Overview

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Overview

Systole Records tab — the home screen

What Is Systole?

Systole is the PEDAL Network's application for cardiopulmonary exercise testing (CPET) data management. It supports the full CPET workflow — from data entry through normative comparison, clinical reporting, exercise prescription, and registry export.

Core capabilities:

Patient Records — Maintain a local database of patients and tests with full search, status tracking, data-completeness filters, and duplicate detection.
Data Import — Three import paths: Breeze .sum files, Systole .pedal files (v3.0–v5.0), and direct read-only access to a BreezeSuite MedGraphics SQL Server database.
Breath-by-Breath Analysis — Wasserman 9-panel plot with adjustable averaging window, draggable AT line, and exercise window markers. Auto-computed Rest / AT / Peak summaries from raw breath data.
Normative Predictions — Compare observed CPET values against 8 validated prediction equations (Jones, Wasserman, Cooper, FRIEND, Burstein, Blanchard, Fernie, Amedro) with percent predicted and Z-score calculations.
Clinical Reporting — Auto-generate structured clinical impressions with narrative fields for blood pressure, SpO₂, ECG, symptoms, and test comparison. Trend charts across serial tests.
Exercise Prescription — Risk-stratify patients using FORCE or Budts criteria and generate individualized heart rate–based exercise prescriptions.
REDCap Export — Export formatted CSVs for direct upload to the PEDAL REDCap database, with automatic record ID assignment and repeat instance tracking.
Demo Mode — Bundled fictional database for safe exploration and training, kept entirely separate from your clinical data.

Tab Map

The Systole interface is organized into top-level tabs, in workflow order:

Tab	Purpose
Records	Home screen. Lists all patients and tests; sub-tabs for Tests, Patients, and Review queue. Entry point for import, new patient, and new test.
Exercise	Patient demographics, test metadata, and observed CPET data entry (Rest / AT / Peak / Recovery columns).
BxB	Breath-by-breath data — Wasserman 9-panel plot and time-down data table. Appears only when a test has BxB data.
Reference	The 8 normative prediction equations with status indicators and detail panel.
Report	Auto-generated clinical impression, narrative fields, and historical trend charts.
Prescription	FORCE / Budts risk stratification and individualized exercise prescription.
Data Management	Bulk import, `.pedal` and REDCap exports, Site ID, MRN normalization, and protocol mappings.
Settings	Application Mode (Demo / Clinical), normative defaults, BxB averaging, database management, auto-backup, MedGraphics connection, developer options.
Debug	Hidden by default. Enable in Settings → Developer Options for raw data inspection.

Who Is It For?

Systole is designed for exercise physiologists, exercise cardiologists, and research coordinators at PEDAL Network sites who need to:

Interpret CPET results using age- and population-appropriate normative references
Generate standardized clinical reports
Prescribe exercise based on physiologic risk stratification
Submit CPET data to the PEDAL REDCap database

Demo Mode and Clinical Mode

Systole maintains two completely separate databases:

Clinical mode — Your real patient database (pedal.db)
Demo mode — A bundled fictional database (demo.db) with 7 patients and 12 tests covering pediatric–adult ages, cycle and treadmill modalities, and BxB / non-BxB cases

Switching modes restarts the app but never moves or merges data. A persistent banner indicates when you are in Demo mode. Reset Demo Data restores the bundled seed at any time without touching clinical data.

A fresh install opens in Demo mode by default; existing installs with pedal.db open in Clinical mode automatically.

Privacy and Data Security

Systole runs entirely on your local machine. No patient data is transmitted over the internet. All data is stored in a local SQLite database on your computer. This makes it safe for use with protected health information (PHI) without requiring network security infrastructure.

The MedGraphics direct integration uses a read-only SQL Server connection from your machine to your institution's existing BreezeSuite database — no new network exposure beyond the existing CPET system.

Exported files (.pedal, .csv) are saved to your local filesystem. You are responsible for handling these files according to your institution's data governance policies.

System Requirements

Systole is an Electron desktop application for macOS or Windows. There is no browser-only mode — native SQLite and MedGraphics integration require the desktop runtime.
macOS 13 (Ventura) or later on Apple silicon, or 64-bit Windows 10 or later. (From v1.2. Earlier versions also ran on macOS 11–12.)
No internet connection required for normal operation. (Only the Budts criteria reference link opens an external page.)
Sufficient local disk space for the database and auto-backups (typical sites use under 500 MB total).

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