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ECG Equipment

The Technological Evolution of ECG Systems

Recent ECG systems, with advanced features to incorporate ECG records into the patients EMR enable the hospitals workflow to be effectively streamlined.

As medical technology advances, it is important for hospitals and medical facilities to stay up to date, especially when it comes to ECG systems. Innovative advancements in communication technologies and low power circuit plan have empowered the development of better and more secure ECG equipments, which are convenient, work with lower force utilization, are more exact, and have the ability to incorporate the latest diagnostic features.

Recent systems have been designed to improve workflow and simplify operation. ECG with its advanced features to incorporate ECG record into the patient’s electronic medicinal record (EMR) enables hospital’s workflow to be effectively streamlined. Newer ECG systems offer better integration, including interoperability with other software, PCs, and smart phones. Innovative developments such as, cloud storage, wireless communications, and advanced data analytics tools are thus creating huge opportunities in the ECG equipment market.

Indian Market Dynamics
 The Indian ECG equipment market grew by about 11 percent in volume and value terms. GE, Philips, and Schiller continue to dominate with a combined market share of about 65 percent. BPL is aggressive in this segment. Mindray, Nihon Kohden, Nasan, JK Medical (Bionet), Silver Meditech, Krishna Medi, and Nidek have major presence in this segment. Many other Chinese and other brands also co-exist.

2016 saw an upward revision in the customs duty by 8 percent from 11 percent in 2015 to 19 percent in 2016. Whereas Philips and Schiller passed on the increase in customs duty partly and increased prices by 3–4 percent, other brands absorbed the hike.

The total occlusion of the epicardial coronary artery leads to myocardial infarction (MI). It is being manifested in electrocardiograms (ECGs) as ST segment elevation in the leads records electrical activity from that region. Because there can be topographic variations in blood supply of the three major epicardial coronary arteries from  person-to-person and the predilection of involvement of particular sites of conduction system with different coronary arteries, the clinical presentation, morbidity, and mortality vary with the artery involved, in cases of acute MI. Hence, early identification of the culprit artery gives a bird’s eye view to the clinician for managing life-threatening diseases. A 12-lead ECG is a simple noninvasive tool used for diagnosing the acute MI. By adding an algorithm to identify the culprit artery in an ECG, it empowers it into a more efficient modality. Schiller and Philips offer the CCAA (culprit coronary artery algorithm) software that helps correctly identify the site of obstruction in the coronary artery. However, these systems have yet to gain popularity with the physicians, who often prefer alternatives such as angioplasty and angiography.

The low-end stress machines are typically procured by private cardiologists, while the discerning corporate chains of hospitals buy dedicated high-end systems.

Technology Trends
Remote ECG monitoring systems are becoming commonplace for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process have kept advancing. However, there remain accompanying challenges.

Wearable systems. A wearable health monitoring system can be based on a microprocessor and customization platform, smart textiles, body area network, commercial Bluetooth sensor, mobile phone, etc. However, the variables involved in the performance of these systems are usually antagonistic, and therefore the design of usable wearable systems in real clinical applications entails a number of challenges that have yet to be addressed including sensor contact, location, rotation, signal correlation, and patient comfort, and two objective functions including functionality and wearability. These variables were optimized using linear and nonlinear models to simultaneously maximize the objective functions. The methodology and results demonstrated that it is possible to overcome most of the design barriers that have so far prevented wearable sensor systems from being used in everyday clinical practice.

Hardware. The portable ECG monitor is developing toward a multi channel, new record, digital, intelligent, network-sharing device that will use digital technology to improve work efficiency and accelerate timeliness. This will significantly improve the accuracy of clinical diagnoses. The research and development trends of ECG detection and analysis systems mainly include the following aspects: a compact instrument, and an acquisition synchronization of 12 channels. The portable ECG Holter system and the heart beeper are products of this developmental trend.

Road Ahead
Currently, there is a significant diagnostic gap in detecting heart disease early, resulting in a burden on both patients and healthcare systems. Manufacturers are focusing on developing ECG systems that could play an important role in achieving the preventative treatment ambitions of many healthcare systems as well as help reduce unnecessary healthcare expenditures. Innovation is needed to advance front-line testing of patients for heart disease. High-sensitivity ECG technology holds significant promise for improving their early detection. It makes sense to use advanced signal processing to create a modern, low-cost, front-line tool to detect heart diseases.

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