2. Push the card completely in, in order to ensure a good connection. If the card is notcorrectly inserted, the cover of the case cannot be closed.WARNING: SpiderView has been designed to fully support flash cards with NANDtechnology. Older MMC cards with NOR technology do not guarantee optimal performanceof the device.WARNING: SpiderView is only guaranteed to work properly if flash cards supplied byMicroPort are used. If you do not use a MicroPort card, the following message will appear:“Warning: Unknown card provider”. Furthermore, a flash card designed for use inMicroPort recorders should not be used for other applications; if this does happen, theSpiderView may no longer be able to read the card.If the flash card is not blank, the name of the last patient recorded is displayed on the screen.This allows you to check the card that you are going to use to perform a new recording. Therecording on the flash card will be automatically erased by starting a new recording.Move to the next screen using the right screen button (2) to visualize the patient’s ECG.SpiderView – UA10709B21

10. STARTING THE HOLTER RECORDING10. STARTING THE HOLTER RECORDING10.1.PROGRAMMING USING THE BUTTONS10.1.1. ECG screenThis screen allows you to:―Visually check the quality of the ECG leads―Program the type of pacemaker to recordECG’s amplitude and scrolling speed can be changed for a better visualization on the screen.This will not be taken into account during the recording.For an accurate analysis of the ECG on the Holter analyzing software, the amplitude of theQRS complexes on the first two channels should be at least 1 mV. This corresponds to theamplitude of the calibration bar on the left side of the display.10.1.2. Pacemaker recordingsIf the patient undergoing a Holter recording has a pacemaker, it is mandatory to declare thepresence and type of pacemaker to ensure the ECG analysis software classifies the pacedbeats correctly.This must be done on the ECG screen: move the cursor to the field “No PM” and modify itusing the buttonsand.The device records single chamber or dual chamber pacemakers with two differentsensitivities: Unipolar (less sensitive) or Bipolar (more sensitive).22SpiderView – UA10709B

10. STARTING THE HOLTER RECORDINGNOTE: If the type of pacemaker is unknown, it is suggested to select bipolar mode.A high sensitivity mode is available. It can be used to detect very low amplitude PM spikes.Because of the high sensibility, it is likely that noise and muscular or movement artifacts aredetected as stimulation spikes. A shielded cable is suggested in order to reduce false pacingspike detections.10.1.3. Insert patient nameThe next screen allows you to enter the patient’s name onto the flash card. This is necessaryso that the Holter recording will be unequivocally associated with this patient’s name whendownloaded.10.1.4. Select recording protocol, insert patient ID and activate the accelerometer sensorIn this screen the ECG analysis protocol can be selected with or without activating theaccelerometer sensor:AdultNormal analysis protocolInfantFrom 0 to1 year (or weight 10Kg)Long QTPatients with long QT or wide T wavesAdult, Infant, Long QT AccAdult, Infant or Long QT protocol with accelerometer activatedThe protocol can be modified on the Holter software after the card has been downloaded,but if the accelerometer sensor has not been activated at the start those data cannot bedisplayed. You may also insert a patient ID number that will be downloaded together withpatient’s name.10.1.5. Select the recording modeSpiderView can work in different recording modes using di

SpiderView is not compatible with the ELATEC and SyneView analysis software systems. . SyneTec, EasyScope, SyneView2 and SyneCom. TYPE OF RECORDING SpiderView offers three types of recording: ― Holter recording only. ― High-Resolution ECG recording only. ― High-Resolution ECG recording followed by a 24-hour standard Holter recording. .