hyper q is a special analysis of high frequency ecg ... · hyper q simply adds another layer of...
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HyperQ™ is a special analysis of high frequency ECG signals enhancing the
accuracy of ischemia diagnosis
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Conventional ECG
• A slowly-varying waveform (up to 100Hz)
• Amplitude measured in milli-volts
Background: High Frequency ECG
Additional valuable information is ‘hidden’ in the ECG signal
HyperQ (High-frequency ECG)
• Fast-varying waveform (150-250Hz)
• Low amplitude, measured in micro-volts
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Ischemic Heart Disease
� Definition: reduced blood supply to the heart muscle, usually due to coronary artery disease (CAD)
� Epidemiology (US, 2010): 17.6M chronic patients; 935K acute myocardial infarctions annually; ~17% of all deaths
� Economic implications: estimated annual costs of � Economic implications: estimated annual costs of $165 Billion in the US alone
� Diagnosis:
� Chronic disease (stable angina, CAD): stress ECG → cardiac imaging → angiography
� Acute disease (acute coronary syndrome): resting ECG → biomarkers → angiography
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The effect of Ischemia on HyperQ Signal
Ischemic Normal
HyperQ Signal
Change in Amplitude and Shape
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HyperQ Scientific recognition*
AHA included HyperQ in its last statement on exercise standards for testing (published in August 2013), pointing out that it has been found to have useful test performance
for detection of CAD
* Circulation. 2013;128:873-934
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Proven for Stress ECG
Numerous clinical studies
demonstrate: HyperQdramatically improvesdramatically improvesdiagnostic capabilities
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Most popular screening test for Coronary Artery Disease (CAD). Around 40 million tests WW are
Stress ECG Testing
Around 40 million tests WW are done annually.
Stress ECG has a low diagnostic accuracy for ischemia. Sensitivity and specificity may fall below 60%.
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Conventional Stress ECG
� No acute chest pain
� Typical settings – Stress ECG lab
� Compares ECG between rest and peak exerciseexercise
� Takes about 10 minutes to reach target heart rate
� Significant ST depressions may suggest Coronary Artery DiseaseHyperQ simply adds another layer of information
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Clinical Study show: HyperQ identifies up to 80% more
patients with ischemia when compared to traditional ECG
Ischemia detection rate
almost doubles with
HyperQ
HyperQ
ST changes
69%69%
39%39%
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Stress ECG Testing in Women*
Women are more likely to have a “false-positive” Stress ECG results
Still, stress ECG testing is the most commonly used method of diagnosing CAD in women
Kohli et. al., Circulation. 2010;122:2570-2580
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A women oriented Clinical Study shows*: HyperQ reduces
the false alarm rate in women by more than 50%
Stress ECG
False positive
diagnosis in women
Proprietary & Confidential │ page 11* Rosenmann, Tzivoni et. al., Journal of Electrocardiology, Vol. 46(1) pp. 19-26, January 2013
ECG
HyperQ 45%45%
20%20%
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HyperQ Stress Testing in Women
Closing the gap in Stress ECG diagnosis accuracy between men diagnosis accuracy between men and women
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HyperQ Analyzer Stress - How it works
One click enables access to better clinical evaluation
Negative Lead
Positive Lead
12 leads view
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HyperQ Analyzer Stress Interpretation
A positive HyperQ lead:A positive HyperQ lead:
•Relative reduction ≥ 50%
•Absolute reduction ≥ 1µV
A positive HyperQ test:
3 or more positive leads
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HyperQ Analyzer Stress Installation
� HyperQ is already installed in each new CS200 Excellence or Touch system
� Each system comes with a license for � Each system comes with a license for 100 free tests
� The software package includes several demo files with typical clinical cases.
� With the new version, HyperQ can use a product key license (no need for a dedicated dongle)
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HyperQ analyzer stress Examples
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Case Study 1
65 year old Woman
Negative SPECT evaluation
Shows abnormal ST depression
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CS-200 Average Screen
Abnormal ST
Depression
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HyperQ Overview Screen
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Case Study 2
75 year old Man
Positive SPECT evaluation
Shows no abnormal ST changes
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CS-200 Average Screen
No ST Changes
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HyperQ Overview Screen
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Solutions for Solutions for Resting ECG
HyperQ enables early detection and monitoring of Acute Coronary Syndrome (ACS)
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Resting ECG has low detection rate in patients having Acute Coronary Syndrome
Detection of patients with NSTE-ACS is a pressing unmet need
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Conventional Resting ECG
� Acute chest pain
� Typical settings – Emergency Room
� Takes about 10 seconds for initial diagnosisdiagnosis
� Significant ST elevations suggest ST Elevation MI
� Significant ST depressions may suggest Acute Coronary Syndrome
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Scientific studies show: High Frequency ECG
morphology is changing during Acute Coronary Syndrome
controlcontrol InflationInflation PostPost--PTCAPTCA
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Clinical studies show that: HyperQ is able to detect patients with Acute Coronary Syndrome (ACS)
• High frequency analysis helps in risk stratification of patients with suspected myocardial infarction
• Reduces unnecessary • Reduces unnecessary hospitalization
Amit et.al., High-Frequency QRS Analysis in Patients with AcuteMyocardial Infarction: A Preliminary Study. Ann Noninvasive Electrocardiol 2013;18(2):149–156
Admission Post PCI Admission Post PCI 2424hh
HyperQ
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How does it work?
One click enables access to better clinical diagnosis
Negative Lead
Positive Lead
12 leads view
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HyperQ Analyzer Rest ExamplesHyperQ Analyzer Rest Examples
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Case Study 1
62 year old Woman
Shows no abnormal ST changes
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Case Study 2
21 year old Male
Shows abnormal ST changes
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