Modes of Operation
While the basic concept of PIERS is related to emergent use in the setting of an ACS, PIERS uses three distinct modes of operation for the patient to interact with the system. This section summarizes the overall concept of operation for the PIERS for each of the operating modes, the framework for PIERS operation and demonstrates how the PIERS will achieve the primary design goal - breaking down the barriers for using the system during an ACS.
The three operating modes are:
Mode 1 – a test and patient training mode,
Mode 2 – a mode in which the PIERS is used on a non-emergent, scheduled basis to collect, transmit and route historical and ECG data to a patient’s personal physician for monitoring and management of chronic coronary artery disease , and
Mode 3 – a mode in which PIERS is used in an emergent, non-scheduled event that may represent an ACS or AMI.
This proposal is focused on ACS and AMI. But, as shown in Figure 4, CAD activity exists over a spectrum ranging from stable angina (associated with a stable atherosclerotic plaque) to unstable angina (associate with an unstable or fissured plaque and platelet activation) to AMI (associated with thrombotic vessel occlusion). PIERS is designed to monitor all phases of CAD activity in high risk patients. By actively monitoring high risk patients in Mode 2, progression from stable to unstable coronary artery disease may be identified early, potentially preventing progression to AMI and its associated morbidity and mortality.
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