From custo diagnostic version 4.6.11, 5.0.7, 5.1.1 and 5.2.0, custo med built in an additional feature that gives you the possibility to adjust the sensitivity of the QRS trigger output. ( The QRS trigger output is an option that needs QRS Trigger cable an update of the license in case the end-user wouldn't have it already)
Under normal conditions, what means an ECG with a average amplitude and no noise, the QRS trigger works properly. In some occasions when the amplitude of the ECG is very small the trigger might every now and then miss a R top. In case of using the trigger pulse for a CT camera or Blood pressure device this might affect the measurement.
To come up with a stable trigger, custo med has added the possibility to adjust the gain of the signal that is used to generate the QRS Trigger.
The setting is in the service center of custo diagnostic. Under Settings, Belastungs EKG\Intern\QRSTriggerAmplifyPercent. Default the setting is set to 100%. Recommended is to change the sensitifity in a range from 100% up to a maximum of 150%. Otherwise disturbance might be amplified in a way that is could be recognized as a R-top.
Make sure you safe the setting with "Speichern"
After restart of custo diagnostic this feature will take effect.
On the following LINK a short video with the complete instruction.