System description
We used acoustic ECG transmitters which were miniaturized, hand-held, battery-operated devices (9V), weighing approximately 350 g. A patient cable was purpose-designed as a harness to be hung around the patient's neck, allowing the height to be adjusted as required. The harness (Fig 1), with clear markings, variable length and appropriate directions of precordial leads, made the placement of standard leads easy. Disposable electrodes were used. GPs or their nurses recorded an ECG in the device's memory, where it was stored for transmission. The ECG acoustic transmitters could only store one recording at a time. The CMC receiving station was computer based, using a 386 file-server with database software which allowed the on-sceen display of the ECG. However, following a replacement of transmitters, receiver and software (Aerotel HeartView), an onscreen measurement program running on a 486DX server and a user-friendly database program were used, while the station also had a fax modem incorporated allowing for instant, direct reporting (Fig 2). Alternative manual ECG recording devices could be used when necessary from the registrars' homes following call diversions. These were portable
ECG recorders with an acoustic coupler to allow recording from the telephone line.

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