Multi-Institutional Ethics Approval
Institutional Ethics Committee approvals secured across more than 5 distinct organisations — a prerequisite for rigorous clinical data and a signal of institutional trust.
CDSCO Approved Medical Device
Comprehensive Cardiac
Autonomic Neurofunction Testing System
NIBRA-CS® — Non-Invasive Autonomic Function Testing System
A comprehensive autonomic function testing platform for evaluating parasympathetic and sympathetic responses using standardized cardiovascular reflex protocols — designed for clinical accuracy and ease of use.
Standalone
Supported by DBT, GoI
Patented
Point of Care Testing
Touchscreen GUI
Clinical Challenge
Autonomic Dysfunction is Often Underdiagnosed
Autonomic nervous system dysfunction is a significant clinical concern across multiple medical disciplines. Early detection and accurate assessment are essential for effective patient management.
Diabetes mellitus with autonomic neuropathy
Unexplained syncope and orthostatic intolerance
Cardiovascular autonomic dysfunction
Neurodegenerative disorders affecting ANS
The Solution
A Complete Autonomic Testing Platform
NIBRA-CS® brings complete autonomic function assessment to the point of care — no specialist operator required, no invasive instrumentation, standardised clinical reports whether you run the full diagnostic battery or a rapid HRV screen. It is a patented, standalone device built for real clinical throughput in hospitals, diagnostic centres, and specialty clinics.
The system integrates ECG and non-invasive blood pressure monitoring with a guided clinical workflow and touchscreen interface — enabling a trained technician to conduct the full test battery and generate a clinician-ready report without additional specialist involvement.
Standardised autonomic reflex tests
6 validated tests across parasympathetic, sympathetic, and HRV domains
Integrated ECG and NIBP monitoring
Simultaneous multi-parameter acquisition with real-time signal feedback
Guided clinical testing workflow
Touchscreen interface walks the operator through each protocol step
Automated digital report generation
Structured, scored reports ready for direct inclusion in patient records
Clinical Validation
Validated Across Leading Institutions
NIBRA-CS® has been deployed and evaluated in paid clinical pilots at nationally recognised medical colleges and teaching hospitals.
800+
Patients Evaluated
5+
Institutions
Multi
Ethics Approvals
1st
Commercial Unit at RIMS
AIIMS, Kalyani
All India Institute of Medical Sciences
AIIMS, Kalyani
All India Institute of Medical Sciences
Clinical validation study conducted at AIIMS Kalyani — one of India's premier public medical institutions — establishing the clinical evidence base for NIBRA-CS®.
MMCH, Midnapore
Medinipur Medical College & Hospital
MMCH, Midnapore
Medinipur Medical College & Hospital
Paid clinical pilot successfully completed with 300+ patients tested — demonstrating real-world clinical throughput and institutional readiness at scale.
RIMS, Ranchi
Rajendra Institute of Medical Sciences
RIMS, Ranchi
Rajendra Institute of Medical Sciences
First commercial unit deployed at RIMS Ranchi. PHC-level screening integration currently underway — marking the transition from clinical validation to active institutional deployment.
JIMS, Budge Budge
Jagannath Gupta Institute of Medical Sciences
JIMS, Budge Budge
Jagannath Gupta Institute of Medical Sciences
Clinical pilots conducted with institutional ethics approval, contributing multi-site validation data for the autonomic assessment protocol.
IIMC, Sonarpur
Institute for Indian Mother & Child Hospital
IIMC, Sonarpur
Institute for Indian Mother & Child Hospital
Clinical pilots conducted at IIMC, Sonarpur, extending the validation dataset across diverse patient populations in the greater Kolkata region.
Clinical Assessment Protocol
Tests Supported
NIBRA-CS® digitizes Ewing's Battery of Cardiac Autonomic Function Tests with standardized workflows, automated calculations and integrated HRV analysis.
Select Per Patient
Two Ways to Test
The operator selects one mode on the device at the start of each session. Within either mode, the sequence is fixed and guided automatically — the operator doesn't pick individual tests.
Full Test Battery
7 ElementsThe complete autonomic work-up — Ewing's six-test battery plus the 5-minute HRV recording, run in one fixed sequence. Produces a full CAN (Cardiac Autonomic Neuropathy) diagnosis.
- 1 Resting
- 2 Deep Breathing
- 3 Response to Standing
- 4 Valsalva Maneuver
- 5 Five-Minute HRV Recording
- 6 Postural Hypotension
- 7 Sustained Handgrip
Duration
19 minutes + prep time
Report
6 pages — full CAN + HRV grading
Short Test
HRV ScreeningA single passive 5-minute HRV recording — no active maneuvers, no BP cuff, Valsalva assembly, or handgrip dynamometer required. Ideal for rapid screening, follow-up visits, or patients who cannot safely perform the Full Test Battery's active maneuvers.
Five-Minute HRV Recording
Passive recording — patient rests quietly, no coaching required
Duration
5 min + prep time
Report
3 pages — HRV status only
A Short Test can always be followed by a Full Test Battery at a later visit if the HRV screen indicates further assessment is warranted.
Resting
Resting ECG acquisition before autonomic assessment.
Parasympathetic — 3 Tests
Deep Breathing
Evaluates vagal activity using the E:I ratio during six controlled breathing cycles.
Response to Standing
Calculates the 30:15 ratio to assess parasympathetic response following active standing.
Valsalva Maneuver
Measures autonomic reflex integrity using the Valsalva ratio with guided respiratory maneuver.
Sympathetic — 2 Tests
Postural Hypotension
Measures the fall in systolic blood pressure on standing to assess sympathetic vasomotor response and orthostatic tolerance.
Sustained Handgrip
Assesses the diastolic blood pressure rise during sustained isometric exercise, reflecting sympathetic pressor reserve.
5-Minute HRV — 2 Analyses
Time Domain Analysis
Reports SDNN and RMSSD from beat-to-beat interval variation, reflecting overall autonomic modulation of heart rate.
Frequency Domain Analysis
Computes LF/HF ratio and spectral power to distinguish sympathetic and parasympathetic contributions to heart rate variability.
Automated Reporting
Clinician-Ready Reports, Automatically Generated
NIBRA-CS® generates a structured autonomic assessment report at the close of each test session — including all scored reflex indices, HRV parameters, and an interpretation guide — formatted for direct inclusion in patient records.
Reports are structured to be compatible with standard clinical documentation workflows. No manual data entry, no third-party software required.
CAN Diagnostic Staging
Full Test reports include a Normal / Early / Definite / Severe CAN classification, combined with HRV status into a Final Interpretation — for the referring physician to review and confirm.
Standardised Report Format
Consistent, scored output for every test session — reproducible across operators and settings.
Full HRV Analysis Included
Time Domain (SDNN, RMSSD), Frequency Domain (LF/HF ratio, spectral power), and Poincaré plot parameters reported.
Cardiovascular Reflex Indices
Valsalva ratio, 30:15 ratio, E:I ratio, and BP response scores — all reported and scored per international reference ranges.
Full Test Report — 6 pages
Short Test Report — 3 pages, HRV status only
Reports provide supportive physiological assessment data for clinical review — every report includes a blank Doctor's Comments field, and final diagnosis remains the responsibility of the referring physician.
Compare Past Reports — Report Comparison Tool →
Clinical Workflow
From Patient Setup to Final Report
NIBRA-CS® standardizes every stage of autonomic function testing through an intuitive guided workflow.
Attach Sensors
Connect ECG electrodes and the non-invasive blood pressure cuff using standard clinical consumables.
Patient Setup
Verify signal quality and acquire baseline ECG and blood pressure before initiating the protocol.
Perform Tests
Guided on-screen instructions lead the operator through parasympathetic, sympathetic and HRV assessments.
Generate Report
Automated analysis produces a comprehensive clinical report with autonomic indices, HRV metrics and interpretation guidance.
Use Cases
Clinical Applications Across Specialties
NIBRA-CS® supports standardised autonomic function assessment across multiple clinical departments, enabling early diagnosis, longitudinal monitoring, and evidence-based research.
Endocrinology
Diabetic Autonomic Neuropathy
Enables early detection of cardiac autonomic neuropathy (CAN) and supports standardised follow-up of diabetic patients through repeatable autonomic function testing.
✓ Early CAN Screening
✓ Disease Progression
✓ Therapy Monitoring
✓ Diabetes Clinics
Cardiology
Cardiovascular Autonomic Assessment
Assesses autonomic dysfunction associated with cardiovascular disease, supporting baroreflex evaluation, preventive cardiology, and risk stratification.
✓ Baroreflex Assessment
✓ Risk Stratification
✓ Preventive Cardiology
✓ HRV Evaluation
Neurology
Syncope & Dysautonomia
Evaluates cardiovascular reflex responses to support the assessment of unexplained syncope, autonomic dysfunction, and neurocardiogenic disorders.
✓ Syncope Evaluation
✓ Dysautonomia Assessment
✓ Reflex Testing
✓ Clinical Decision Support
Clinical Research
Research & Clinical Trials
Standardised protocols, digital reports, and reproducible autonomic testing support longitudinal studies, epidemiological research, and multicentre clinical trials.
✓ Longitudinal Studies
✓ HRV Research
✓ Clinical Trials
✓ Digital Data Export
For Institutions
CDSCO licensed — regulatory clearance for institutional purchase in India
On-site installation, operator training, and commissioning included
Full procurement documentation available on request
Procuring for Your Hospital or Department?
NIBRA-CS® is CDSCO licensed, Made in India, and procurement-ready for government and private institutional purchase. Every deployment includes on-site installation, staff training, and ongoing technical support.
Whether you are evaluating for a single department or planning a multi-centre rollout, our team will work with your biomedical, clinical, and purchase committees to provide the documentation, demonstrations, and pricing you need to make an informed decision.
Suitable for
Hospitals
Inpatient and outpatient autonomic testing departments
Neurology Clinics
Specialised autonomic function assessment
Diabetes Centres
CAN screening and longitudinal neuropathy monitoring
Research Institutions
ANS research studies and clinical trials
Medical Colleges
Clinical training and academic autonomic function programmes
Diagnostic Centres
Point-of-care autonomic testing as a standalone service
Official Documentation
Procurement Documentation
Regulatory approvals, patents and institutional documents supporting procurement, compliance and clinical evaluation.
Patent
View Document →
Granted Patent Certificate
Details
Granted patents protecting the core autonomic assessment methodology and device architecture.
Regulatory
View Document →
CDSCO Manufacturing Licence
Details
Regulatory approval authorising manufacture and commercialization of the medical device in India.
Grant
View Document →
BIRAC / DBT Grant
Details
Innovation grant from the Department of Biotechnology supporting clinical development of NIBRA-CS®.
Incubation
View Document →
IIM Calcutta Innovation Park
Details
Official incubation and innovation support through one of India's leading technology incubation centres.
In the Field
System in Clinical Use
NIBRA-CS® deployed across clinical institutions and national healthcare events.
CAN Testing — IIMC, Kolkata
World Diabetes Day 2025
TIDE 2.0 Pravartan — New Delhi
Pilot Testing — JIMSH
School of Tropical Medicine
Launch — Global Bio India 2023
CDSCO MD5 Approval
With MeitY Joint Secretary — March 2026
Backing & Recognition
Institutional Backing & Funding
Recognised and funded by leading national science, technology, and innovation bodies across India.
Get in Touch
Request a Demonstration or Institutional Enquiry
Contact our team to schedule a product demonstration or discuss deployment for your institution.
Institutional Enquiry
Demonstration requests, procurement evaluation, pilot deployment, and clinical collaboration. Direct line: [email protected]
📞 Quick Contact
🏢 Also by Inovocare
Based in Kolkata, India
Incubated at IIM Calcutta Innovation Park. Serving institutions across India.
Registered address: 377, Purbalok, Mukundapur
Kolkata – 700099, West Bengal, India