What Are The Clinical Advantages Of The Atys Systoe?

The Atys SysToe is a ground breaking device designed for the rapid and automatic assessment of toe or finger systolic pressures. Here are some of its key clinical advantages:

  1. Ease of Use: The SysToe is user-independent, meaning it can be operated easily by healthcare professionals without extensive training
  2. Accuracy and Reliability: Utilizing infrared photoplethysmography (PPG) and a patented algorithm, the SysToe provides accurate and reproducible measurements, even in patients with conditions like diabetes or chronic renal failure
  3. Versatility: It can measure pressures as low as 20 mmHg and is suitable for use in various settings, including vascular labs, diabetic units, and general practice
  4. Clinical Validation: The device has been clinically validated, showing good agreement with traditional methods like laser Doppler. It is particularly useful for patients with calcified arteries where other methods might fail
  5. Comprehensive Assessment: The SysToe can calculate the toe brachial index (TBI) or finger brachial index (FBI) when brachial pressure is known, aiding in the diagnosis and monitoring of peripheral arterial disease (PAD) and critical limb ischemia (CLI)
  6. Patient Comfort: The automatic inflation and deflation of the occlusion cuffs ensure a comfortable experience for patients
    These features make the Atys SysToe an invaluable tool for healthcare providers, enhancing the diagnosis and management of vascular conditions with efficiency and precision.

Clinical Paper Validates Meditech ABPM-06 For Use with Children.

A new peer reviewed clinical paper has just been published validating the popular Meditech ABPM-06 ambulatory blood pressure monitor for use with children.  

The objective of the clinical validation published in the journal Blood Pressure Monitoring 29(4):p 198-202, August 2024 was to validate the ABPM-06 in a paediatric population according to the International Organization for Standardization Protocol 81060-2:2018.

Ambulatory blood pressure monitoring (ABPM) devices like the ABPM-06 play a crucial role in diagnosing hypertension, not only in adults but also in paediatric patients

A total of 86 healthy patients, consisting of 34 males and 52 females, aged between 3 and 17 years, were enrolled in the study.

The validation process involved utilizing the same-arm sequence protocol, both in resting positions and during stress testing.

The ABPM-06 performed well in both clinical and ambulatory validations and met the established criteria regarding the mean and SD values of the differences between the device readings and the observed SBP and DBP measurements.

The ABPM-06 Oscillometric device fully adheres to the ISO 81060-2 : 2018 standard requirements for 24-hour ABPM in the paediatric population (ages 3–17 years) and is suitable for use with children and adolescents as well as adults.

The ABPM-06 is available directly from PMS Instruments and we are proud to have been Meditech’s exclusive UK Distributor and Service Centre for over 25 years.

New Cardioline ECG Product Launch

PMS (Instruments) Ltd are proud to introduce the Cardioline range of ECG machines and PC based ECG systems.

There are 4 devices to choose from and they all feature 12 lead ECG acquisition with high quality University of Glasgow protocol interpretive programmes.

The machines feature an on-screen preview of ECG – prior to printing which saves paper.

The Cardioline 100S is a powerful 12 lead Diagnostic Electrocardiograph that optimises ECG workflow thanks to a smart user interface and connectivity to a dedicated ECG management system. It offers quick ECG acquisition for fast and easy operation with accurate measurements and interpretation suitable for adult and paediatric patients.

Powered by battery or mains, it prints out in multiple popular formats. It is easy to clean and disinfect thanks to its flat silicone keyboard.

The touchECG is a next generation PC based ECG allowing a simultaneous view of 12 or 15 lead high quality signals on screen, and continuous acquisition of up to 30 minutes. The high-resolution digital ECG signal is transmitted via Bluetooth to the computer where the touchECG software is installed.

Automatic interpretation and analysis of the ECG is then undertaken using the University of Glasgow algorithm for both adults and children with specific criteria depending on age, gender and race.

The ECG 100L has been designed for portability and ease of use without compromising Cardioline’s recognized quality standards. Using a high resolution 5-inch colour touch screen, as well as dedicated keys for fast operation. A smart user interface guides the user through the different steps necessary to acquire the ECG. Various on-screen messages inform the user of ongoing operations and warn in case of errors for example in case of lead off.

The device is equipped with USB port to export the ECG stored in the device’s memory in a PDF format. The ECG100L is supplied with the 12-lead Glasgow resting ECG interpretation algorithm.

Last but not least is the ECG200L with a similar specification as the ECG100L but with enhanced A4 printing formats which include standard or Cabrera 3, 3+1, 3+3, 6 or 12 channels in automatic mode and 3, 6 or 12 printout channels in continuous mode, as well as printout of the rhythm strip.

Undiagnosed High Blood Pressure – The Silent Killer

According to new estimates produced by The British Heart Foundation, four million people under the age of 65 in the UK are living with untreated high blood pressure with further analysis finding that 1.3 million of these people are under the age of 45. 

As well as significantly raising the risk of heart attack and stroke, it can also be the cause of an increased risk of vascular dementia, raised cholesterol and diabetes.

Getting your blood pressure under control is one of the most important things you can do to reduce your risk of having a heart attack or stroke.

Checking your own blood pressure with an A&D Medical clinically validated BP monitor is an easy and inexpensive way to understand if you are one of the millions of people across the UK living with undiagnosed high blood pressure and giving you the information needed to get the correct treatment and advice.

Taking a blood pressure reading takes less than 5 minutes and can be done in the comfort of your own home not just in a doctor’s surgery or pharmacy.   

Many people assume that high blood pressure is generally associated with older, overweight or unfit people. Though these conditions can lead to a high risk of heart attack and stroke, many people with an active lifestyle can also fall victim to this silent killer.

A considerable number of young people in the UK aged 16 to 24 unknowingly have risky high blood pressure too.

Stessful workplace environments are a major cause of high blood pressure with busy people all too easily putting the issue to the back of their minds.

Ordering an A&D Medical clinically validated BP monitor and getting your blood pressure under control is one of the most important things you can do to reduce your risk of having a heart attack or stroke.

With waiting lists at an all time high and the NHS under more pressure than ever before, acting now could give you the greatest opportunity to receive the life-saving treatmment you may need.

PMS Instruments stock a vast range of blood pressure monitors with different cuffs sizes to suit every individual.

So don’t become a statistic, order yours today and give yourself the best chance of taking the necessary steps to avoid long-term harm.

AliveCor’s KardiaMobile® 6L Recommended by NICE.

The KardiaMobile 6L manufactured by AliveCor and available from PMS Instruments is the first personal ECG device to be recommended for use in psychiatric services in England and Wales to measure cardiac QT intervals.

Following a conditional recommendation from the National Institute for Health and Care (NICE HTE10), the KardiaMobile 6L opens up the opportunity to ease an unmet clinical need for the ‘instant’ measurement and detection of cardiac abnormalities, such as prolonged QT intervals in psychiatric patients who are taking anti-psychotic medications.

Detecting abnormalities in patients within this group is essential as it could prevent severe or even fatal cardiac events. A prolonged QT interval indicates an abnormality detected on an ECG highlighting a disturbance in the conduction of electricity in the lower chamber (ventricles) of the heart. High doses of various antipsychotic medications can trigger prolonged QT intervals

Now, with the availability of the KardiaMobile 6L, having to configure and attach a 12 lead ECG cable to psychiatric patients after asking the patient to partially undress can be a thing of the past.

To record a 6 lead ECG the patient simply places an index finger on each of the two top plates and touches the bottom plate onto the skin of their left leg. Results are instant and can either be stored in a file on a PC or forwarded as a PDF in an email to the patient’s GP.

Testing and monitoring at regular intervals throughout a patient’s treatment, as well as in the acute phase, may be needed so the fact that NICE now recommend using the KardiaMobile 6L, and that operating it is so straight forward is really exciting news!

Say goodbye to applying messy gel and conductive stickers to psychiatric patients and experience the simplicity of using the KardiaMobile 6L. KardiaMobile 6L can be purchased from www.pmsinstruments.co.uk

New UP-200 Pulse Oximeter

The A&D Medical UP-200 fingertip pulse oximeter is an easy to operate oximeter featuring one-button control. Designed to measure arterial oxygen saturation (SpO2) and pulse rate in adults it is suitable for use in hospitals, GP Practices or home use. Simply place the Pulse Oximeter on your finger, press the button, and the results are clearly shown in any direction on the easy to read autorotate LCD.

With its fast measurement response time the device is small, light-weight and portable making it easy to take measurements on the go. The power saving features prolong battery life, whilst the low battery indicator ensures you’re never caught out.

With its rotational display the UP-200 features different display modes and will display, SpO2%, pulse rate, pulse waveform and pulse intensity on its display. Compliant with the IEC 60601-1 Quality Standard, the UP-200 fingertip pulse oximeter is suitable for on the spot Sp02 measurements and has an IP ingress protection of 22.

Key Features

• LED display
• CE 0123 Marked
• Displays SpO2%, pulse rate, pulse waveform and pulse intensity
• Auto power off
• One button control
• Universal finger clip suitable for adults
• Lightweight and portable
• Autorotate view readings from any angle
• Requires 2 x AAA batteries (supplied)
• 2 year warranty

Supplied with

• Carry case
• Lanyard
• Instruction manual
• 2 AAA batteries

Cuff Size Matters

Blood pressure monitors with an upper arm cuff provide the most accurate blood pressure readings but using the correct cuff size is really important in order to avoid inaccurate results.

Ensure the cuff is the correct size

If the cuff you use is too small for the arm, your blood pressure reading will be artificially high. If your cuff is too large, you may get a lower-than-actual reading. This is known as miscuffing.

On people with big arms, a large cuff is needed and as a general rule the inflatable bladder in the cuff needs to encircle at least 80% of the arm. The width of the cuff should be at least 40% of the arm circumference.

Measure your arm

To make sure you are using the correct size cuff for your arm place a tape measure around the bicep, at mid-arm to measure the arm circumference in cm. The left arm is typically used.

Typical cuff sizes

Not all blood pressure monitors can use different sizes of cuffs. Check with us first to make sure your digital A&D Medical UA and UM series or Meditech ABPM device can.

Typical cuff size ranges are as follows but can vary by manufacturer. For A&D UA series monitors the following cuff sizes are available.

  • Small fits an upper arm between 16-24 cm
  • Adult fits an upper arm between 22-32 cm
  • Semi-large fits an upper arm between 23-37 cm
  • Wide range fits an upper arm between 22-42 cm
  • Large adult fits an upper arm between 31-45 cm

Wide range cuffs like that supplied with the A&D Medical UA-1020-W are becoming popular with clinicians as one cuff can be used across a wider arm circumference range. This monitor can also use a small cuff.

All A&D Medical and Meditech cuffs have visual range markers to make cuff positioning easier and ensure the correct size is used. When applied correctly the cuff should wrap snugly around the arm with just enough space to slide two fingertips underneath.

One cuff does not fit all and using the correct cuff size is important both for healthcare professionals in a clinical setting and the public when buying monitors for home use.

At The Heart Of Healthcare Technology For 48 Years!

As we celebrate our 48th year in business I’ve recently taken a nostalgic look back over the various innovative products PMS have introduced to the UK healthcare market since 1975.

Some of them really were ahead of their time and have led to the development of subsequent products still in use today. Here I take a look back at a few of the more notable ones.

1994 – A&D Medical TM-2421 24 Hour Blood Pressure Monitoring System

The UK’s first dual method, Korotkoff Sound/Oscillometric 24 hour BP monitor, it proved to be very popular from 1994 to 2007 when it was replaced by the improved A&D TM-2430 24 Hour BP monitor.

1995 – E – Z Therm The 3 Second Thermometer

This was one of the UK’s first Tympanic thermometers. It was very popular and sold in large numbers. The fast measurement time meant it was popular for use in children and as a replacement for Mercury thermometers.

1997- A&D Medical UA 767 Digital Blood Pressure Monitor

The classic low cost and easy to use three in one digital BP monitor that gave systolic, diastolic and heart rate simultaneously on a large LCD display. Clinically validated it was popular with GPs and Hospitals as well as being used for clinical research. The latest generation is the A&D Medical UA-767 + AFib still one of our most popular digital BP monitors used extensively by the NHS.

2003 – Meditech Merlin ECG watch

Ahead of its time and before Smartwatches were available the Merlin watch was a low-cost ECG event recorder designed to capture transient arrhythmias. It was easy to wear and activate and could store up to 15 minutes of ECG recordings. PMS sold the watch until 2013 when it was discontinued by Meditech. It led to the development of the Meditech CardiUP3! Holter ECG. The latest AliveCor KardiaMobile 1L and 6L are great examples of how mobile ECG technology has moved on.

2009 – Tidi Disposable Cuff Barriers

Originally introduced by PMS as a cost-effective alternative to expensive single use blood pressure cuffs and as a hygienic solution to using fabric cuffs. They are still by the NHS today and were especially popular during the COVID-19 pandemic.

Introducing these products helped establish the PMS Instruments ethos of being At The Heart Of Healthcare Technology and to the development our innovative product range which still includes 24 hour blood pressure monitors, waiting room and digital blood pressure monitors, and mobile, resting and Holter ECG monitors.

PMS Instruments receives the Feefo Platinum Trusted Service Award 2023

PMS Instruments have been awarded a Feefo Platinum Trusted Service Award, an independent seal of excellence, which recognises businesses that consistently deliver a world-class customer experience.

Feefo established the Trusted Service Awards in 2014 to recognise brands that use the platform to collect verified reviews and receive exceptional feedback from their customers. The awards are unique because they truly reflect a business’s dedication to providing outstanding customer service by analysing feedback from real customers.

PMS Instruments has been a Gold Award holder since 2017 and a Platinum Award holder since 2020.

Working with over 6,000 brands, Feefo is the world’s largest provider of verified reviews, helping brands understand customers by analysing verified reviews and providing insight into trends, needs and habits. With 96% of customers relying on reviews to purchase, Feefo also creates trust between consumers and businesses by adopting a unique approach to only collect verified reviews from real people.  

With consumer confidence at near historic lows due to rising inflation, as well as research from the Institute of Customer Service revealing that complaints rose to 17.3% in the second half of 2022, this award celebrates brands that are successfully navigating tough market conditions to deliver exceptional service.

Feefo only awards Platinum Trusted Service Awards to businesses that have achieved Gold standard for three consecutive years. To receive a Gold Trusted Service Award, businesses must have collected at least 50 reviews with a Feefo service rating of between 4.5 and 4.9 between 1st January 2022 and 31st December 2022.

PMS Instruments is also an approved supplier on Practice Index where we have received over 150 five star reviews.

Congratulating PMS Instruments, Tony Wheble, CEO at Feefo, said: “The Trusted Service Awards have always been about recognising companies that go way beyond the norm in customer service and in turn receive great feedback from delighted customers”. A particular congratulations to PMS Instruments for winning a Platinum Trusted Service Award by providing great customer service consistently over a number of years. I look forward to seeing them continue to achieve next year and beyond.”   

Does It Matter What Time You Take Your BP Medication?

The Treatment in Morning versus Evening (TIME) study has recently been published. The study compared the morning dosing of blood pressure lowering medication with evening dosing of the same medication for people with high blood pressure.

Previously it was thought that the time of day you took your medication influenced how effective it was.

However, the results of the TIME Study by the University of Dundee has shown that the time of day you take your medication does not have any impact in terms of heart attacks, strokes or cardiovascular death.

The study included 21,104 patients over the age of 18 with high blood pressure from across the UK (England, Wales, Scotland and Northern Ireland). Each participant was randomly instructed when to take their medication.

There were slight differences in side effects. Patients who took their medication in the morning were more likely to report feelings of dizziness, light-headedness, indigestion, upset stomach, diarrhoea and muscle aches. Those who took their medication in the evening were more likely to report an increase of visits to the toilet.

These results mean that a patient, with their doctor can choose which time of day to take their medication to minimise side effects and which time of day suits them the best.

The TIME study was sponsored by the University of Dundee and funded by the British Heart Foundation (CS/14/1/30659). In addition, the study was supported by the British and Irish Hypertension Society, SHARE, UK Biobank, and UK Clinical Research Networks (UKCRN).

KardiaMobile 6L NICE Draft Guidance

Last month NICE published first draft guidance from its Early Value Assessment pilot project recommending smartphone-linked ECG devices.

NICE has identified there is an unmet clinical need for a more easily accessible and available ways to measure heart rhythm disturbance such as QT interval in the psychiatric service setting.

Before beginning treatment and at regular intervals during their treatment patients taking antipsychotic medicines may need to be tested for heart problems. Issues such as rhythm disturbance can influence the medicines prescribed to them, the dosing and whether they should stop taking them.

Currently a 12 lead ECG is used to measure QT intervals which psychiatric patients can find distressing as they need to remove clothing and have gel filled electrodes attached to their chests.

The KardiaMobile 6L ECG is a small portable device which can be used in any setting, including home visits and only requires the patient to rest their thumbs or finger on the top of the device and the bottom onto the skin of their left leg. This may be less distressing for the patient.

The KardiaMobile 6L data is recorded electronically and can be sent to any smart phone or tablet.

Identify More Hypertensives With A Waiting Room Blood Pressure Monitor

Guidance on preventing cardiovascular disease (CVD) was originally published in 2019 and was updated this year.  Optimal treatment of AF, high blood pressure and raised cholesterol is highly effective in preventing CVD events.

Over 40% of people with high blood pressure remain undiagnosed and of those diagnosed with high blood pressure, only 67% are optimally managed.

How do we diagnose and manage more effectively?

GP Practices are encouraged to actively screen patients and seek out hidden hypertensives. To the average practice this could mean hundreds of extra appointments for a simple blood pressure measurement.

They need help in the form of the easy to use, clinically validated A&D Medical TM-2657P waiting room blood pressure monitor.

Originally the idea of allowing patients to measure their own blood pressure was greeted with scepticism by some clinicians, but practice managers were quick to see the advantages.

Ideally located in a quiet corner of the waiting room, this type of monitor is designed for professional high volume use and automatically prints a reading, with the date and time, on a small slip of paper.

The patient usually shows this reading to the doctor or nurse at the beginning of the consultation and if the readings are too high or low they can then re-measure. In some practices patients hand results to a member of the reception team, who record it electronically for later review.

For practice managers, they offer good management and effective use of resources freeing clinical staff for other roles where they may be better utilised. Some practices report they ‘save’ up to 100 appointments per month on average.

For patients the feedback is positive and the monitors promote understanding and compliance.

Recently we have been involved in a couple of projects looking to target patients who don’t visit a GP regularly or have access to another healthcare provider. TM-2657P blood pressure monitors have been placed in public access buildings like Libraries and Pharmacies.

They have identified new undiagnosed hypertensives with elevated blood pressure and helped manage existing hypertensive patients promoting medication compliance.

The Smart Choice For Measuring Lung Function At Home

The MIR SmartOne® is a low-cost, home spirometer for self-monitoring that offers a basic level of lung function screening using Bluetooth technology to connect to a smart phone or tablet.

It is ideal for people who would benefit from home assessment of lung function, such as those with asthma, cystic fibrosis or chronic obstructive pulmonary disease (COPD). 

Using the SmartOne® app (iOS or Android) users can record PEF (peak expiratory flow- the maximum speed of the air  exhaled as hard as possible after filling the lungs completely) and FEV1 ( volume of air expelled during the first second of the same exhalation) from the comfort of their own home in real time.

The results can then be emailed electronically as a PDF to a health care professional.

The SmartOne® uses the same bi-directional digital turbine technology found in other MIR spirometers, offering a higher level of performance and accuracy than a conventional peak flow meter. It meets the ATS/ERS 2019 standard as well as ISO 26782 (for Spirometry) and ISO 23747 (for PEF).

In addition to displaying the PEF and FEV1 measurements the app will calculate a Normal Base Line Value based on the users age, weight, origin height and sex.

Three tests are performed per measurement session, after which the SmartOne app automatically selects the highest value and compares it with the users Baseline Value assigning a traffic light colour to it which is then displayed with the test result.

The results are stored in the App making it easy to track trends over a period of time.

By using the SmartOne® on a regular basis changes and patterns can be monitored by the user and their healthcare professional and appropriate treatment taken if needed.

NICE have published a Medtech Innovation Briefing (MIB96) on the SmartOne for measuring lung function which is available on their website.

SysToe, an accurate option for the diagnosis and evaluation of Peripheral Arterial Disease (PAD)

Peripheral arterial disease (PAD) occurs when plaque builds up in the arteries that carry blood to head, organs, and limbs.

Limitations of Ankle Brachial Index (ABI)

The Ankle Brachial Index (ABI) test has been in use for diagnosis and evaluation of peripheral arterial disease (PAD) for over half a century. Nevertheless, it is not without its issues.

  • Training is required before the operator is able to carry out reliable measurements
  • Some patients feel pain in the leg during cuff inflation
  • It takes time to perform the measurement
  • False values can result from medial calcification of the tibial/peroneal arteries which may prevent the measurement of ABI.

Why measure Toe Systolic Pressure?

The toe arteries are affected by medial calcification later than the leg arteries. The toe systolic pressure can be measured to circumvent the problem of medial calcification of the tibial/peroneal arteries.

Toe pressure measurements show a good agreement with ABI and remain measurable and reliable in patients with arterial wall calcification.

Does the measurement of toe systolic pressure using SysToe improve the diagnosis and reliability of diagnosis?

The SysToe is easy to use, quick and fully automatic and not operator dependent. It improves clinical evaluation and follow-up of PAD in every day practice.

SysToe drastically improves the reliability of distal toe pressure measurement, especially in diabetic and chronic renal failure patients, since the measurement of ankle pressure and ankle brachial index may be difficult or impossible in these patients because of medial calcification.

As a fully automated, totally non-invasive and painless (unlike ankle pressure measurement)  technique, systolic toe pressure measurement with SysToe is easily performed outside the Vascular Lab by Diabetologists, Podiatrists and General Practitioners for the follow-up of patients with peripheral arterial disease.

Therefore, the use of more expensive examinations (such as complete duplex Doppler ultrasound of lower limb arteries) can now be reduced. The use of a SysToe can have major clinical care pathway advantages and cost savings as well as saving patient assessment time.

PMS customers use the SysToe for

  • Assessment and diagnosis of peripheral arterial disease
  • Diagnosis of critical limb ischemia
  • Follow up of diabetic patients, patients with chronic renal failure, elderly patients
  • Assessment of healing potential of ulcers

PMS Instruments receive Feefo Platinum Trusted Service Award 2022

PMS Instruments have been awarded the Feefo Platinum Trusted Service award for the third year running.

Since 2014, Feefo has recognised the businesses who deliver exceptional experiences, using feedback from real customers.

The Trusted Service Awards are unique as they are based purely on feedback from real customers. This means they are a true reflection of commitment to outstanding customer service.

Feefo have given Platinum Trusted Service awards to businesses who have achieved Gold standard for three consecutive years. To receive a Gold Trusted Service award, businesses must have collected at least 50 reviews with a Feefo service rating of between 4.5 and 4.9 between 1st January 2020 and 31st December 2021.

Andrew Webb, Manging Director at PMS Instruments commented: “We’re thrilled to receive this award from Feefo. It means a lot because it’s based on feedback from our customers and, ultimately, keeping them happy is why we come to work each day. The award also recognises just how hard our staff have worked in really difficult circumstances. We’re fully committed to the highest quality of service, so it’s vital for us to listen, understand and respond to all our customers.”

Congratulating PMS Instruments, Kim Burgess, Head of Customer Success at Feefo, said:

“The Trusted Service Awards recognise companies who go above and beyond to provide the very best customer experience.

“I’m so impressed by how our customers have overcome the challenges of the past two years. A particular congratulations to our Platinum Trusted Service winners. It’s an extremely tough challenge.

“I can’t wait to see what our customers achieve in 2022.” 

About Feefo

Feefo is a leading global customer reviews and insights platform on a mission to empower its clients to fully understand how their customers experience their product or service.   

NICE One! KardiaMobile Recommended For AF Detection.

The National Institute for Health and Care Excellence (NICE) have recently published a Medical Technology Guidance report (MTG) 64 featuring the AliveCor KardiaMobile. KardiaMobile is now the first and only NICE recommended personal ECG device for detecting atrial fibrillation in an ambulatory setting.

KardiaMobile is now NICE accredited.

KardiaMobile is recommended for detecting atrial fibrillation (AF) for people with suspected paroxysmal AF, who present with symptoms such as palpitations and are referred for ambulatory electrocardiogram (ECG) monitoring by a clinician.

Why did NICE make this recommendation?

Detecting atrial fibrillation in people with suspected paroxysmal AF usually involves wearing a continuous ECG Holter monitor. KardiaMobile is a portable wireless ECG recorder that can help detect AF.

The NICE committee consisting of a panel of experts looked at published clinical evidence that shows significantly more people had AF detected using the KardiaMobile single-lead device compared with a Holter monitor.

The clinical experts agreed that monitoring with KardiaMobile could increase infrequent AF event detection because it could record an AF event whenever symptoms are presented. 

Cost modelling shows that KardiaMobile is cost saving compared with a Holter monitor by an average of £13.22 per patient over 2 years in people presenting with symptoms such as palpitations. 

This positive recommendation acknowledges AliveCor’s digital innovative technology and empowers patients and doctors to remotely monitor their heart rhythm.

KardiaMobile can support an earlier diagnosis of AF in an ambulatory setting and this recommendation highlights AliveCor’s commitment to the NHS Long Term Plan to reduce the incidence of cardiovascular disease in the UK.

KardiaMobile is the world’s most clinically-validated personal ECG. Unlike traditional ECGs, KardiaMobile provides a compact, patchless and wireless solution that can be used at any time and anywhere.

The user starts a 30-second ECG recording on their smartphone via the Kardia app – by placing two fingers from each hand on each of the two top electrodes – enabling the patient to remotely capture a medical-grade recording of their heart activity. KardiaMobile provides instant detection of AF, bradycardia and tachycardia, which are leading indicators of cardiovascular disease.

KardiaMobile can also detect normal heart rhythm, offering users peace of mind.

This guidance replaces NICE’s earlier medtech innovation briefing on KardiaMobile for the ambulatory detection of atrial fibrillation (MIB232) published in October 2020.

PMS Instruments. Expertise, Experience and Trust for service, calibration and support.

These are the key words our customers associate with PMS Instruments, as well as being the fundamental foundations of our calibration and service department.

Back in 2016 I posted an article with a picture of an A&D Medical TM-2655P waiting room blood pressure monitor that had recorded a staggering 103,366 readings since we originally supplied it in 2004!

Since then, we have calibrated and serviced a number of A&D Medical waiting room blood pressure monitors that have recorded in excess of one hundered thousand readings!

At PMS Instruments as an ISO-9001 Quality Assured company we keep detailed service and calibration records for every item of equipment we service and repair.

What’s the secret of this reliability and low cost of ownership?

I am convinced it is regular, preventative and routine servicing by PMS Instruments which extends the ‘in service’ life of the monitors and prolongs the investment our customers make in their equipment.

How does the service you get from PMS Instruments differ?

The A&D Medical TM-2655P and TM-2657P waiting room blood pressure monitors are specialist instruments, requiring specialist knowledge and test equipment.

With every service and calibration PMS Instruments carries out, each monitor is subjected to an approved individual ISO-9001 quality assured Work Instruction. This comprises a series of up to 70 detailed steps our service engineers must follow, and which the product must pass, in accordance with the manufacturer’s service manuals.

You get so much more from PMS Instruments than the basic 10 minute on site functional test some companies offer.

Our popular Fixed Price Service and Support Plan includes:

  • Annual calibration of your device and detailed calibration certificate issued.
  • Priority unlimited telephone and technical support.
  • Fixed price servicing cost.
  • Fast priority response for all servicing and repairs.
  • 20% discount off non standard service items including pumps
  • Standard service parts and consumables including filters.
  • Replacement of the cotton cuff inner.
  • Supply of premium packing box and material included.
  • Courier collection and return included.
  • Priority turnaround time typically 3-5 working days from receipt of equipment.
  • Inclusive annual service and calibration to manufacturer’s specification.

You get what you pay for…

PMS Instruments’ service and calibration team are certified to ISO-9001 and use only genuine manufacturer approved spare parts.

Depending on the model it can take up to 90 minutes for our Service Engineers to adjust, calibrate and service an A&D Medical waiting room blood pressure monitor and we are the experts at it! Rapid turnaround time means minimum downtime and a full service and calibration certificate is issued.

Not convinced and still want to use another company?

Can the company you use tell you how many readings your waiting room blood pressure monitor has taken during its lifetime? If they can’t schedule your service and calibration with PMS Instruments and we will.

Community Pharmacies to Offer Hypertension Case Finding ABPM Service

According to the Pharmaceutical Services Negotiating Committee (PSNC) Hypertension is one of the biggest risk factors for CVD (Cardio Vascular Disease) affecting 7 million people and represents a financial burden of approximately £9 billion a year to the NHS.  

The NHS Long Term Plan commits the NHS to reducing morbidity and mortality due to CVD, tackling inequalities and a shift towards prevention strategies. It specifically states that community pharmacy, in collaboration with other providers, will provide opportunities for the public to check on their health through tests for high BP and other high-risk conditions.

The 2019-2024 Community Pharmacy Contractual Framework agreed to pilot a model for detecting undiagnosed CVD in community pharmacies through NHS England and NHS improvement’s Pharmacy Integration Fund (NHSE&I). The majority of the pilot scheme started after March 29th when Covid restrictions were eased. The scheme covered 6 Primary Care Networks (PCN). 35 pharmacies participated in 4 geographies. The pilot sites included rural and urban areas, areas of high ethnicity and areas of mixed deprivation/affluence. The pilot scheme ended in September 2021.

As a result of the, success of the pilot scheme, from 1st October 2021 a new Hypertension case finding service can be offered by UK pharmacies.

Which monitor should a pharmacist purchase?

The Meditech ABPM-06 ABPM monitor meets and exceeds the list of considerations the PSNC suggests pharmacists consider when purchasing an ABPM on their website. The non-exhaustive list includes;                 

  • Is maintenance and training included in the purchase price?

PMS Instruments includes remote support and training. We can also provide a standard operating procedure (SOP)

  • Calibration versus replacement cost and the carbon footprint of both activities;

As a Meditech Official Service Partner we offer a fixed price service and calibration plan after the first two years

  • Frequency/cost of cuff replacement and other consumables;

Meditech cuffs are latex free wipeable and hygienic. Meditech ABPM monitors can use re-chargeable batteries reducing running costs

  • Complexity of use – time taken to use (and explain use, in the case of ABPM);

The easy-to-use Meditech ABPM-06 monitor has been designed with comfort in mind and based on feedback from thousands of customers worldwide

  • For ABPM, the usability of any inclusive software to support set up for the patient and interpretation of readings. Additionally, software and hardware compatibility with existing pharmacy IT systems needs to be considered, e.g., can you plug the meter into a USB port on a PC in the pharmacy.

Meditech ABPM-06 has automatic textual analysis to the latest NICE guideline classifies into 1 of 3 hypertension classifications, as well as number of successful readings determines if recording has been successful. It automatically generates average readings for rapid standard assessment. Comes with a standard USB PC cable for genuine plug and play operation.

  • ABPM must be validated by the British and Irish Hypertension Society (BIHS)

Meditech ABPM-06 is listed on the BIHS website and is FDA and CE approved with an AA grade

The Meditech-06 from PMS Instruments has a whole list of features including free 2 Year Premier Support including remote training and technical support. The Meditech-06 is Supplied with

• Adult (25-32cm) cuff
• Large adult (32-42cm) cuff
• USB PC cable
• CardioVisions analysis software
• Carry pouch, shoulder strap, waist belt
• Quick start user instructions
• 3-year warranty on monitor

To discover even more reasons to purchase a Meditech ABPM-06 from PMS Instruments click HERE

Monitoring Your BP At Home

Monitoring your blood pressure at home and can be a way to feel more in control of your own health and wellbeing. Your GP may even have recommended you take your own BP measurements at home so that you know your numbers.

But which home BP monitor to buy? There are so many now on the market, available from anywhere from your local supermarket to large online retailers. The options can seem over whelming. It needn’t be.

When choosing a BP monitor we would recommend you check for 3 things 

  1. Has it been clinically validated? This means it has been tested and approved by the British and Irish Hypertension Society (BIHS) and will it provide arcuate and reliable readings.
  2. Is it fully automatic as these are the easiest monitors to use at home.
  3. The cuff fits your arm. Cuffs come in a range of sizes but most monitors are supplied with a standard adult cuff which will fit an arm measuring 22-32cm. The cuff should wrap snugly around your upper arm, with just enough space to slide two fingertips underneath.

You can purchase an additional cuff which will fit your arm if your arm is either smaller or larger than a standard cuff size.

Or look for a monitor with a wider range cuff such as the A&D Medical UA 767S-W which is supplied with a wide ranging cuff which will fit an arm measuring 22-42 cm. For more of the monitors features Click here

The A&D Medical UA 767S + AFib is a popular choice for its proven record of reliability and wide use across the UK with GP surgeries and within the NHS. It also comes with a 5 year warranty. For more of the monitors features Click here 

PMS Instruments can supply you with a BP monitor to suit you, your needs and your budget.

Disposable Hand and Arm Hygienic BP Covers

A&D Medical protective hand and arm covers are specially designed for use with the TM-2655P and TM-2657P waiting room blood pressure monitors.

They demonstrate to your patients that when they use your waiting room blood pressure monitor, you take any safety and hygiene concerns they may have seriously. This gives them the confidence to use the monitor after post COVID lockdown.

They are manufactured from thin polyethylene and cover the upper arm and hand to prevent a patients arm coming in to direct contact with the inside of monitor. These single patient use hygienic arm and hand covers are easy to apply and comfortable to wear.

With a length of 75cm they accommodate most arms and fit an arm circumferences of up to 44cm. Each overarm and hand cover is perforated making them easy to detach. Each batch/bundle of 200 has a convenient attachment string which means the covers can be hung neatly near the waiting room monitor or anywhere keeping the waiting room tidy.

They are designed for single patient use and are easy to apply. Simply pull one over sleeve off, insert your arm fully in to the cover, take a blood pressure measurement, remove the cover and dispose of. They are hygienic and cost effective providing effective protection to a patients arm. Free samples are available from PMS Instruments. Further information is available on our website https://www.pmsinstruments.co.uk/acatalog/A-D-Medical-Arm-and-Hand-Cover-for-TM-2655P-TM-2657P-703.html#SID=42

The ISO 80369-5 BP Cuff Standard

ISO80369-5 was developed as an international standard to prevent cuff connection errors with different types of medical devices that use the same or similar connectors. Whilst connection errors were few and far between they could have fatal consequences.

The US Food & Drug Administration (FDA) reported several real life incidents involving misconnections.

In one a blood pressure cuff was accidentally connected to an Intra Venous (IV) catheter.

A patient had an IV catheter in their arm but no IV fluids had been started. The patient also had an automatic BP cuff fitted on the same arm for continuous monitoring. The BP cuff tubing was disconnected from the blood pressure monitor while the patient went to the bathroom.

When she returned, her spouse accidentally connected the BP cuff tube to the IV catheter and approximately 15 mL of air was delivered to the IV catheter by the blood pressure monitor.

Unfortunately the patient died from a fatal air embolus, despite resuscitation efforts.

As a precaution and so this can’t happen again new ISO connectors are being introduced on blood pressure cuffs to ensure correct device connections, even in complex working environments and avoiding fatal consequences.

Japanese company A&D Medical are one of the first manufacturers of clinically validated digital blood pressure monitors to have introduced ISO-80369-5 connectors to their blood pressure cuffs and monitors.

The latest UA-651SL Plus is compliant with the ISO80369-5 regulation. It features A&D Medicals latest 4th generation Electric Control Exhaust Valve (ECEV) which precisely controls cuff deflation.

This low cost digital monitor can use 4 different cuff sizes for arm sizes ranging between 16cm – 45cm, including small, adult and large cuffs.

In the UA-651SL Plus A&D Medical are one of the few manufacturers to have a model that can use small, adult and large adult cuffs.

It’s important to note that ISO80369-5 cuffs cannot be used with non-compliant ISO80369-5 blood pressure monitors and they are not interchangeable with earlier models.

Pulse Oximeters and COVID-19

NHS England recently updated their guidance to support the remote monitoring, using pulse oximetry, of patients with confirmed or possible COVID-19.

It builds on the COVID Oximetry @home standard operating procedure, as well as the general practice and community health services standard operating procedures which were published last year.

Patients most at risk of poor outcomes are best identified by oxygen levels.

NHS England and NHS Improvement coronavirus have developed a standard operating procedure for using pulse oximeters to monitor oxygen saturation levels and an assessment pathway. Pulse oximeters can help detect asymptomatic presentations of “silent hypoxia” with low oxygen saturation but often with normal heart rate and other obs.

The assessment pathway classifies Oxygen saturation levels in to one of three classifications. Mild where O2 is 95% or higher, moderate where O2 is 93-94% or severe where O2 is 92% or lower. At a severe stage urgent admission to Hospital should be considered.

According to NHS England guidance an ideal blood oxygen level is between 95% and 99% and an ideal heart rate is between 50 and 90 beats per minute (bpm).

The NHS England Annex 2: Remote monitoring COVID-19 diary gives some practical tips on how to use a pulse oximeter correctly. These include

  • Remove any nail polish or false nails and warm your hand if cold.
  • Make sure you have been resting for at least five minutes before taking your measurement.
  • Rest your hand on your chest at heart level and hold still.
  • Pulse oximeters works best on your middle or index finger. It should not be used on your ear.
  • Keep still and keep the pulse oximeter in place for at least a minute, or longer if the reading keeps changing.
  • Record the highest result once the reading has not changed for five seconds.
  • Be careful to identify which reading is your heart rate and which is your oxygen level.

They have also produced a diary card which can be used to record results and any symptoms.

The link for the guidance and diary is below.

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0445-remote-monitoring-in-primary-care-annex-2-diary-jan-21-v1.2.pdf

ECG electrodes. Cost Vs Convenience and time.

For many customers price is the only focus when purchasing electrodes for resting 12 lead ECG’s. It’s undoubtedly an important factor but should it be the only criteria considered when purchasing? 

In 2019 The Royal Papworth Hospital under took a trial to compare the cost effectiveness of two different brands of ECG electrodes. Ambu and a Brand Competitor.

Comparison was made between quality of ECG trace, time taken to carry out the ECG procedure, electrode attachment and patient comfort.

During the trial electrodes were placed on patients according to clinical guidelines for a 12 lead ECG recording.

Before the electrodes were applied, if needed, skin preparation was performed to obtain a better electrode-skin contact. The patient’s skin was shaved and cleaned with alcohol wipes and wiped by a gauze swab before the electrodes were placed to obtain an artefact-free ECG.

All filters on the ECG monitor were ‘off’ when recording an ECG. To minimize any noise, all forms of electronic devices that may cause interference were also switched off and patients were advised and encouraged to relax as much as possible to reduce muscle artifact.

Participants were assigned to two groups either using AMBU BlueSensor SU ECG electrodes or Skintact Easitab Resting ECG electrodes (competitor).

The average time it took to take an ECG using the Ambu electrodes was 3.39 minutes. The average time using the competitor Brand was 6.53 minutes. The time includes the preparation of the patient’s skin, shaving where necessary.

When using the Brand Competitor 7 razors were used, none were used with the Ambu electrodes.

The use of wipes and gauze was eight times higher for patients being monitored with the competitor electrodes and 28 additional competitor electrodes were used in comparison with five of the Ambu electrodes.

The average price (including wipes, razors, skin preparations and extra electrodes) of taking an ECG using the competitor electrodes was 57 pence compared to 54 pence using the Ambu electrodes.

The trial concluded that: The Ambu SU is the lower cost electrode when the additional patient preparation, extra electrodes and staff time are considered and that the reduced need for skin preparation improves the patient journey.

KardiaMobile NICE MIB232

This guidance has been updated and replaced by NICE medical technologies guidance 64 published 6th January 2022.

The AliveCor KardiaMobile ECG PMS Instruments distribute has just been recognised by the National Institute for Health and Care Excellence (NICE) for the fast and precise ambulatory detection of atrial fibrillation.

The recently published NICE Medtech Innovation Briefing (NICE MIB232) demonstrates how AliveCor’s technology can support patients and health care professionals, and highlights alignment to the NHS long term plan.

Highlights from the NICE MIB232 report conclude:

  • The published evidence from 11 studies, across 1,218 adult patients, demonstrates that KardiaMobile can detect more cardiac arrhythmias, but can do so faster than standard care.
  • The brief showcases KardiaMobile’s diagnostic accuracy for detection of cardiac arrhythmias with sensitivity ranging between 77.0% and 96.6% and specificity ranging between 76.0% and 99.1%.
  • KardiaMobile is suitable for patients to use with suspected paroxysmal AF, which might not be detected using a standard 12-lead ECG if the person is not in arrhythmia at the time of recording.
  • The convenience of an at-home medical-grade ECG that can be taken at any time of the day increases the diagnostic yield of an arrhythmic episode being detected and recorded.

It was also noted that patients preferred not having electrodes connected to the skin or travel to and from the surgery or hospital especially during the Covid 19 Pandemic.

All six experts involved with the studies described the technology as innovative. With one stating that it had already changed clinical pathways for those with suspected arrhythmia, one that it had potential to change standard of care, and another suggested it could be used in settings, outside of healthcare.

All of the experts thought that this technology had the potential to change standard care in some way (earlier diagnosis, quicker intervention, fewer hospital visits and referrals, fewer strokes) improving both patient outcomes and patient satisfaction.

At a cost of only £82.50 + VAT and ease of use compared to the cost of an ECG event recorder the KardiaMobile ECG could be a cost effective way of diagnosing AF earlier in suspected patients and improving patient outcomes.

Celebrating Meditech’ s 30 Year Anniversary

2020 is a memorable year and not just because of the COVID-19 pandemic. It also marks the 30th year in business of one of our key partners, Meditech.

Established in Hungary in 1990 Meditech have established a reputation for quality, accuracy and reliability in the design and manufacture of professional cardiovascular medical devices. From small beginnings their Distributor reseller network now covers 5 continents and I am proud to say PMS have been their exclusive UK and Ireland Distributor and Service Partner for over 20 years.

We sold our first Meditech product the Elite PC based ECG back in 1997. The E-Lite was one of the world’s first “plug and play” cost effective 12-lead resting ECG systems. It was popular with GP surgeries and pioneered the use of computers in the recording of ECG’s helping to start the trend for paperless ECG’s.

Next up was the ABPM-04 24 hour ambulatory blood pressure monitor introduced in 2003. This product really put Meditech on the map. Clinically validated to the demanding British Hypertension Society accuracy protocol it launched with the first generation CardioVisions analysis software fully compatible with Windows XP.

With thousands of ABPM-04’s sold worldwide it has become a classic ABPM renowned for its reliability that is still available to this day.

Several of the original monitors we sold over 17 years ago are still in regular use!

Other product milestones include

2000 Merlin ECG Event watch
2000 CardioTens combined ABPM and ECG Event monitor
2003 CardioClip 7 day looping ECG recorder
2004 CardXplore combined ABPM and Holter ECG recorder
2007 ABPM-05
2007 CardioMera 24 Hour Holter ECG
2017 CardiUP3!/12! Second generation Holter ECG
2019 ABPM-06

The latest ABPM-06 is the result of 30 years of product design, engineering precision and of course customer feedback that sets Meditech apart from competitors.

On behalf of everyone at PMS I would like to offer congratulations to the team at Meditech for the achievements and innovations over the last 30 years. We are looking forward to many more.

Life Goes On

It’s very easy to forget that life, although not as we knew it, is still going on. Covid 19 has dominated our lives for the last 6 months and it looks set to continue that way for at least the next 6.

Many GP surgeries have put a temporary hold on offering 24 hour ABPM services

Some are using waiting room BP monitors in place of face to face measurements. Others are not using them at all to reduce the number of patients in the waiting room.

Some are not using the waiting room at all requesting that their patients wait outside the surgery until called directly into the consulting room.

There are so many different ways and we are all trying to provide the best service we can during these strange unprecedented times.

Now could be the perfect time to get your Surgeries BP monitors serviced, if they are not currently being used, so they are ready for when things return to a more normal service.

Some surgeries have decided to wait until they feel comfortable in offering monitoring again.

Either way however you are dealing with the current pandemic we will continue to offer service and calibration of A&D Medical waiting room BP monitors, Meditech ABPM monitors and ECG monitors.

I am pleased to report that for the 27th year running we recently passed the ISO9001 quality standard audit. We are registered to provide repairs and support services for a range of specialised medical instruments.

With us you can be assured that when your monitors are serviced they go through a  comprehensive assessment of up to 70 tests carried out by our own manufacturer trained engineers.

As all monitors are collected and returned by our courier the engineer does not have to enter your premises, therefore maintaining all of your existing covid-19 safety measures.

Despite the Pandemic we are maintaining our fast turnaround time which remains at 3-5 working days. All it to takes to arrange is a quick call or email to us and we will do the rest.

Nothing is normal right now but life does go on and you can be assured we are still here offering you our support and service.

Cleaning Blood Pressure Equipment and Cuffs During COVID-19

As customers start to get ready for the new normal we’ve been receiving a number of calls and emails regarding the safe cleaning of blood pressure cuffs, including 24 hour ABPM cuffs.

Our advice is to use a disinfectant from a reputable brand which complies to the BS EN 14476 standard as this will ensure the spray is effective against a range of viruses including Coronavirus.

Different disinfectants have different contact times, the time the surface must remain wet for the product to be effective. If the solution is not left wet on the surface for the directed time it may not work as effectively.

Before disinfecting cuffs ensure they are dirt and grease free otherwise this may make the disinfectant less effective.

If you are using old style Meditech woven cloth material cuffs we recommend you upgrade to the new hygienic wipe style. ERKA and A&D Medical also have wipe able cuffs in their range.

Purchasing additional cuffs could also provide further protection by leaving time between patient uses.

Even before the outbreak of Covid-19 our TiDi blood pressure cuff barriers were popular. Since the outbreak they have become indispensable for many customers.

Intended for single patient use they are manufactured in latex free FABRICEL tissue fused with a leak proof polyethylene film. They wrap around the patients arm and the cuff is applied over the top ensuring the blood pressure cuff never comes in to direct contact with the skin.

They can be used with all ABPM, digital and manual blood pressure cuffs and are thin enough not to affect measurements. 

They are available in 3 sizes

Adult (TID916114)- 300 barriers are supplied in 6 boxes of 50.

Large Adult (TID916115)- 150 barriers are supplied in 3 boxes of 50.

Paediatric (TID916113)- 300 barriers are supplied in 6 boxes of 50.

For waiting room BP monitors the same disinfectant complying with BS EN 14476 can be used. Single use protective overarm sleeves (AND093) protect the TM-2655P and TM-2657P inner from dirt and liquid and from coming into direct patient contact. Manufactured from latex free polythene they are 40cm long and fit an arm circumference of 38cm.

Moving Matters During COVID-19

The last few weeks since lockdown on the 23rd March have changed the way we all work and like all businesses PMS Instruments have had to adapt. As a NHS Supply Chain partner we were assigned key supplier status from day one and whilst adopting Government guidance have remained open throughout.

The initial surge in orders we received tested the resilience of my staff, manufacturing supply chain partners as well as our own procedures and processes but we also had another challenge.

We were committed to relocating our Offices.

As any business knows finding suitable business premises can be a real test. We had been in our existing building in Maidenhead since 1982 and weathered a number of changes over the last 38 years in terms of technology, the local area, society and the NHS.

We had responded to these challenges in a positive and pragmatic way but when the Royal Borough of Windsor and Maidenhead announced plans to redevelop the building we occupied as part of their regeneration plans for the town, there was no option but to relocate.

After a great deal of time and effort I identified new larger offices that would meet our requirements for expansion in Wokingham and by the end of January terms were agreed.

Moving a business established in the same building for nearly 40 years is similar to moving house but I can confirm it’s 1000 times more stressful!

There’s a lot more to consider and take in to account. If you move home, don’t have any Broadband or a functioning phone for a week it’s an inconvenience but not the end of the world. If PMS moved without any of these it would restrict our ability to support the NHS at a time of national emergency.

Surely it’s all just down to careful planning right? Well that’s what I thought until Covid-19 and lockdown on 23rd March and our carefully laid plans went out of the window.

By the end of March we were ready to move but struggling to get key infrastructure like IT and comms installed. It seemed the whole world was in lockdown and they were.  

So we waited…and waited…and waited. Then we moved and it was worth it.

Due to an incredible effort from PMS staff, our office refurbishment company, legal and surveying team, comms, IT and removal company we have now moved to our new offices.

My personal thanks to all those involved directly and indirectly and most importantly thanks to our customers for their support and understanding over this period.

FDA Guidance Allows Use of KardiaMobile 6L to Measure QTc in COVID-19 Patients

The KardiaMobile 6L – the world’s only six-lead personal ECG – is now cleared for use in the measurement of a patient’s QTc and detection of potentially dangerous QT prolongation.

A prolonged QTc can lead to a potentially fatal side effect, called drug-induced sudden cardiac death (DI-SCD) linked with the use of several medicines now being used in the treatment of COVID-19.

The QTc is a heart rate corrected interval that reflects the integrity of the heart’s electrical recharging system. Abnormal prolongation of the QTc can stem from congenital long QT syndrome, many disease states, electrolyte abnormalities, and over 100 FDA-approved medications that have the potential for unwanted QT prolongation.

Patients with a prolonged QTc are at greater risk of their hearts going into a potentially dangerous arrhythmia called Torsades de Pointes which can lead to sudden cardiac arrest and even worse, sudden cardia death.

With the global pandemic of COVID-19, several drugs being used off-label to treat COVID-19 which have the potential for unwanted QT prolongation and worse, DI-SCD.

With the KardiaMobile 6L a patient’s QTc can be obtained without exposing clinical staff to affected patients which helps to conserve personal protection equipment (PPE) and thereby expand the capacity of strained medical resources.

Healthcare professionals can now use KardiaMobile 6L to collect a six-lead ECG (Lead I, II, III, aVR, aVL, aV), and then use manual tools to calculate QT duration allowing them to make assessments with respect to patient medication.

Lead I I-ECGs could detect AF more accurately than a manual pulse check

A new study which looks at Lead-I ECG for detecting atrial fibrillation in patients with an irregular pulse using single time point testing has been published in Health Technology Assessment Volume: 24, Issue: 3 January 2020 https://doi.org/10.3310/hta24030

This study aimed to assess whether or not the use of lead-I ECGs in GP surgeries could benefit patients and offer good value for money to the NHS.

The objective was to assess the diagnostic test accuracy, clinical impact and cost-effectiveness of using single time point lead-I ECG devices for the detection of AF in people presenting to primary care with relevant signs or symptoms, and who have an irregular pulse compared with using manual pulse palpation (MPP) followed by a 12-lead ECG in primary or secondary care.

The study found that if GPs were to routinely use lead-I ECG devices, including the AliveCor KardiaMobile, people with suspected AF could receive treatment while waiting for the AF diagnosis to be confirmed by a 12-lead ECG.

The study found that using a manual pulse check followed by a lead-I ECG offers better value for money when compared with a manual pulse check followed by a 12-lead ECG. This is mostly because patients with AF can begin treatment earlier when a GP has access to a lead-I ECG device.

The report also stated that the AliveCor KardiaMobile lead –I ECG is the most cost-effective option in a full incremental analysis.

Review of the Meditech ABPM-06

It’s not that often that Meditech introduce a new ABPM. The last one, the ABPM-05 was introduced in 2007 the year the iPhone was launched. When they do it’s worth the wait.

There is a lot of thought that goes into the design and features customers really want in a new monitor. As well as good design it is important the technical elements are addressed so that the 30 year plus reputation for reliability and accuracy that Meditech have and customers from around the world expect, is maintained.

We’re proud that Meditech chose PMS Instruments and the UK as their first launch partner for the new ABPM-06 so what’s it really like to wear, use and operate?

First impressions are good. It’s got the same familiar look as the ABPM-05 which means it’s compact and light.

It uses the same size and type of wipeable cuffs which means users of the old ABPM-04 and ABPM-05 can use their existing cuffs interchanging between units. The cuffs are durable and easy to wipe clean which is important for patient hygiene.

One major improvement is the type of PC interface cable the new ABPM-06 is supplied with. The old ABPM-04 and ABPM-05 used either a serial interface or USB optoelectronic fibre optic cable which was unique to Meditech. Although repairable these old cables are expensive to replace or purchase new.

As customers frequently want to use their ABPM in more than one treatment room the new ABPM-06 is now supplied with a standard mini USB A mini to USB B PC cable. This resolves any potential cable comms issues as there is only one way the cable will go in.

Meditech have taken the wise decision to integrate the ABPM-06 into their popular CardioVisions analysis software rather than offer a completely new software platform. This means the look and feel of the software, programming, downloading and printing will be familiar to users of the old ABPM-04 and ABPM-05 with no new software to learn.

Programming the ABPM-06 takes seconds and key patient information like name, date of birth and ID is retained in the monitor so there is no doubt who has worn the monitor.

In the interests of customers I have worn a new ABPM-06 twice now and found the monitor comfortable and unobtrusive throughout.

I programmed the monitor to record every 30 minutes during the day and hourly during the night as recommended by the latest NICE guideline NG136.

Of the 40 readings taken over 24 hours all were successful with no errors. I was aware of the monitor going off at night but the new SleepWell® function added to the new AA grade algorithm meant the device wasn’t uncomfortable and the measurement inflation and deflation time was quick.

Downloading the results took seconds and the automatic text reporting, trend graph and presentation of key metrics like average daytime reading value are clear.

Feedback from new and existing customers who have purchased the ABPM-06 since we introduced it has been very positive. For a free demonstration, loan or for more information just call or email us.

Save time and money one measurement at a time

At around £1,500.00 is the A&D TM-2657P waiting room blood pressure still worth the money?

Self patient blood pressure measurement devices like the A&D TM-2657P are not new and there are now several hundred in use in the UK since they were first introduced by PMS Instruments 17 years ago in 2002.

Sited in the waiting room, for many Practices they are an integral part of their long term medical conditions clinics allowing them to work smarter, not harder, whilst helping patients take ownership of their conditions and play a more active role in their treatment.

A number of GP practices have adapted established protocols whereby patients pass their blood pressure results to the reception team and are then advised as to whether there is a need for further clinical follow up.

The protocol needs to be easy to follow and comprehensive to ensure that the receptionist is taking no responsibility for a clinical decision. When implemented correctly, after suitable training the process works very well.

Why is all this relevant to Primary Care and the NHS?

When this type of service is introduced anecdotal evidence from PMS Instruments GP customers suggests that waiting room BP monitors are used by up to 240 patients every month and only 80 of them require any further intervention. This represents a potential “saving” of over 160 face to face GP clinical appointments. 

Let’s do some maths!

According to NHS England, the average GP appointment costs £30 so in the example above that’s a saving of £4800 to the NHS every month.

So the payback period in terms of time saved and the initial £1500 cost of the monitor is established but what are the other benefits?

It’s about time.

According to a report published in Pulse in August 2019, over half of GPs have said the average waiting time for non-urgent appointments at their practice is now over two weeks.

Anything that can help reduce this must be a good thing and waiting room blood pressure monitors like the TM-2657P can.  

With the protocol above Doctors and nurses who want to monitor a patient’s blood pressure ask the patient to use the waiting room BP monitor and they only need to see a Doctor if their readings move out of an agreed range. Patients can do this at any time the practice is open freeing up valuable appointment time.

Nurses who run chronic disease clinics can also ask patients to monitor their blood pressure before coming to their clinic. Apart from saving nursing time it gives an immediate focus to the consultation.

Public Health England and NHS England have agreed ambitions and a goal over a 10 year period to improve the detection and treatment of high blood pressure with the following targets

  • 80% of the expected number of people with high BP are diagnosed by 2029
  • 80% of the total number of people diagnosed with high BP are treated to target as per NICE guidelines by 2029

How do we achieve these objectives when Primary Care is already overstretched?

In this instance the technology, in the form of waiting room BP monitors, already exists we just need to encourage wider adoption and not be afraid to adopt new approaches.

Time is money as the saying goes and the A&D TM-2657P saves time and money one measurement at a time.

ERKA The Original Aneroid?

With an established reputation for quality, Erka has been developing and manufacturing sphygmomanometers as well as stethoscopes since 1889.

The ERKA name has a worldwide reputation and represents a guarantee of quality for services and quality goods that are designed, produced and Made in Germany. 130 years of experience means the highest precision, trust and innovation and are just some of the reasons why so many consumers purchase.

PMS Instruments have been their UK Distributor since 2001.

Designed for manual blood pressure measurement the ERKA Switch Comfort Aneroid Sphygmomanometer offer outstanding quality, precision and ease of use as standard.

The sensitive deflation screw valve of the ERKA Switch allows the user to make precise adjustments to the deflation speed.

The innovative design of the SWITCH allows the device to be switched from a right-handed to a left-handed device in a single step.

Buy with confidence direct from PMS Instruments an official authorised Distributor or via the NHS Supply Chain NPC code FFE1244.

Features include

•             Shock resistant to AAMI SP10

•             Special tempered copper-beryllium membrane

•             Easy to read 56 mm diameter polycarbonate head

•             Weight without cuff 120g

•             Latex free, DEHP free, PVC free single tube cuff

•             Manufactured in Germany for precision

•             5 year warranty after registration

•             Wide range of cuff sizes available

The New Meditech ABPM-06

PMS Instruments are pleased to announce the UK launch of the new ABPM-06 24 hour ABPM.

The ABPM-06 is the latest generation premium ambulatory blood pressure monitor from Meditech, technology leaders worldwide in the manufacturing of ambulatory blood pressure monitors since 1990.

It builds on the near 30 year plus reputation and experience of Meditech’ s engineers and maintains the tradition of reliability and accuracy that thousands of customers around the world have come to expect.

The ABPM-06 has all the features customers like in the ABPM-04 and ABPM-05 plus some important new innovations

  1. AA grade Independent clinical validation to 3 separate protocols
  2. Built in voice recording (max 8 x 15 seconds)
  3. Free, all-inclusive software packages
  4. Unique SleepWell® function
  5. Dual valve system for patient safety
  6. Proven technology and long-life reliability

With both the ABPM-04 and ABPM-05 patients could trigger additional measurements by pressing a button. This feature is retained but with the ABPM-06 they can now also record up to 8 x 15 second voice memos.

For the first time patients can now record voice memos of symptoms during the recording for example if they are feeling dizzy and give detailed feedback to their Doctor over the monitoring period. This voice memos are downloaded and stored with the recording on the PC.

The ABPM-06 is A/A clinically validated to the ESH-IP, BIHS and AAMI protocols so accuracy is assured. The extended measurement range gives the doctor a more precise BP profile and overnight dipping and morning surges can easily be identified.

Meditech have designed a unique SleepWell® function to disturb the patient as little as possible during the night. The ABPM-06 won’t repeat failed readings unless necessary. This helps avoid measurements being taken uncomfortably close together.

The ABPM-06 comes with a standard USB cable. Cuff compatibility with earlier versions is maintained.

As you would expect the ABPM-06 is supplied with the popular CardioVisions analysis software which provides detailed automatic reporting and textual analysis.

For existing customers there is no new software to learn. Demonstrations are available and you can buy with confidence direct from PMS Instruments, the exclusive UK and Ireland Meditech authorised distributor since 1997.

KardiaMobile 6L-Different but the same

Since we launched the KardiaMobile 6L last week we’ve seen phenomenal interest in the new product which has the potential to be a real game changer in the diagnosis of Atrial Fibrillation as well as potentially other arrhythmias.

It’s important to point out that both products use the same clinically proven AI technology but the KardiaMobile provides 6 times more of it!

For instance both versions of the KardiaMobile will display and record a Premature Ventricular Contraction (PVCs) but now with KardiaMobile 6L Cardiologists can identify where they originate from in the heart.

As well as recording 30 seconds of 6 Lead ECG (Lead I, Lead II, Lead III, aVR, aVL and aVF) ECG in real time it can also be set to record Lead 1 only so it offers the best of both worlds! You can buy yours from our Web site

KardiaMobile 6L KardiaMobile
CE Marked and FDA cleared 6 lead
personal ECG 		CE Marked and FDA cleared 1 lead personal ECG
Detects Atrial Fibrillation, Bradycardia, Tachycardia, and Normal Sinus Rhythm Detects Atrial Fibrillation, Bradycardia, Tachycardia, Normal Sinus Rhythm
Increased ability to identify cardiac arrhythmias such as atrial flutter, heart block and PVCs Clinically proven AI- technology
Clinically proven AI-technology Most widely-used 1-lead personal ECG in the world
Select single or 6-lead ECG, depending on patients’ unique remote monitoring needs  
£149 + VAT £99 + VAT

New NICE Hypertension Guideline NG136

NICE have today published their Hypertension in Adults guidance NG136 which replaces CG127.

This provides updated guidance on the diagnosis of hypertension and measuring blood pressure. Although there are some changes since 2011, the recommendation that ABPM should be used as a preferred method of diagnosis still stands. 

“Based on the evidence in the previous guideline and the committee’s experience and knowledge, it was agreed that ABPM remains the gold standard for the accurate measurement of blood pressure in primary care. ABPM has therefore been retained as the preferred method for the diagnosis of hypertension.” NG136 recommendations 1.2.1 to 1.2.5 &1.2.8

Although this recommendation was made in 2011 there is still a large variation in practice. NICE have suggested that new resources and training are needed. NG136 recommendations 1.2.1 to 1.2.5 &1.2.8

Meditech’s CardioVisions may be a solution to the training aspect. CardioVisions software works with both Meditech’s ABPM-04 and ABPM-05. Supplied by PMS Instruments it supports Windows 7, 8 &10 and is very easy to use. With colour coded trend graphs, flexible programming and data retrieval. Patient’s results are automatically classified from normal to stage 2 Hypertension.   

NICE NG136 also suggests that the initial cost of using ABPM’s is outweighed by the long term benefits of accurate diagnosis and subsequent treatment. NG136 recommendations 1.2.1 to1.2.5 &1.2.8

A new guide line is the recommendation of the use of ABPM for a patient with a clinic blood pressure reading of 140/90 to180/120 to confirm hypertension.

“If clinic blood pressure is between 140/90 mmHg and 180/120 mmHg, offer ambulatory blood pressure monitoring (ABPM) to confirm the diagnosis of hypertension”. NG136 1.2.3

In addition there is a recommendation for the use of ABPM for patients with white-coat effect Hypertension

“Consider ABPM or HBPM, in addition to clinic blood pressure measurements, for people with hypertension identified as having a white-coat effect or masked hypertension (in which clinic and non-clinic blood pressure results are conflicting).” NG136 1.4.18

Meditech are on the list of validated blood pressure monitoring devices provided on the British and Irish Hypertension Society’s website.

New AliveCor KardiaMobile 6L And The Diagnostic Power Of Six Leads

The ECG has come a long way since Nobel prize winning Willem Einthoven invented the first practical electrocardiogram (ECG or EKG) in 1895. The 3 lead string galvanometer also known as the Einthoven galvanometer he introduced in 1901 was 7 metres long, required 5 operators and weighed over 270 kiliograms!

Although the original “Einthoven triangle” configuration which refers to the imaginary inverted equilateral triangle centered on the chest and the points being the standard leads on the arms and leg was chosen largely for convenience it is still in use today.

I wonder what Einthoven would make of the new AliveCor KardiaMobile 6L PMS Instruments have launched today?

Things have definitely come on in the 159 years since he was born.

The new AliveCor KardiaMobile 6L records a six lead 30 second clinically validated ECG using a smartphone or tablet and App.

At 9cm long and weighing 24 g the KardiaMobile 6L has two electrodes on the top and one on the bottom.

The two electrodes on the top are for your fingers, and the one on the bottom to contact the skin of your left leg.

To record a 6 lead ECG hold the KardiaMobile 6L in your hands, placing your fingers on the front electrodes then touch the third electrode to the skin of your left knee or ankle. It’s that easy.

Why six leads?

The 2 fingers and left leg configuration allow the KardiaMobile 6L to record Lead I, II, II, aVL, aVR, and aVF ECG leads which are known as the frontal plane leads recording vertical and lateral electrical forces. By looking at the axis through the heart each of the individual 6 leads records the ECG from a slightly different perspective giving 6 times more information than the original KardiaMobile 1 Lead.

That’s 6 more times data for the KardiaMobile App and for your Doctor to analyse and providing more visibility into certain arrhythmias that are leading indicators of cardiovascular disease

For example with the 6 leads of ECG data the KardiaMobile 6L records it could be possible to identify if there is any deviation of axis out of the normal range in the frontal plane and if P waves are present.

With the launch of the KardiaMobile 6L six really is better than one!

Detecting Irregular Heartbeats (IHB)/AFib Using A&D’s Latest Blood Pressure Monitors.

A&D have a long history and pedigree in pioneering innovation and the development of blood pressure monitors with leading edge functions. With over 40 years of patient-focused thinking it has made them one of the leading blood pressure manufacturers in the world. Their latest clinically validated digital monitors feature a new 2nd generation IHB/AFib algorithm to detect an irregular rhythm during a measurement. 

It is currently available in the latest 2019 versions of the UA-767S AFib+ and UA-767S-W AFib+ from leading distributor PMS Instruments and will be available in more models soon.

It’s the latest development of an Irregular Heartbeat (IHB) detector and algorithm originally pioneered by A&D in 2014. With this feature as well as the existing World Health Organisation (WHO) blood pressure classification index introduced in 2003, A&D monitors really are at the Heart of Healthcare Technology.  

Why is the detection of Atrial Fibrillation important?

AFib is an irregular heart beat that can lead to strokes and other heart related conditions.

The NHS long term plan (NHSLTP) recently published ambitious targets for Atrial Fibrillation (AFib) and high Blood Pressure detection over the next 10 years.

For Atrial Fibrillation the targets are

That 85% of the expected number of people with AF are detected by 2029

That 90% of people with AF who are known to be at high risk of stroke to be adequately anti-coagulated by 2029.

The A&D UA 767S Afib+ and UA-767S-W Afib+ with %IHB/AFib detection could help with these aims.

The monitors classify the %IHB into 4 different grades showing how often an IHB has been detected during the measurement and illustrated by an icon.

0% no indication

1 – 9% grade 1

10 – 24% grade 2

25 – 100% grade 3

This feature is for monitoring purposes only and we recommend contacting your doctor if the grade is high.  

This new feature has been clinically validated and published in the Journal of Clinical Hypertension J Clin Hypertens. 2017;19:1143–1147 Tomoyuki Kabutoya et al. The paper concludes that the new algorithm had high diagnostic accuracy for detecting AF and a low false-positive rate.

Kardia Mobile ECG App now detects Bradycardia and Tachycardia

The latest update of the AliveCor Kardia mobile ECG app for Apple iOs and Android devices now includes 2 new FDA-cleared, medical-grade ECG detectors, Bradycardia and Tachycardia.

This brings the total to 4 clinically relevant detectors including automatic instant analysis for Bradycardia, Tachycardia, Atrial Fibrillation, and Normal ECGs.

What is Bradycardia?

Kardia Instant Analysis Bradycardia indicates that atrial fibrillation is not detected in the ECG, and the heart rate is less than 50-beats per minute, which is slower than normal for most people. The normal range for heart rate depends on your age and physical condition. A heart rate of less than 50-beats per-minute can be normal for healthy adults, athletes and during sleep.

What is Tachycardia?

Kardia Instant Analysis Tachycardia indicates that atrial fibrillation is not detected in the ECG, and the heart rate is faster than 100 beats per minute. This can be normal with stress or physical activity. The normal range for heart rate depends on your age and physical condition. The most common form of tachycardia is sinus tachycardia, which is a normal increase in heart rate.

While Bradycardia (heart rate less than 50 beats per minute) and Tachycardia (heart rate higher than 100 beats per minute) are often nonthreatening, these arrhythmia’s can be indicative of heart disease or other health conditions, such as thyroid disease.

A slow or fast heart rate may be asymptomatic, or cause symptoms such as dizziness or shortness of breath. Kardia Mobile users will now be able to detect these arrhythmias and use the insight to inform conversations with their doctor.

Beyond the patient-doctor relationship, Kardia Mobile also provides peace of mind by diminishing the number of unclassified readings that users may receive. 

The latest Basic version of the App now also allows multiple ECG’s to be stored on the mobile device.

Kardia Mobile Recommended In UK Accident & Emegency Departments

The latest clinical validation study on the AliveCor Kardia Mobile ECG has just been published in The Lancet. The study was funded by research awards from Chest, Heart and Stroke Scotland (CHSS) and the British Heart Foundation (BHF).

Whilst previous clinical studies have concentrated on the AliveCor’s use to detect Atrial Fibrillation (AFib) in Community Pharmacy and Primary Care settings this latest multi-centre trial looked at patients presenting to Accident and Emergency Departments with palpitations and pre-syncope but with no obvious cause at their initial consultation. 

The multi-centre, randomised controlled trial included 243 patients recruited over an 18 month period from 10 prestigious centres across the UK including Hospitals in Edinburgh, Reading, London, Exeter, Plymouth, Chesterfield, Leicester and Nottingham.

What was the problem the researchers identified?

It is estimated that Palpitations and pre-syncope are together responsible for 300,000 annual Accident and Emergency Department attendances in the United Kingdom (UK) alone. However diagnosis of the underlying rhythm is difficult as many patients are fully recovered by the time they attend Hospital and their ECG is normal.

What was the outcome?

Use of the AliveCor Kardia Mobile ECG smartphone-based event recorder in Accident and Emergency units was five times more effective at detecting heart rhythm problems than standard tests and should be used in all Accident and Emergency units, researchers say.

Use of the Kardia Mobile ECG also increased the number of patients diagnosed with cardiac arrhythmia.

The Study participation survey and questionnaire demonstrated the Kardia Mobile was well received and liked by patients with the majority agreeing or strongly agreeing the Kardia Mobile was easy to use.

The £99 Kardia Mobile ECG recorder also cut the cost of diagnosis by more than £900 per patient and cut the time taken to diagnose by more than three weeks.

A copy of the paper can be accessed using the following link

M.J. Reed, N.R. Grubb, C.C. Lang, et al., Multi-centre Randomised Controlled Trial of a Smartphone-based Event Recorder Alongside Standard Car…, , https://doi.org/10.1016/j.eclinm.2019.02.005