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Thymatron® System IV
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Description
Specifications
Features Checklist
Advantages of the Thymatron® System IV over the MECTA Spectrum
A one-page course in Advanced Electroconvulsive Therapy
 
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Description
Somatics Thymatron® System IV
ANESTHESIA DEPTH MONITOR NOW AVAILABLE!
The Thymatron® System IV has just become the first ECT device in history to feature an Anesthesia Depth Monitor. The recent unavailability of the anesthetic Brevital© (methohexital) has required many doctors to switch to other less-familiar agents, including especially propofol, whose biphasic action and seizure-shortening properties require special care in its use.

The new Anesthesia Depth Monitor provides a continuous front-panel display of your choice of 3 measures shown to correlate highly with anesthesia depth and with the Bispectral Index© (BIS©): 95% Spectral Edge Frequency (SEF-95), relative Delta power (% Delta), and Median Frequency (MF). Although these measures are presently available only on OR monitors costing in the range of US$10-20,000 they are now included with the Thymatron® System IV at no additional cost (upgrades to existing Thymatron® System IV units will also be made available, price to be announced).
EXTENDED LOWER STIMULUS RANGE--ULTRABRIEF STIMULATION
Pulsewidth and frequency settings down to ultrabrief 0.3 msec and 20 Hz allow you to deliver stimuli up to 8 seconds long across the entire dosage range, to optimize treatment in accordance with research showing greater efficacy of short-pulsewidth, low-frequency, extended-duration stimuli (Isenberg et al, 1996; Chanpattana, 2001).
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POSTICTAL SUPPRESSION INDEX
The PATENTED Postictal Suppression Index reports the degree of EEG flattening immediately following the seizure, which has been reported to correlate with clinical efficacy (Nobler et al, 1993; Krystal & Weiner, 1994; Krystal et al, 1995; Krystal, 1998; Suppes et al, 1996; Petrides et al, 2000; Perera et al, 2002).
STATE-OF-THE-ART MONITOR/PRINTER
Allows you to monitor EEG1, EEG2, EKG, and EMG (or, choose 4 channels of EEG), plus 2 derived channels: digital heart rate and anesthesia depth index, while providing hard-copy documentation for the patient's chart.
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IMPROVED FRONT-PANEL FLEXDIAL© SELECTOR
Lets you select all the traditional Thymatron® functions plus important new ones, including an Ultra-brief (0.25 msec) pulse and programs that automatically set the most effective combination of stimulus parameters at any stimulus dose you have selected.
EXPANDED, COMPREHENSIVE END-OF-TREATMENT REPORT
Now includes, in addition to the familiar Thymatron® DGx measures, your choice of the following new measures unique to the Thymatron® System IV (U.S. pat. #5,871,517):
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EEG COHERENCE MEASURES of maximum sustained coherence and time to peak coherence, interhemispheric cross-correlation measures reported to reflect seizure quality and clinical impact (Roemer et al, 1990-91; Krystal & Weiner, 1994; Krystal et al, 1995; Krystal, 1998; Perera et al, 2002).
EEG AMPLITUDE MEASURES of maximum sustained EEG power, and time to peak power, with separate values for early, mid- and postictal seizure phases, found by the Columbia and Duke University groups to be important correlates of seizure quality and efficacy (Nobler et al, 1993, 2000; Krystal & Weiner, 1994; Krystal et al, 1995; Suppes et al, 1996; Krystal, 1999; Perera et al, 2002).
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HEART RATE MEASURES, including peak heart rate, a key measure of cerebral seizure duration and quality (Larson, Swartz, & Abrams, 1984; Swartz, 1993; 1996) that reflects the autonomic (brainstem) response to ECT. This is supplemented by continuous digital heart rate monitoring for safety and seizure generalization, with the result printed each second on the recording strip.
A POWERFUL 32-BIT INTERNAL COMPUTER
Employs Power Spectral Analysis (FFT) to process and store up to 10 minutes of digitized EEG for the special features described here. You can send this data to any IBM PC-compatible computer via a rear-panel serial port for further comprehensive EEG analysis.
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DIGITAL EEG MACHINE FUNCTIONS
The Thymatron® System IV has all the functions of a sophisticated 4-CHANNEL DIGITAL EEG MACHINE with frequency, coherence, asymmetry, and power spectral analytic programs. These allow you to record and analyze EEGs in your ECT patients between treatments to measure ECT-induced frontal EEG slowing and other EEG manifestations reported to reflect treatment impact and efficacy (Fink & Kahn, 1957; Roemer et al, 1990-91; Sackeim et al, 1996).

Because each ECT treatment session is STORED IN MEMORY, you can retrieve it if you run out of paper during a treatment -- just slip in another roll after the treatment and press a button for a complete printout.
PATENTED INDEPENDENT SAFETY MONITOR CIRCUIT AND ALARM
Prevents the patient from receiving an excessive electrical dose regardless of the operation of the regular circuits.
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TRUE EMG RECORDING OF THE MOTOR SEIZURE
Unlike simple movement detectors, the Thymatron® System IV's EMG can measure seizure muscle activity that is not visible to the naked eye, and which typically continues substantially longer than visible movements (Couture et al, 1988).
JUST SET ACCORDING TO AGE AND TREAT
Setting the Thymatron® System IV according to the patient's age facilitates easy selection of a stimulus charge for unilateral, bitemporal, or bifrontal ECT that is in the preferred range (Beale et al, 1994; Petrides & Fink, 1996).
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EASY UPGRADES
Because the special computer-automated programs of the Thymatron® System IV are stored on REPLACEABLE MICROCHIPS, future system updates (there have been 4 already) can easily be accomplished via chip replacement.
SEIZURE ENERGY INDEX
A new, improved Average Seizure Energy Index measures a dimension of the seizure -- its intensity -- that is not reflected in seizure duration (Nobler et al, 1993, 2000; Krystal & Weiner, 1994; Krystal et al, 1995; Suppes et al, 1996; Krystal, 1999; Perera et al, 2002).
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PRINTOUT OF SEIZURE DURATION BY EEG, EMG, AND EKG CRITERIA
The Thymatron® System IV measures the EEG, EMG, and EKG, and automatically prints the corresponding seizure duration estimates with precision and reliability Larson, Swartz and Abrams, 1984; Swartz et al, 1994; Krystal et al, 1995).
THE PATENTED AUDIBLE EEG©
Also provides continuous EEG monitoring even if the recording paper runs out. It correlates highly with the visual EEG and keeps you constantly aware of the progress of the EEG seizure without having to watch the recording (Swartz & Abrams, 1986).
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EXTENDED SEIZURE ALERT
Because longer seizures generate more cognitive side-effects, may clinicians prefer to terminate seizures that exceed 120 to 180 seconds on the EEG (Abrams, 2002). To advise the clinician that this point has been reached, the Thymatron® System IV provides an intermittent click tone when a user-selected interval has elapsed after the stimulus and monitoring has not been terminated.
RAPID STIMULUS TITRATION
Is facilitated with the Thymatron® System IV using a simple method-of-limits procedure (McCall et al, 1993; Rasmussen et al, 1994).
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