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 a QRS-Trigger cable and an update of the license, in case the end-user wouldn't have it already)
Under normal conditions, what means the ECG has an average amplitude and not much noise or no noise on the ECG, 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, also in this occasions, 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 sensitivity in a range from 100% up to a maximum of 150%. Otherwise disturbance might be amplified in a way that it 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.