PMS Instruments Awarded Feefo Gold Trusted Service Award 2018

I am pleased to report that PMS Instruments has again been awarded the Feefo Gold Service award, an independent seal of excellence that recognises businesses for delivering exceptional experiences, as rated by real customers.

Created by Feefo, Trusted Service is awarded only to those businesses that use Feefo to collect genuine ratings and reviews. Those that meet the high standard, based on the number of reviews they have collected, and their average rating, are awarded. A badge of honour, this accreditation remains unique, as it is based purely on the interactions with verified customers.

As all reviews are verified as genuine, the accreditation is a true reflection of a business’ commitment to outstanding service.

PMS Instruments met the criteria of collecting at least 50 reviews between January 1st 2017 and December 31st 2017, with a Feefo service rating of between 4.5 and 5.0.

I am proud of the team at PMS and it’s a real honour to receive this award from Feefo. To be recognised for delivering exceptional experiences to our customers is a great achievement. We’ve been working hard to ensure our customers receive the best service possible, and being able to listen, understand and respond to their needs has enabled us to improve our offering. We’re looking forward to another successful year ahead.

Could AliveCor SmartRhythm Monitoring Revolutionise AF Detection?

The latest App version 5.0.2 from AliveCor introduces a new premium feature “SmartRhythm” monitoring.

What is SmartRhythm monitoring?

SmartRhythm monitoring from AliveCor is a system that takes heart rate and activity data gathered from an Apple Watch, and evaluates it using a deep neural network to predict heart rate patterns. If  heart rate differs from the neural network prediction, SmartRhythm will notify you to record an ECG either on your phone with Kardia Mobile or for convenience and if you have one with the KardiaBand.

Taking frequent ECGs can help you better manage your heart health, and capturing an ECG specifically during times when heart rate does not match activity levels may be useful.

SmartRhythm monitoring uses the Apple Watch Photoplethysmogram (PPG) sensor to evaluate heart rate approximately every 5 seconds. Your heart rate itself depends on many factors such as activity, stress, time of day and more. So at times your heart rate pattern should be high (during exercise), sometimes, it should be low (at rest) and sometimes it may signify a heart problem.

Patented AliveCor SmartRhythm monitoring technology uses an autoregressive, deep neural network that can learn the normal relationship between heart rate and activity, and notify you when it sees an unexpected pattern. It notifies you when the actual data from the Apple Watch doesn’t match what the SmartRhythm model expects to see.

Receiving a SmartRhythm notification does not necessarily mean that something is wrong. There are many perfectly normal situations that can cause a SmartRhythm notification, including exercise the Apple Watch can’t detect, stress or anxiety, consumption of caffeine or alcohol, and even motion artifact from wearing the watch band too loosely.

Conversely, not getting a SmartRhythm notification does not necessarily mean that everything is normal, since the Apple Watch sensor is only measuring your heart rate and does not capture the full complexity of your heart. SmartRhythm monitoring should be used as an additional means to capture frequent ECGs.

Does SmartRhythm monitoring affect Apple Watch battery life?

Yes. SmartRhythm causes a higher battery usage and you will need to charge your Apple Watch more frequently. This is because SmartRhythm requires the Apple Watch to be in Workout mode as it is evaluating heart rate data continually which increases battery usage.

AliveCor internal testing has shown that with a series 2 or newer watch you can expect around 16 hours of battery life. It can still be worn over night just top up the charge for an hour or so.

The first generation Apple Watch is not supported because it has a smaller battery and will only last 5 hours.

What’s Next?

Kardia for Apple Watch is just the first step in bridging the gap between consumer wearable devices and the science of clinically validated ECG healthcare devices.

The availability of a wearable, mobile ECG device like the Kardia has the potential to dramatically improve early detection of arrhythmias. Many arrhythmias start as occasional, intermittent problems that usually don’t show up in a doctor’s office and are notoriously difficult to diagnose.

AliveCor products including the Kardia Mobile and Kardia Band are available directly from UK Distributor PMS Instruments.

AliveCor®, KardiaBand™ and SmartRhythm™ are trademarks of AliveCor, Inc. Apple Watch® is a trademark of Apple Inc.

Meditech CardiUP!3 24 Hour Holter ECG introduced

January 2018 sees the official UK launch of the new Meditech CardiUP!3 Holter ECG.

Continuous full disclosure Holter ECG monitors were first used in the 1970s and typically operate for 24-48 hours recording every single heartbeat during this period. This can mean that upwards of 100,000 beats are recorded over a 24 hour period. They are especially useful if the wearer does not feel or is not aware of the ECG abnormality.

Holter ECG recorders are generally used to investigate suspected symptoms of arrhythmia including palpitations, light-headedness or syncope (partial or complete loss of consciousness), which has not been detected during a shorter 12 lead, surgery based ECG.

Is there still a need for Holter ECG recorders?

NICE clinical guideline Clinical guideline CG180  on Atrial Fibrillation management recommends the use of a 24‑hour ambulatory ECG monitor in patients with suspected asymptomatic episodes or symptomatic episodes less than 24 hours apart  or with suspected paroxysmal atrial fibrillation undetected by standard ECG recording.

What’s different with the CardiUP!3 Holter?

The latest generation CardiUp!3 from Meditech has a large internal memory which means it can record continuous digital full disclosure ECG from 24 hours or for up to 7 days using just 1 AA battery!

The large LCD screen displays real-time ECG which lets you verify ECG quality, ensuring accurate hook up in real time. Connection is by a new standard mini USB connection.

The CardiUP!3 has a manual programming option which means it can be programmed without connection to a PC. This can be useful if a PC is not available or a treatment room is occupied.

The Meditech CardioVisions analysis software supplied with the CardiUP!3 provides automatic beat-by-beat ECG, ST, PQ, QT and HRV analysis and includes pacemaker beat detection. The QRS detection algorithm of the software is 99.9% accurate according to the IEC 60601-2-47 International Standard and AHA and MIT databases and gives rapid automatic ECG annotation and analysis in minutes.

Running costs are minimised thanks to the latest low power electronic design techniques. The CardiUp!3 Holter uses just 1 AA Alkaline or rechargeable battery.

To find out more or to arrange a demonstration just call us on 01628 773233.

Published Clinical Research Demonstrates The Effectiveness Of Key Products

At PMS Instruments we are always looking to share published clinical research that demonstrates the effectiveness of key products we distribute.

At the European Society of Cardiology Congress in Barcelona recently there were a number of clinical studies, papers, posters and presentations focusing on the Kardia Mobile ECG and its effectiveness in AFib detection.

This is important as the research helps validate the accuracy of AliveCors medical grade algorithm giving users’ confidence in Kardia Mobile ECG technology and potentially saving lives.

In one recent Study Professor Julian Halcox of Swansea University Hospital in Wales presented The REHEARSE-AF Study with simultaneous publication in Circulation and the The Journal of the American Heart Association. This randomized study provided AliveCor Kardia units to 500 patients, who used them to record two ECGs per week for a year and compared the results to 500 patients who received conventional care from their General Practitioner. At the end of the year, the Kardia group had a 4-fold increase in AFib diagnosis compared to the control group, thereby enabling the initiation of potentially life-saving anticoagulant therapy.

A Cleveland clinic study showed Kardia Mobile AFib detection accuracy similar to that of Doctors. Dr Khaldoun Tarakji from the Cleveland Clinic presented the iREAD Study which evaluated the accuracy of the AliveCor automatic AFib algorithm versus expert cardiology over-read of both the Kardia recordings and 12-lead ECGs. Dr Tarakji found that in 52 patients the Kardia algorithm had a 96.6% sensitivity and a 94% specificity compared to a cardiology over-read of the simultaneous 12-lead ECGs for the diagnosis of AFib. Additionally, over 93% of the patients found the Kardia to be easy to use and that it “lessened AFib-diagnosis anxiety.”

Another Study found that the Kardia Mobile was able to detect more patients with AFib that were previously undiagnosed. Dr Bryan Yan of The Chinese University of Hong Kong presented research of over 12,000 patients aged 65 and older. He found that for each 30-second ECG recorded using the Kardia Mobile, his team were able to identify more patients with previously undiagnosed AFib. This demonstrates the empirical value of convenient, inexpensive self-screening using the Kardia Mobile ECG.

Finally at the ECS Dr Ngai Yin Chan of Princess Margaret Hospital in Hong Kong presented the AFinder Study which used community volunteers to perform opportunistic screening for AFib using AliveCor’ s Kardia Mobile in over 10,000 Hong Kong citizens age 50 and older. 244 participants were found to have AFib, with 74 of those previously undiagnosed. This study verifies that by using Kardia Mobile senior citizens who were not medical professionals could perform medical screening of their peers with successful identification of a serious medical condition.

These are examples of just some of the many published research articles from around the world which demonstrate that if the AliveCor Kardia Mobile ECG is trusted by Clinicians you can trust it to!

The economic case for the AliveCor Kardia Mobile ECG

The AliveCor Kardia Mobile ECG has swiftly become one of our more popular products. If you’ve not yet heard of it, the Kardia Mobile ECG is an incredibly handy and portable ECG monitor that is held in the patient’s hand. The only thing it needs is a smart phone with the Kardia app installed.

Using a single channel ECG monitor with automatic ECG evaluation, it can detect possible Atrial Fibrillation (AF). The smartphone application shows a real-time visualisation of the ECG recording, as well as historical data for comparisons.

The device has been popular for the home market, for those needing to track either their own or a relative’s health. However, there’s a serious economic case for the Kardia Mobile ECG to become a standard for surgeries. If surgeries have access to the mobile ECG, to be able to supply to patients, a lot of time can be saved.

Let’s first look at the current representative pathway for patients presenting with palpitations according to a case study from NHS Coastal West Sussex.

Patient present with palpitations > Sees GP > GP refers > Hospital receives letter > Consultant receives letter > Outpatients > 24hr ECG > Negative Test > Has 7-day ECG > Outpatients and decision > Has 7-day ECG > Outpatient and decision > Consider Implantable Loop Recorder (ILR) > Put on waiting list > Lost to system > Sees GP > GP writes letter > Hospital receives letter.

That’s quite a list, 18 steps in all. Goodness knows the time, resource and cost this entire process could be to the system.

Here’s a potential pathway with the Kardia:

Patient presents with palpitations > Sees GP > GP supplies Kardia Mobile ECG > Symptomatic trace > Sees GP > Advice and management.

Already, you can see where the Kardia Mobile ECG being part of your surgery’s strategy could save valuable time and money. The aforementioned case study does give some idea for the potential savings to be made.

The previously quoted pathway is costed up at £1305, nearly £6000 if the ILR (implantable loop recorder) is included. Whilst all of these steps and the costs suggested might not always be the case, it shows that it could be an expensive process. Taking into consideration that an estimated 2,000,000 people in the UK have Atrial Fibrillation, we simply must find a more sensible solution, the AliveCor Kardia Mobile ECG.

The same pathway, with the inclusion of the Kardia Mobile ECG being supplied comes in at just £172.50. That’s an incredible saving.

Across the country, that’s a potential saving of £2,265,000,000 (without ILR, £11,377,000,000 with ILR in every case) which is a staggering figure. This is no longer about whether surgeries ­should be supplying the Kardia Mobile ECG, it’s a case of when they start.

That time is now.

 

Hokanson Cuff Changes Are Ahead.

Hokanson whose range of vascular instruments, cuffs and accessories are distributed in the UK and Ireland by PMS Instruments recently announced some changes to their cuffs. All cuffs manufactured after 31st August 2017 will now be supplied with male bayonet connectors.

Hokanson vascular cuffs have been the standard in vascular laboratories and clinics throughout the world for over 40 years and as they have been using “leur” type connectors for many years why the change now?

As ever the idea is to make medical devices safer and in the case of “small bore connectors” which includes blood pressure and vascular cuffs minimize medical device tubing misconnections.

Small-bore connectors are parts used to connect medical devices such as tubing, syringes, IV lines and other accessories that deliver fluids and gases for patient care. Although thankfully rare, tubes using standard luer connectors but with different functions have in the past been mismatched and connected incorrectly.

In the USA the FDA provide several examples of this happening on their website including the case of a blood pressure cuff which was accidentally connected to an IV catheter.

The FDA, and the International Organization for Standardization (ISO), decided to take action and IEC 80369-5:2016 was published in March 2016 to provide specifications for the small-bore connectors used with blood pressure cuffs. Hokanson have standardised on a male bayonet connector.

The following cuffs will be affected.

Hokanson UDC/UPC cuffs, the DP and SC cuffs that currently come with a Luer connector will be changed to a bayonet connector. This includes the SC10, SC12, TMC7 and SC5.

Hokanson cuffs with D rapid version hoses (SC12D, SC12LD, etc.) will remain unchanged. CC thigh cuffs will come with the bayonet connectors, and that connector can be cut off for use with an E20 rapid cuff inflator Y-connector (as with the Luer).

We will be providing Permanent Conversion Kits as well as Adaptor Kits to ensure compatibility and allow you to use legacy leur connector cuffs. Conversion kits are for permanent conversion of cuffs already being used that will change them to the new standard bayonet connector. Adapter kits are for customers who want to use both Luer and bayonet connectors, until all cuffs in use have bayonet connectors.

There is no requirement requiring customers to remove or stop using products currently in use from the market.

European Society of Cardiology. Diagnosis and timeley detection of AF.

 

I have recently been re-reading the 2016 European Society of Cardiology (ESC) Guidelines for the management of atrial fibrillation (European Heart Journal (2016) 37, 2893–2962 doi:10.1093/eurheartj/ehw210.

Of particular interest was the section on “Diagnosis and timely detection of atrial fibrillation” especially in the light of the popularity of the low cost clinically validated Kardia Mobile ECG from AliveCor.

In their latest review, when putting forward proposals to enhance current guidelines the ESC specify 4 different recommendation classes. A Class I recommendation is defined as

“Evidence and/or general agreement that a given treatment or procedure is beneficial, useful, effective”.

Within the section for screening for atrial fibrillation they have issued a class I recommendation that  

“Opportunistic screening for AF is recommended by pulse taking or ECG rhythm strip in patients >65 years of age”

Clearly that is advice worth taking but in a busy GP Practice, where appointment time is limited to 10 or 15 minutes and resources under pressure, is it always practical to carry out a 12 lead ECG to get a rhythm strip?

Fortunately technology has the answer and there is the Kardia Mobile ECG App for that!

For under £99 the Kardia Mobile and App produces a 30 second rhythm strip that has the same diagnostic accuracy as a 12 lead single channel ECG Lau JK, Lowres N, Neubeck L, Brieger DB, Sy RW, Galloway CD, et al. Int J Cardiol. 2013;165(1):193-4.

It is therefore ideal for use in Primary Care to implement the recommendations of the ESC. The ESC go on to say

“There is good evidence that prolonged ECG monitoring enhances the detection of undiagnosed AF, e.g. monitoring for 72 h after a stroke…and daily short-term ECG recordings increase AF detection in populations over 75 years of age”

Again the Kardia Mobile is ideally suited for regular home monitoring, for instance once in the morning and once in the afternoon.

As it records a 30 second rhythm strip in real time, it is ideal for capturing paroxysmal AF for later analysis by a GP or Cardiologist.

It can be used to replace manual pulse checks providing qualitative ECG evidence in 30 seconds.

There is also an association with high blood pressure and AF. The Kardia Mobile ECG can help here as well.

To save time during a consultation, as well as to opportunistically screen for AF, why not use a Kardia Mobile before taking a blood pressure reading?

In the UK NICE have provided guidance on this with NICE Guideline CG127 Hypertension in adults: diagnosis and management on whether to use an automatic or manual blood pressure device.

Clause 1.1.2 states

“Because automated devices may not measure blood pressure accurately if there is pulse irregularity (for example, due to atrial fibrillation), palpate the radial or brachial pulse before measuring blood pressure. If pulse irregularity is present, measure blood pressure manually using direct auscultation over the brachial artery.”

Using a clinically validated Kardia Mobile by AliveCor before taking a blood pressure reading can save time as well as ensuring the most appropriate (automatic or manual) BP device is used. For up to date independent reviews on the Kardia Mobile ECG or to purchase visit our website.

 

 

 

 

A history of A&D Medical

A History of A&D Medical

At PMS Instruments we’re proud of the fact that we are the UK’s largest distributor of A&D’s innovative blood pressure monitors for both home healthcare & healthcare professionals and have been since 1989!

A&D are an established and trusted blood pressure brand and with our near 30 year experience with them in the UK and Ireland I thought it a great opportunity to provide a little history, as PMS Instruments have been with them all the way!

Who are A&D? A history of innovation.

A multi-national Japanese company established in 1977 A&D are world leaders in measurement technology and launched their first blood pressure model the UA-102, in 1979. They use their unique skills in analog-to-digital and digital-to-analog conversion technology to produce state-of-the-art equipment, including electronic balances, scales, weighing indicators and of course blood pressure monitors.

Success by investing heavily in Research & Development.

In 1984, they introduced their innovative oscillometric blood pressure measurement technology. Over time and backed up by numerous independent clinical studies the oscillometric method went on to become the standard method for digital blood pressure monitoring in both home healthcare and professional healthcare markets throughout the world.

2001 saw the first introduction of their unique Irregular Heartbeat Indicator in blood pressure monitors closely followed in 2003 by another innovation, the World Hypertension Society (WHO) blood pressure classification index. Both technologies are still in use today and found in millions of A&D blood pressure monitors worldwide.

Other innovative products like the iconic TM-2655P waiting room blood pressure monitor followed in 2002 with the Mercury free UM-101 sphygmomanometer arriving in 2005. New updated versions of these models were introduced last year (TM-2657P, UM-102).

Keeping up to date with Telemedicine, Telehealth and Wellness Connected.

In 2015, A&D launched their Wellness Connected app, giving patients the option of syncing their Blood Pressure results to their smartphone or tablet allowing users to manage and monitor their health, in one simple, easy-to-use app.

The latest innovation in A&D’s product range, the UM-201 Blood Pressure Monitor, has just been validated to the International Protocol and offers one-touch Oscillometric measurement, variable cuff sizes & is clinically validated for accuracy.

Why buy an A&D BP monitor and why buy it from PMS Instruments?

If I am asked this question I happily remind potential customers that A&Ds “Honmono” philosophy means they are one of the few manufacturers to focus on the consumer and professional blood pressure markets and as noted above have a proven pedigree and track record of accuracy and reliability.

Whether it is a monitor for home use, 24 hour ABPM or waiting room BP monitor here’s why you should purchase your A&D BP monitor from PMS Instruments.

  • Largest UK Distributor of A&D blood pressure monitors
  • NHS Supply Chain partner
  • ISO-9001 approved service, repair and warranty partner
  • Extensive A&D experience
  • 5* independent customer service approval
  • Latest current models in stock
  • Extensive range of spare parts and accessories from stock
  • Free demonstration and loan on some models

Are we doing enough to diagnose high blood pressure?

How often do you “Think BP”?

Did you know that in the UK alone, according to the British Heart Foundation (BHF), there are an estimated 7 million people with undiagnosed high Blood Pressure who don’t know they are at risk. Over 24% of people in England are estimated to have high Blood Pressure. At least half of all heart attacks and strokes are associated with high BP and it is a major risk factor for chronic kidney disease, heart failure and cognitive decline.

If these are the challenges facing Primary and Secondary Care the question is what can GP Practices, Hospitals and Clinical Commissioning Groups do to diagnose more patients with high blood pressure?

Can we do BP better and “Think BP”?

The BHF Guidance recommends key areas and stresses that clinicians should “Think BP” at every opportunity. I have separated their recommendations into a couple of key areas below where I think existing technology available from PMS Instruments could help.

Think BP in the Waiting Room— Consider giving patients access to a self-test blood pressure station in GP waiting rooms and Hospital Outpatient clinics. Professional, clinically validated monitors like the A&D Medical TM-2657P are designed for high volume use have been popular with GPs for many years and are now being used in Hospitals. They save both time and money in the long run and especially in a Hospital setting like a Renal Unit free up members of staff for other clinical duties.

Think BP during a consultation-Think BP and increase opportunistic screening in your GP Practice or Hospital. Make blood pressure testing routine for all patients attending clinics such as Renal, Sexual Health, Asthma, COPD, Diabetes, weight management, smoking cessation and other clinics. Patients can record their blood pressure in the GP or Hospital waiting room before they attend the clinic. The printed results can then be handed to the clinician during consultation saving time and staff resources.

For a trial, demonstration or to find out more about the TM-2657P call us today on 01628 773233.

Quality, customer service Feefo Gold Trusted Award

I am pleased to announce that PMS Instruments have won a Feefo Gold Service award, an independent seal of excellence that recognises businesses for delivering exceptional experiences, rated by real customers.

Created by Feefo, Trusted Service is awarded to businesses that use Feefo to collect genuine ratings and reviews. A badge of honour, this accreditation remains unique as all the awards are based purely on the interactions with verified customers. This feedback has been collated by the Feefo review platform, with the accolades being awarded based upon performance.

PMS Instruments have met the criteria of achieving a Feefo service rating of between 4.5 and 5.0 between January 1st 2016 and December 31st 2016.

It’s a real honour to receive this award from Feefo. To be recognised for delivering exceptional experiences to our customers is a great achievement. We’ve been working hard to ensure our customers receive the best service possible, and being able to listen, understand and respond to their needs has enabled us to improve our offering in 2016. We have been working closely with all our customers to build trust and transparency online, and ultimately helping shoppers buy with confidence and make better decisions.

Feefo ensures that all feedback is authentic, by matching it to a legitimate transaction which combats the rising issue of fake reviews.

Our stand out product is the AliveCor Kardia mobile ECG with a rating of 4.7 out of 5 over the last year.

We’re looking forward to another successful year ahead. You can look at our latest reviews here.