CDSCO Approved Medical Device
Comprehensive Cardiac
Autonomic Neurofunction
Testing System
Non-Invasive Baro-Reflex Assessment Combined 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
Solution
A Complete Autonomic
Testing Platform
NIBRA-CS® is a Patented diagnostic unit designed for Autonomic Neurofunction testing. It stands out as a portable, digital-health enabled standalone device with minimal infrastructural requirements, tailor made for Point-of-Care settings. NIBRA-CS® addresses the critical issue of Dysautonomia detection, an criminally undiagnosed complication for diabetic individuals and the elderly among other groups.
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✓ Standardized autonomic reflex tests
✓ Integrated ECG and NIBP monitoring
✓ Guided clinical testing workflow
✓ Automated digital report generation
Tests Supported
Clinical Tests
Supported
Standardized cardiovascular autonomic reflex tests designed for comprehensive autonomic function assessment, measuring parasympathetic and sympathetic responses along with detailed 5-minute heart rate variability (HRV) analysis across time and frequency domains.
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The Tests included are as following:
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Baseline
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Resting ECG​​
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Parasympathetic
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Deep Breathing Test​
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Response to Standing
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Valsalva Maneuver
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Sympathetic
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Postural Hypotension​
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Sustained Handgrip
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HRV
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Heart Rate Variability (5-minutes)​
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Baseline
Resting ECG
Baseline electrocardiogram recording for cardiac rhythm assessment.
12-lead equivalent baseline ECG recording provides the foundation for all subsequent autonomic testing. Records resting heart rate, rhythm, and morphology for comprehensive cardiac assessment.
Parasympathetic
Deep Breathing Test
Heart rate variation during controlled deep breathing cycles.
Measures the E:I ratio during six cycles of deep breathing at 6 breaths per minute. Evaluates parasympathetic (vagal) control of heart rate with high sensitivity for early autonomic dysfunction.
Response to Standing
Cardiovascular reflex assessment during active standing.
Calculates the 30:15 ratio by analyzing heart rate changes upon standing. The initial tachycardia followed by reflex bradycardia reflects integrated baroreflex and parasympathetic function.
Sympathetic
HRV
Valsalva Maneuver
Autonomic reflex evaluation during forced expiratory effort.
The patient performs forced expiration against resistance for 15 seconds. Measures the Valsalva ratio from the heart rate response across all four phases, assessing both sympathetic and parasympathetic pathways.
Postural Hypotension
Blood pressure changes associated with postural transition.
Measures systolic blood pressure drop upon standing. A fall of greater than 20mmHg systolic or 10mmHg diastolic indicates orthostatic hypotension and sympathetic vasomotor dysfunction.
Sustained Handgrip
Blood pressure response during isometric handgrip exercise.
Diastolic blood pressure is monitored during sustained handgrip at 30% maximum voluntary contraction. The rise in DBP evaluates sympathetic efferent pathways and peripheral vascular resistance.
Heart Rate Variability
5-minute HRV analysis for autonomic nervous system assessment.
Time-domain and frequency-domain analysis of R-R intervals over a 5-minute recording. Provides LF/HF ratio, SDNN, RMSSD, and spectral power indices for comprehensive autonomic balance assessment.
Reports
Automated
Clinical Reports
NIBRA-CS® automatically generates standardized autonomic testing reports including heart rate variability analysis, Valsalva response and cardiovascular reflex indices.
Standardized Report Format
Consistent, clinician-ready reports for every test session
HRV Analysis Included
Time-domain and frequency-domain heart rate variability metrics
Cardiovascular Reflex Indices
Valsalva ratio, 30:15 ratio, E:I ratio, and BP response scores
Download a Sample Report by Clicking Here
Workflow
Simple Clinical Workflow
From patient setup to final report, NIBRA-CS® guides clinicians through every step of the autonomic testing process.
01
Attach Sensors
Place ECG electrodes and non-invasive blood pressure cuff on the patient for simultaneous monitoring.
02
Patient Setup
Position the patient according to the test protocol and ensure stable baseline readings before initiating the autonomic assessment.
03
Perform Test
Follow the guided clinical test workflow with real-time signal monitoring and visual feedback.
04
Generate Report
Receive automatic analysis and a comprehensive digital clinical report with scored results.
Applications
Clinical Applications
NIBRA-CS® serves a wide range of clinical and research applications across multiple medical specialties.
Diabetic Autonomic Neuropathy
Early detection of autonomic dysfunction in diabetes. Enables longitudinal tracking of neuropathy progression with standardized testing protocols.
Autonomic Research
Standardized protocols for research studies into autonomic nervous system function and dysfunction. Digital output enables data export for analysis.
Syncope Evaluation
Assessment of cardiovascular reflex responses for evaluating unexplained syncope and pre-syncope. Supports differential diagnosis.
Cardiovascular Autonomic Assessment
Evaluation of autonomic nervous system function in clinical cardiology and preventive care programs.
Environments
Designed for Clinical and
Research Environments
NIBRA-CS® is built to fit seamlessly into diverse clinical and academic settings.
Hospitals
Inpatient and outpatient autonomic testing departments
Neurology Clinics
Specialized autonomic function assessment
Diabetes Centers
Diabetic autonomic neuropathy screening
Research Laboratories
Autonomic nervous system research studies
Medical Colleges
Clinical training and academic research
Credibility
Validation & Credibility
NIBRA-CS® is built strategic collaboration with 5+ elite medical institutions for clinical validation, ethical oversight, and commercial implementation.
AIIMS, Kalyani
Clinical validation conducted at AIIMS Kalyani
MMCH, Midnapore
Paid clinical pilot successfully completed at Medinipur Medical College (300+ patients tested).
RIMS, Ranchi
First commercial unit deployed at RIMS Ranchi; PHC-level screening integration underway.
JIMS, Budge Budge
Clinical pilots conducted at Jagannath Gupta Institute of Medical Science & Hospital
IIMC, Sonarpur
Clinical pilots conducted at Institute for Indian Mother & Child Hospital, Garia.
500+
Patients Evaluated
Data gathered across multiple clinical pilots at AIIMS Kalyani, JIMS,Midnapore Medical College and Hospital and IIMC.
Multi-Instituional
Ethics approval
Institutional Ethics committee approvals secured across more than 5 distinct organizations.
Documentation
Regulatory & Institutional Documentation
Official approvals, intellectual property filings, and institutional collaborations supporting the development and clinical deployment of the NIBRA-CS® autonomic testing platform.
Download NIBRA-CS® Patent
Download CDSCO Form MD5
Gallery
System in Clinical Use
Explore the NIBRA-CS® system - from device hardware to clinical reports.
CAN Testing at IIMCH, Kolkata
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World Diabetes Day 2025
TIDE 2.0 Pravartan, New Delhi
Pilot Testing at JIMSH, Budge Budge
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School of Tropical Medicine, Kolkata
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Launch at Global Bio India 2023
CDSCO MD5 Approval
With MeitY Joint Secretary
Patrons
Partners in Our Journey
The development of NIBRA-CS® has been supported by leading institutions, innovation programs, and government initiatives that promote healthcare technology and translational research.
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Non-Invasive Baro-Reflex Assessment – Combined System. A comprehensive autonomic function testing platform designed for clinical use.
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Designed and Developed by
Inovocare Healthsoft Solutions Pvt. Ltd.
Incubated at
IIM Calcutta Innovation Park (IIMCIP)
​​Address
IIM Calcutta Innovation Park
Kolkata – 700104
West Bengal, India
© 2026 Inovocare Healthsoft Solutions Pvt. Ltd. All rights reserved.
​​WhatsApp (Demo Requests):
+91-8100268525
Email address:
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