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Technical Support

 

toll-free: 866-346-5837 option 1
phone: 281-444-4947
fax: 978-461-5991
email: support@nemon.com

Frequently Asked Questions

  1. The DR200 / Tel-a-heart keeps displaying a “Lead Loose” message?
  2. How do I remove the flash/memory card from the DR200 recorder?
  3. Do I have to use NorthEast Monitoring flash/memory cards in the recorder?
  4. What should I do when I get the message, “Flash file not found” on my computer?
  5. What do I do when I see the message, "Card has files other than flash.dat, use Explorer to erase"?
  6. When should I replace a cable?
  7. How do I care for the cable?
  8. What do I do when the recorder keeps counting and won’t begin recording?
  9. What do I do when the recorder will not boot up or start after new batteries are inserted?
  10. How do I return broken equipment?
  11. How do I adjust time and date on the DR180?
  12. How do I adjust for Daylight Savings time on the DR180?
  13. How can I get my reports to print more quickly on my HP laser jet printer?
  14. How can I get a manual?
  15. How do I install the Holter LX Analysis software?
  16. How can I customize the Holter LX Analysis software?
  17. How can I get more training on using the Holter LX Analysis software?
  18. How often should I back up my Holter data?
  19. I recently downloaded Holter LX Analysis 5.2 and it is requesting a dongle number. Why?
  20. On what operating systems can I run the Holter LX Analysis software?
  21. I downloaded Holter LX Analysis 5.2. My remote site is requesting a dongle number. Why?
  22. Can I continue to use Holter LX Analysis 5.0 without a USB key (dongle)?
  23. I analyzed a Holter recording with a lot of artifact and I tried to print a report and
    full disclosure, but I have a "Report Gen" error.
  24. What should I do when the software identifies pauses that are not real?
  25. My patient is in atrial fib. How can I relabel all the SVPBS that were counted?
  26. How can I quickly re-label incorrectly labeled pacemaker failures?
  27. How does the compact flash card fit into the DR180?
  28. I have a Holter unit from NorthEast (direct, via Rozinn, Welch Allyn, etc.) and when it starts up it gives me the version number of the firmware built into the recorder. Can I get the latest firmware version without returning the unit?
  29. I have an older, tape-based Holter system. Can I use the Holter LX Analysis software to analyze the Holter data captured on the tapes?
  30. My Holter stops recording before it should have.
  31. Which software (LX Event or Holter LX Analysis) should I use with my recorder (DR200/E Tel-a-heart or DR200/HE Combo Holter + Event)?
  32. Can DR200 Event data that has been transferred to an SD card, be viewed with the Holter LX Analysis software?
  33. How do I edit the Patient ID if I make a mistake while entering it into the DR200 Holter?
  34. Does LX Analysis require certain versions of Java?
  35. What is the structure of the files and/or database used in LX Event?
  36. After installing software from NorthEast, including the new Sentinel drivers, I now get an error when I start up my computer that refers to a "Sentinel Protection Server to SuperPro and UltraPro network keys"? How do I fix this?
  37. For the DR180+ units, what firmware versions work with which size memory cards and in what modes?
  38. How do we view the patient-marked diary events indicated during a Holter recording? Is it possible to write a report which includes samples of all the patient-marked diary events? Can it display the EKG 1-5 minutes before and after the diary marker?
  39. I have a study where many T-waves were categorized as PVBs. Why did that happen and how is that best handled?
  40. How can I adjust the period over which the LX Analysis software operates in order to eliminate data during portions of the study?

1.  Question: The DR200 / Tel-a-heart keeps displaying a “Lead Loose” message?
Answer:  Electrodes that are dried out will cause this message to appear and should be replaced. However, some types of electrodes, including the new, high-impedance gel formulations, cause the “Lead Loose” message to be displayed even though there is not an issue with the signal quality. If you are receiving an adequate signal, you can turn the “Lead Loose” message off under “Settings.”

2.  Question: How do I remove the flash/memory card from the DR200 recorder?
Answer: Gently press inward on the SD card to release. The card should pop-out. Never pull the card out, as it may damage the recorder.

3. Question: Do I have to use NorthEast Monitoring flash/memory cards in the recorder?
Answer: Flashcards from other vendors may be used in the recorders, however, because some card manufacturers provide memory cards which draw too much battery current, some cards may cause the batteries to be depleted prematurely resulting in the Holter stopping early. Because of this, we recommend that you first test cards purchased from another vendor for a greater amount of time than the expected use. Also, before using a new flashcard, you will need to format the card using the Initialize function in the Holter program.

For more information on flash/memory cards, go to Answer for Question 30.

4. Question: What should I do when I get the message, “Flash file not found” on my computer?
Answer: First make sure that the card reader is plugged in and that a card is inserted correctly into the reader. Second, it may be that your computer can no longer see your Card Reader. To fix this, remove card reader plug from the computer and plug into a different USB port on the computer. Third, try turning off and restarting your computer. If you still cannot see the Flash file, your reader may be defective. Try using another reader if available, or call your dealer or NorthEast Technical Support for further assistance.

5. Question: What do I do when I see the message, "Card has files other than flash.dat, use Explorer to erase"?
Answer: This means that there are files on the card other than flash.dat. You must remove these files using Windows by clicking on “Start” and then “My Computer”. Double-click on the appropriate Removable Disk to see all of the files on the card. Delete all files except for flash.dat.

6. Question: When should I replace a cable?
Answer: A problem with your recordings may be the result of a cable that is not functioning properly because it is damaged or old. First check to see if you cable is damaged or badly worn, if so, it should be replaced. Even if the cable appears to be fine, a cable that needs replacing may result in one or more of the following issues: poor quality hook-ups – any or all channels are artifact , low voltage QRS, or lead quality test always below 3.

7. Question: How do I care for the cable?
Answer: Keep your cable in good working order for as long as possible by caring for it as follows:

Don’t bend or wrap wires around recorder
Clean leads between uses with metricide or bleach
Make sure electrodes are new and kept at right temperature. Not dried out or rusted.
Check cable for breakage between uses.

8. Question: What do I do when the recorder keeps counting and won’t begin recording?
Answer: Remove and erase the card using the Holter program and reinsert. If this does not solve the problem, please call your dealer or NorthEast Technical support for further troubleshooting or an RMA number

9. Question: What do I do when the recorder will not boot up or start after new batteries are inserted?
Answer: Call for an RMA so you can return the recorder to be repaired.

10. Question: How do I return broken equipment?
Answer: An RMA is required to return broken equipment. Contact your dealer or NorthEast Technical Support for an RMA number and instructions on returning.

11. Question: How do I adjust time and date on the DR180?
Answer: You can adjust time and/or date by using the Settings feature on the DR180. Get to settings by removing and reinserting the batteries on the recorder.

12: Question: How do I adjust for Daylight Savings time on the DR180?
Answer: Because the dates for changing the time has been changed by the government, you should disable the Daylight Savings Time feature in the recorder as it no longer prompts to change on the correct dates. Instead, you will need to adjust the time manually, as required.

13: Question: How can I get my reports to print more quickly on my HP laser jet printer?
Answer: In the printer settings make sure that print as image is checked on. If you continue to have problems use PCL5E drivers.

14. Question: How can I get a manual?
Answer: Current NorthEast Monitoring manuals can be found on this web-site under Downloads and Documents. If you don't see what you are looking for, contact NorthEast Technical Support.

15. Question: How do I install the Holter LX Analysis software?
Answer: An installation instruction sheet was included in your software package or can be found on the back of the CD box. Additionally, there are instructions in the manual. If you encounter problems or have questions with the installation process, call your dealer or NorthEast Technical Support for assistance.

16. Question: How can I customize the Holter LX Analysis software?
Answer: Refer to the manual for instructions on how to customize the software using the Configurations feature.

17. Question: How can I get more training on using the Holter LX Analysis software?
Answer: NorthEast offers three types of customized training to meet your organization’s needs: On-site training, Off-site training, and Internet training.  Please call NorthEast Sales or Technical Support for more information regarding training options and pricing.

18. Question: How often should I back up my Holter data?
Answer: Back-ups should be done on a regular basis as determined by your organization. In order to do backups, your computer must have a CD drive. Instructions on how to back up your software is included in the manual. Call your dealer or NorthEast Technical Support for additional assistance.

19. Question: I recently downloaded a new version of the Holter LX Analysis software and it is requesting a dongle number. Why?
Answer: New versions of the software require an updated registration code. Please contact Northeast Technical Support or send an email to support@nemon.com requesting “Upgrade LX Analysis software.” Please Include your contact information, original USB key (dongle), serial number and software registration code in the email. Also let us know which version of the software you are currently using.

20. Question: On what operating systems can I run the Holter LX Analysis software?
Answer: Software version 5.3 has been tested to run on XP and Vista operating systems. Version 5.2 has been tested to run on XP, although we have found that it can also run on Vista systems. If you encounter issues installing your software, please contact NorthEast Technical Support for assistance.

21. Question: My remote site is requesting a dongle number. Why?
Answer: Beginning with version 5.2, the Holter LX Analysis software requires a registration code. Please contact your distributor regarding pricing and further information.

22. Question: Can I continue to use Holter LX Analysis 5.0 without a USB key (dongle)?
Answer: Yes, but keep in mind that for future software releases a USB key (dongle) will be required.

23. Question: I analyzed a Holter recording with a lot of artifact and I tried to print a report and full disclosure, but I have a "Report Gen" error.
Answer: In version 4.1, trying to print reports that include ST segment episodes and full disclosure for patients with noisy recordings sometimes fails. When it happens, first generate a report that does not include ST segment episodes or full disclosure. Then, generate a full disclosure report by printing just two hours of full disclosure at a time.

24. Question: What should I do when the software identifies pauses that are not real?
Answer: If the QRS complexes are very small, some of them can be missed so that the software identifies false positive pauses. If that happens, go to Review > Calibration, move the calibration lines as close to the baseline as possible, and press Done. The software will reanalyze the signal using a higher gain and find the small QRS complexes.

25. Question: My patient is in atrial fib. How can I relabel all the SVPBS that were counted?
Answer: If the patient is in atrial fibrillation throughout the recording (look through the signal in the Page window to verify this), go to Trends and drag across the entire histogram, from one end to the other. The trend should turn magenta. Press the Disable SVPBs button and then Review > Update.

26. Question: How can I quickly re-label incorrectly labeled pacemaker failures?
Answer: In Critical Events (the Interval Editor in version 4.1), select Sense Failure, then drag across all the bars in the histogram at the top of the window; they should turn magenta. Press the Q button to re-label all the examples Questionable/Unknown. Do the same for Capture Failure. Then, still in Critical Events, go to Questionable and drag across the histogram again; this time, press the "P" button to re-label all the examples Paced. They are now counted as paced beats, but not pacemaker failures.

27. Question: How does the compact flash card fit into the DR180?
Answer: Insert the compact flash card with the blue side up. If you have a flashcard that is not labeled by NorthEast, you should insert the card with the connectors facing in and the back side up.

28. Question: I have a Holter unit from NorthEast (direct, via Rozinn, Welch Allyn, etc.) and when it starts up it gives me the version number of the firmware built into the recorder. Can I get the latest firmware version without returning the unit?
Answer: If you have a DR180, DR180+ or RZ153, you'll need to return the unit to our Channel Partner (dealer / distributor) or directly to NorthEast for this update. The version current at the time this FAQ was written (May 2007) is v2.14. If you have a DR200, it is possible that the firmware can be updated "in the field" by inserting a special SD flash data card with the update on it. Please contact your nearest Channel Partner or NorthEast directly to arrange this update.

29. Question: I have an older, tape-based Holter system. Can I use the Holter LX Analysis software to analyze the Holter data captured on the tapes?
Answer: If you have a version of Holter LX Analysis prior to 5.0, the answer may be "Yes". Each tape-based system had to have a particular version of computer interface board installed in order to read and analyze the data stored on the tape. You can contact NorthEast with the type of tape-based Holter you have and the serial number of the interface board, and the version of the Analysis software and we can tell you whether they will "play" together. Another approach might be to update / upgrade to a newer version of this equipment. We offer significant discounts and savings to existing customers with older gear from NorthEast Monitoring.

If you have Holter LX Analysis 5.0 or later, the answer is "No", you cannot use that software to read / analyze the data on the tape.

30. Question: My Holter stops recording before it should have.
Answer: The shortened recording times may occur because the Holter is shutting down due to a depleted battery. One cause of premature battery depletion is flash/memory cards that draw too much current. NorthEast Monitoring tests all cards that we provide with our Holter recorders, and know that these cards draw low enough current to allow us to meet all the specifications of the Holter units. However there are a number of memory card manufacturers and vendors who provide memory cards with much greater current draw, and you may inadvertently buy one of these memory cards from another source. We have found that flash/memory cards vary greatly with respect to the current that they use, even when purchased from the same manufacturer. They still meet the so-called "spec" for the card, but achieve it at the expense of very high current. This high current will deplete the battery in less than the desired recording time.

We do know that some cards from some manufacturers have consistently lower current. Lexxar and SanDisk are two manufacturers that we have tested and recommend. If you choose to purchase cards from other manufacturers, we recommend that you first test the card for a greater amount of time than the expected use. Call NorthEast Technical support for more information regarding cards we have tested.

For more information on flash/memory cards, go to Answer for Question 3.

31. Question: Which software (LX Event or Holter LX Analysis) should I use with my recorder (DR200/E Tel-a-heart or DR200/HE Combo Holter + Event)?
Answer:
To use the DR200/HE in Holter mode, you MUST have some level of Holter LX Analysis software. The levels are Remote, Basic, Enhanced, Enhanced Plus and Pro.

To use the DR200/HE or /E in telephonic Event mode (this is the most common method of transmitting event recordings), you can use ANY event software, but using our LX Event makes life a bit easier and guarantees that the telephonically transmitted data with patient header information will be correctly / automatically received by the receiver.

To use the DR200/HE or /E in data card Event mode (this special mode is available only to users of our hardware and software), you must use our LX Event software.

32. Question: Can DR200 Event data that has been transferred to an SD card, be viewed with the Holter LX Analysis software?
Answer: Currently only LX Event can read and display an event data file that has been transferred from the DR200 memory to an SD data.  We have a utility (for internal use only) that will show event files on the Holter LX Analysis system but it is a rather ugly display, not for customer use.  If there is enough demand, we may include such a feature in some level of a future release of Holter LX Analysis. 

33. Question: How do I edit the Patient ID if I make a mistake while entering it into the DR200 Holter?
Answer: When entering the characters for the Patient ID, press the ENTER button to advance from one character to the next. If you need to backspace, hold down the ENTER key for a bit longer than normal. When you have entered the complete Patient ID, finish by pressing the EVENT button. Once you have entered the Patient ID and completed the process by pressing and holding the EVENT button, the only way to change the Patient ID is to remove the battery and start over again. See, "To Start the Recorder for Holter", on the handy Hookup Guide.

34. Question: Does LX Analysis require certain versions of Java?
Answer: At the time of writing this FAQ, the most recent version of Java is 1.6.0. Although it is officially still a "beta" version, it has been thoroughly tested with LX Analysis and is available from the Sun Microsystems web site.

You can check your version of Java by typing the following at the DOS shell command prompt: >java -version. Here is what we get in response to this command:

java version "1.6.0_03" Java(TM) SE Runtime Environment (build 1.6.0_03-b05) Java HotSpot(TM) Client VM (build 1.6.0_03-b05, mixed mode, sharing).

Holter LX Analysis v5.3 requires Java 1.6.0 or higher. Holter LX Analysis v5.0, v5.1 and v5.2 requires Java 1.4.2 or higher. However, we are aware of a problem with Java 1.6.0 and Holter LX Analysis v5.0 & v5.1. These older versions of Holter LX Analysis do not work properly with the latest Java 1.6.0. The easiest solution to this problem is to update Holter LX Analysis to at least v5.2 and preferably to the latest version which is v5.3. If it is important to maintain the use of these Holter LX Analysis v5.0 or v5.1, there are a few options.

Do not update from the older versions of Java on the computer that runs Holter LX Analysis v5.0 or v5.1. If you are required to update to a newer version of Java for an application other than Holter LX Analysis, there are options:

  1. Maintain separate computers for the two applications that require different versions of Java
  2. Carefully manage the environment variable JAVA_HOME and PATH when running either of the two applications that require different versions of Java.

In theory one can install two versions of Java on the same machine and switch which version is being used for a given application. We have never tested this and have no further details on how to do it, except to say that it involves a change to the environment variable JAVA_HOME and the entry in the PATH variable just before running an application, you can change which version of java is being used. This can still be a problem if it is necessary to run both applications at the same time. One would have to open each one in a separate command shell. Again, we have not tried any of this so we don't have working samples of commands to do it.  

35. Question: What is the structure of the files and/or database used in LX Event?
Answer: There is a "database" file called "NMPatients.ndb" that has the search keys for the "FIND" frame. It also has the path to the data files. This is an ASCII file. In the directories with the actual patient data pointed to by this key file is the raw data. This is in the form of a ActiveProcedure.npe file, backups and the raw phone.wav files. The .npe file is also an ASCII file with the raw data included as a readable, but hex, line of data.  

36. Question: After installing software from NorthEast, including the new Sentinel drivers, I now get an error when I start up my computer that refers to a "Sentinel Protection Server to SuperPro and UltraPro network keys"? How do I fix this?
Answer: After installing the Sentinel drivers, do the following:Start up the Windows "Control Panel" (on my system it is, Start -> Control Panel, while on other systems it might be something like, Start -> Settings -> Control Panel). When in the Control Panel, go to Administrative Tools -> Services. Scroll down to and highlight the selection for the Sentinel Protection Server. Right click on the Sentinel Protection Server and select Properties. Set the Startup type to "Manual" (as opposed to Automatic or Disabled). Click on Apply and then exit from the tools.

37. Question: For the DR180+ units, what firmware versions work with which size memory cards and in what modes?
Answer: If you are using the DR180+ recorder in 12-lead Continuous mode, the recorder will work properly with v2.14 firmware and any card, including those 1GB or higher.

If you are using the DR180+ with v2.15 software (current version as of Jan 2008), you are able to use any card from 128MB or higher for either 12-lead Continuous or 3CH modes.

If you are using the DR180+ recorder in 3CH mode and the firmware is v2.14, a card of 1GB or higher will cause most recordings to fail before 24 hours, and just before failure, there may be some intermittent data loss. Repeating: this is not a problem in 12-lead Continuous mode.

38. Question: How do we view the patient-marked diary events indicated during a Holter recording? Is it possible to write a report which includes samples of all the patient-marked diary events? Can it display the EKG 1-5 minutes before and after the diary marker?
Answer: All the patient marked Diary events are included in the "Saved Strips" and will be printed out when either "Full-sized Strips" or "Half-sized Strips" are selected. At this time (v5.3) the "Full-size" Strips" include a 1- minute full disclosure like printout in addition to the 25 mm/sec printout. There is a plan for a future release to have the option for a 3 minute mode also. We have added this request to our Enhancement Request list for further evaluation.

39. Question: I have a study where many T-waves were categorized as PVBs. Why did that happen and how is it best handled?
Answer: We expect the T-wave detections were caused by a slightly long period, from the R-wave to the apex of the T-wave (not to the end of T) and low R-wave amplitude. In cases where there is no clean channel and with an R-wave larger than the T-wave, the best thing to do is generally to increase the "extra dead time". This adds to the refractory time during the normal T-wave period where an R-wave detection is not possible. While the program attempts to adjust this time as a function of heart rate, sometimes it is necessary to increase the Extra Dead Time value directly.

Extra Dead Time can be changed in Settings -> Scanning Criteria. Normally it is set to 0.06 but try changing it to 0.10 or even 0.15. The maximum value the program will accept is 0.30. If your Settings in the Scanning Criteria allow for two channel processing, it will use the Primary and Secondary Channels specified in the Scanning Criteria. Normally the Primary Channel is used for R-wave detection and the Secondary Channel is used in the case of a possible missed R-wave. Both channels are used for morphology and artifact measurements.

40. Question: How can I adjust the period over which the LX Analysis software operates in order to eliminate data during portions of the study?
Answer: There are a couple of ways to adjust the time period over which the LX Analysis software operates. It is possible to alter what is analyzed by two methods. 1) First, you can go to the TREND screen, then drag the cursor across the region you want to exclude, label it ARTIFACT by clicking on the ARTIFACT button. Repeat as necessary to eliminate multiple regions in the study. 2) A second approach eliminates all time after a designated point. Identify the time that you would like the analysis to end by placing the cursor at that point on either the TREND or PAGE screens. Then from the toolbar, select Review > Shorten Analysis Time.

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