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Ongoing campaign to trade up to card(X)plore

Meditech CardioTens, a combined event ECG and ABPM device was considered a great technological advancement when it first came out. Even though, the unit’s quality is still well approved by many medical professionals all around the world, its successor multifunctional device card(X)plore allows users to get an even better and more complex picture about their patients’ cardiovascular condition.

CardioTens was quite extraordinary in its time. I’m proud of our team which was able to achieve such extraordinary level of performance in the engineering field" – says István Szőllősi, M.D., managing director of Meditech, who was involved in the development process from the beginning. What made the CardioTens unit so innovative? In Hungary – and in medical research generally around the world – even the ambulatory blood pressure monitoring was a relatively new technology back then. Initially, hypertension research had been part of cardiology, and it became an autonomous discipline later.

ABPM was usually used by cardiologists, since heart disease and hypertension often go hand in hand. Thus, the idea of designing a multifunctional device which records ECG and starts blood pressure measurements at the same time came naturally. Nowadays we often take all technical conditions for granted, however, it was different at the end of the previous century. Dr Szőllősi points out: “It might sound strange, but back then the memory of a personal computer wasn’t bigger than 640 Kb, moreover a medium that stored 2 Megabytes of data was considered a high-tech one. Since continuous ECG data recording requires large storage capacity, the developer team opted for designing an ECG event recorder. Even though it was a well-known technology by that time, the creators of CardioTens brought something new to the table.

Contrary to former models of event recorders that hadn’t recorded signals until the patient had pushed the appropriate button, CardioTens recorded ECG signals along with the blood pressure measurements. The latter were programmed in advance. This in itself was a great advancement, but Meditech’s multifunctional recorder went beyond that. Developers designed an algorithm system which was able to detect and categorize different ECGs beats, and in case of certain parameter changes, it could start an extra BP measurement along with the relevant ECG recording (which was even longer than the automatic ECG recording stored along with every automatic blood pressure measurement). Several parameter settings were - and still are - available in the software, but perhaps the most important is ST depression referring to an insufficient oxygen supply of the heart. This feature was so important that it made CardioTens an active Holter ECG. The innovation made possible to also detect asymptomatic events (they could be captured by the preset parameters), not only the events perceived by the patient. Accordingly, CardioTens was perfect to record silent ischemic periods. Before CardioTens, only the full disclosure Holter recorders had achieved this, however, they were not able to measure blood pressure values. The device served as a great tool for the adjustment of antihypertensive treatment for patients with hypertension, since medical professionals could check whether an ischemic event correlates either with high or with low blood pressure values. They also had the chance to examine if it depends on the dosage or the timing of taking the medications.

In the end, it is not surprising at all that the market had an absolutely positive reaction to the new device. Even the social security system has been reformed in some countries for the sake of CardioTens and similar units. The financing available for the Holter examinations changed as follows: the doctor who performed an examination with a multifunctional unit could get more refund than the total amount available for a separate ABPM and ECG examination. This step provided financial motivation for medical professionals to use combined devices example in Hungary, the UK, and Russia, among others.


How was card(X)plore made?

In parallel with the technological developments, our team was allowed to place the advantages of the CardioTens unit into a more modern device. That is how card(X)plore unit has become reality. What are its new features compared to CardioTens, and why is it more useful in everyday healthcare?

“If I was asked to name the three most important features, I would list the followings:card(X)plore gives a more complex picture about the patient's cardiovascular condition

  1. Full ECG storage: the card(X)plore device stores every single ECG beats, therefore the software is able to categorize all beats after the recording period. This is more accurate way compared to CardioTens’ real-time categorization technology.
  2. 3-channel recording: upgrading the number of the channels from 2 to 3 means a few percent increase in the accuracy according to international Holter studies. In case of Holter devices, this achievement is a great step.
  3. In-built actigraphy: card(X)plore presents data about its position and also the state of motion with a dual-axes accelerometer sensor. So, if we assume that the unit is worn in accordance with the user manual’s recommendations (in a pouch fixed to the patient’s waist), the above data provides the patient’s general upright or lying position and her state of motion. Consequently, we will have information on the correlation between an ischemic event and the patient’s activity level. It is important to know if a cardiovascular issue presents itself during extreme physical activity or a period of quiescence.”


Will „too good” become the new standard?

As a result of technological advances of card(X)plore unit, we may have a much better picture of the multiple correlation of related diseases. The unit offers a 3D matrix to examine the patient’s current body position/activity level, blood pressure values, and the changes of the ST segment. From a medical point of view, designing card(X)plore was necessary, and as Mr. István Szőllősi says, Meditech is proud of the final result indeed. However, this is still not the time of unclouded happiness, since there are some countries where financial decision makers haven’t considered the importance of multiparameter cardiovascular monitoring. We can find several countries where they do not help doctors to perform ABPM and ECG monitoring together, but only one of these examinations is financially supported within 24 hours,  even if the combined examination would be much more beneficial from a medical point of view.

„At the same time, it is a great pleasure to see that, despite the financial struggles, a number of conscientious medical professionals use the device worldwide and spend a bit of extra time on checking the complex results.” The card(X)plore unit hasn’t become a generally used technology yet - as one of its designers describes, it is „too good” to become a mass product. Nonetheless, the Meditech team never gives up on the hope that one day "too good" may become the new standard in everyday healthcare.

If you are interested in turning your old CardioTens unit into a new card(X)plore, please contact us directly or get in touch with your local Meditech distributor for further information.