Medtronic 19061 User Manual

Rev.
4.0
DSN009462
Sensor Optimization of CRT Response (SOCR) System
User Guide
Caution: Investigational device. Limited by federal law (USA) to investigational use.
Exclusively for clinical investigations. Investigational Device / Instrument de recherche.
SOCR System User Guide Page 1 of 27 Revision B April 2013 Medtronic Confidential
Approval date:
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Term
Definition
Rev.
4.0
SYMBOLS DEFINITIONS:
Attention, consult accompanying documents.
Device is type CF, direct cardiac applied parts.
Caution or Warning notice.
Do not reuse, single patient use only.
Conformité Européenne (European Conformity). This symbol means that the device fully complies with R&TTE Directive 1999/5/EC.
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Do not dispose of this product in the unsorted municipal waste stream. Dispose of the product according to local regulations.
TERMINOLOGY DEFINITIONS:
Subject Patient under study. Impedance Ratio of voltage measured divided by current injected. Vector Pacing lead electrode configuration for impedance measurement.
SOCR System User Guide Page 2 of 27 Revision B April 2013 Medtronic Confidential
Approval date:
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Rev.
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Table of Contents
1. Physical Characteristics.................................................................................4
1.1 System Components..........................................................................4
1.2 Power Source...................................................................................... 4
1.3 Intended Use Environment................................................................5
2. System Overview...........................................................................................6
2.1 System Description............................................................................6
2.2 Intended Use.......................................................................................8
2.2.1 Intended Use of the Model 19061 AHM Module................................8
2.2.2 Intended Use of the Model 19062 Heart Sound Sensor Device........8
2.2.3 Intended Use of the Model 15420 Patient Cable...............................9
2.3 Cleaning and Maintenance ................................................................ 9
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2.4 Warnings and Precautions ................................................................ 9
2.5 Potential Adverse Events ................................................................10
2.6 Contraindications.............................................................................10
3. System Setup ..............................................................................................11
3.1 Biopac System Overview.................................................................11
3.2 Connections to the Biopac System ................................................12
3.3 Connections to and Use of the AHM Module.................................13
3.4 Connections to the Subject.............................................................15
3.5 Installing and Uninstalling the SOCR Investigational Software...16
3.6 Starting the SOCR Investigational Software..................................16
3.7 Software Setup for the AHM Module...............................................17
3.7.1 Programming Impedance Vectors...................................................19
3.8 Software Setup for the Heart Sound Sensor Device .....................20
4. Setup Test Procedure..................................................................................21
Appendix A – Installing the SOCR Investigational Software...............................22
Appendix B – Uninstalling the SOCR Investigational Software...........................25
SOCR System User Guide Page 3 of 27 Revision B April 2013 Medtronic Confidential
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Table 1.
System Components
Component
Description
Rev.
4.0

1. PHYSICAL CHARACTERISTICS

1.1 SYSTEM COMPONENTS

Components included as part of the SOCR research system are shown in Table
1.
DSN009462
Investigational Model 19061 AHM Module
Investigational Model 19062 Heart Sound Sensor Device
Biopac MP150 and UIM100C Data acquisition system Model 2090 Programmer with
Viva/Brava Software with 2090 A/B and cable
Model 2090 Programmer with SOCR Investigational Software with 2090 A/B and cable
Laptop Computer with AcqKnowledge Software package
Investigational Model 15420 Patient Cable
RA/RV leads Connections to subject right heart LV lead or LV catheter/patient cable Connections to subject left heart Millar pressure catheter LV pressure component Millar PCU-2000 and patient cable LV pressure measurement component
Impedance measurement and pacing component
Heart sounds component
Programmer for Heart Sound Sensor Device
Programmer for AHM Module
Used for data acquisition software
Used for connection of AHM Module to subject pacing leads

1.2 POWER SOURCE

The AHM Module is powered by six 3.6V AA lithium batteries. A set of batteries will provide at least 4-hours of procedure time before requiring replacement. These batteries will be provided by Medtronic to centers for use in the study. The Heart Sound Sensor Device has a self-contained battery. All other system components requiring power (i.e. the laptop, Biopac MP150, and the 2090 Programmers) will use AC line power.
of 3.6V AA lithium batteries provided by Medtronic prior to each clinical case.
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Caution: It is recommended that the AHM Module be fitted with a fresh set
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Rev.
4.0
Caution: It is recommended that the SOCR System be disconnected from
the subject during battery replacement.
Caution: The 2090 Programmer is powered with AC line power.
Caution: The Biopac MP150 Data Acquisition System is powered with AC
line power.
Caution: The laptop computer is powered with AC line power.

1.3 INTENDED USE ENVIRONMENT

The SOCR System is designed to operate in an Electrophysiology (EP) Lab or hospital environment under the direct supervision of medical personnel. The system was not tested to handle exposure to autoclave (except for the Model 15420 Patient Cable sterilization procedure), hyperbaric chambers, cold temperatures, high temperatures, high humidity, steam, special gases (anesthetic etc.), fluids, or other severe conditions.
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Caution: The Model 19061 AHM complies with Part 15 of the FCC rules. Operation is subject to the following two conditions: (1) this device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation. Changes or modifications of any kind not expressly approved by Medtronic could void the user’s authority to operate the equipment.
AHM FCC ID: LF519061
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2. SYSTEM OVERVIEW

2.1 SYSTEM DESCRIPTION

The SOCR System (Figure 1) contains electronics that control the continuous stimulation and sensing required to collect real-time intracardiac impedance and heart sounds signals. The impedance signals are collected from selected electrode vector configurations using the subject’s implanted pacing leads/LV catheter and an investigational impedance pacing unit, the Model 19061 Acute Human Monitor (AHM) Module. A Model 2090 programmer with the SOCR Investigational Software along with a switch on the front panel of the AHM Module allow the user to select specific electrode vector configurations for current stimulation and voltage sense measurement. The heart sounds signals are collected from an investigational Model 19062 Heart Sound Sensor Device placed on the subject.
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Real-time impedance and auxiliary signals from analog output terminals of the AHM Module, real-time heart sounds and EGM/marker signals from the two programmers through a 2090A/B Analog Output Module, and real-time LV pressure signals from the Millar PCU-2000 are transmitted to the applicable Biopac Data Acquisition System’s analog input terminals. The Biopac Data Acquisition System transmits the acquired analog input signals to the computer’s data acquisition software [AcqKnowledge®] which subsequently saves the data to the computer’s hard disk and displays real time waveform data on the computer’s display.
The AHM Module also contains circuitry for standard pacing interventions with the implanted right atrial (RA) lead, right ventricular (RV) pacing lead, and left ventricular (LV) pacing lead or catheter. The leads are connected to an investigational Model 15420 Patient Cable in order to interface with the AHM Module. The LV catheter is directly connected.
The Biopac MP150 Data Acquisition System also collects physiologic signals from standard EP laboratory equipment used for subject monitoring during device implant. These physiologic signals may include ECG, blood pressure, or other physiologic signals. Available physiologic signals can be recorded simultaneously with the above signals but are not required by Medtronic to obtain the study objectives.
The SOCR system is shown pictorially in Figure 1.
SOCR System User Guide Page 6 of 27 Revision B April 2013 Medtronic Confidential
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Figure 1. SOCR System Components.
Warning: The SOCR System is intended for investigational use only and
should be used only by trained Medtronic personnel, clinical study investigators and designated clinical staff trained in performing the acute clinical study protocol.
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2.2 INTENDED USE

The SOCR System (Figure 1) is intended to be used in the Electrophysiology (EP) Lab for the clinical investigation of continuous intracardiac impedance and heart sounds signals during the defined acute human study protocol.

2.2.1 INTENDED USE OF THE MODEL 19061 AHM MODULE

The AHM Module contains electronics that control the continuous stimulation and sensing required to collect real-time intracardiac impedance signals from a selected electrode vector configuration using conventional implanted pacing leads/LV catheter. A Model 2090 programmer operating the SOCR investigational software along with the HVB/LVR3 switch on the front panel of the AHM Module allow the user to select specific electrode vector configurations for current stimulation and voltage sense measurement. The AHM Module also contains electronics to provide the standard pacing interventions using the conventional implanted pacing leads/LV catheter needed during the course of the study. The real-time impedance signal and EGM/markers generated by the AHM Module are recorded by the data acquisition system.
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2.2.2 INTENDED USE OF THE MODEL 19062 HEART SOUND SENSOR DEVICE

The Heart Sound Sensor device is used to collect a real-time heart sounds signal. Although the Heart Sound Sensor device has a header and shield graphics indicating that leads can be connected to it, no leads are connected to the device for the purposes of this study. The device has no therapy functions. The heart sounds signal is transmitted through telemetry, using the Viva/Brava software operating on a Model 2090 programmer, and recorded by the data acquisition system.
The Heart Sound Sensor device is provided sterile. It can be temporarily placed in the subject’s device pocket during an implant procedure, and, for this purpose, it is single use.
The Heart Sound Sensor device can be cutaneously attached to the subject post implant, and, for this purpose it can be re-used. See Section
2.3 for cleaning instructions.
Do Not Reuse: The Medtronic Model 19062 Heart Sound Sensor device is for single patient use only when placed in the subject’s device pocket.
SOCR System User Guide Page 8 of 27 Revision B April 2013 Medtronic Confidential
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2.2.3 INTENDED USE OF THE MODEL 15420 PATIENT CABLE

The Model 15420 patient cable is used for connection between the implanted subject’s pacing leads to the AHM Module. The cable will be supplied non-sterile. It should be cleaned and steam sterilized prior to use. All surfaces may be cleaned with water, mild detergent or 70% isopropyl alcohol. Care should be taken to ensure complete removal of all cleaning agents. A soft bristle brush may be used to facilitate the cleaning of small surfaces. During cleaning, the connector block should be opened and the adaptor area cleaned. The cable may be wiped clean. This cable will enter the sterile field and therefore must be sterilized prior to use , including first use. Autoclave the cable under the following conditions: 121 °C (250 °F), vacuum cycle for 50 minutes.
2.3 C
After completion of the study, the AHM Module should be cleaned using damp cloth or towel with either water or alcohol based solvent. The module should not be immersed or exposed to excessive moisture. Patient cables can be wiped down and must be returned to the clinical staff for sterilization prior to their next use. After cutaneous use, a Heart Sound Sensor device can be cleaned using damp cloth or towel with either water or alcohol based solvent. No special maintenance is required between uses of the SOCR System.
2.4 W
used for pacing interventions and impedance signal generation. The Heart Sound Sensor device is to only be used for heart sounds signal generation. Neither can be used for rescue attempts in the event that defibrillation, cardioversion or resuscitation is required. Emergency backup equipment must be available prior to the start of the study.
LEANING AND MAINTENANCE
ARNINGS AND PRECAUTIONS
Warning: The AHM Module supplied by Medtronic is to only be
SOCR System User Guide Page 9 of 27 Revision B April 2013 Medtronic Confidential
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Warning: External defibrillator pads should be placed no closer than
2.5 cm to any other study electrodes.
Caution: If an LV catheter is placed, ensure that none of the
unused catheter cable pins present a direct unintended conductive path to
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