Medtronic 2090 Programming Guide
Programming guide
Software version 9.1
Model VSA02 (for 9790c)
Model VSC02 (for Vitatron CareLink Programmer)
Caution: Federal Law (U.S.A.) restricts this device to sale or on the order of a
physician (or properly licensed practitioner).
The following are trademarks of Vitatron B.V.:
Holding
Beat-to-Beat®Mode Switching, Sensor Blending®, Sensor Cross-Checking®, Clarity®,
®
Diamond
, Selection®, Ruby®,Topaz®, Jade®LegacyTMand Vita®.
Table of contents
1. Introduction 3
2. The screen layout 5
2.1 The Vitatron desktop 5
2.2 General screen layout 7
2.3 Menu options 9
2.4 Vitatron desktop tutorial 10
2.5 Scrolling 19
3. Follow-up 21
3.1 Start-up and Auto-Identify 21
3.1.1 Start-up 22
3.1.2 Selecting Auto-Identify 23
3.2 How to use the built-in ECG recorder 26
3.2.1. Using the ECG in the Vitatron desktop 26
3.2.2. Using the ECG during follow-up 27
3.3 How to program a parameter 34
3.3.1 Parameter programming 34
3.3.2 Parameter pertinency 36
3.3.3 Batch programming 37
3.3.4 Nominal programming 38
3.3.5 Additional programming for the
Selection AFm 902 41
3.4 How to measure pacing thresholds 42
3.5 How to perform a sensing test 45
3.6 How to retrieve data 48
3.6.1 Status and Diagnostic Observations 49
3.6.2 Histograms 50
3.6.3 Holters 53
3.6.4 Mode Switching Trend 54
3.6.5 Selected Event Recording 55
3.7 How to set Diagnostic Features 57
3.7.1 Histograms or Holters 57
3.7.2 Mode Switching Trend 58
3.7.3 Selected Events 59
3.7.4 Additional Diagnostics for the
Selection AFm 902 59
1Programming Guide
Table of contents
3.8 Results from Counters 66
3.9 Battery & lead data 67
3.10 How to print pacemaker data 68
3.11 How to save pacemaker data to diskette 70
3.12 How to enter patient data 71
3.13 How to temporarily program a parameter 76
3.14 How to set ECG markers 79
3.15 How to end a programming session 84
3.16 How to switch between Vitatron and
3.17 How to cancel/activate the programming
4. Programming reference 89
4.1 Programming the Clarity DDDR, Clarity SSIR,
4.2 Programming the Vita 2 DDDR and Vita 2 SSIR 101
4.3 Notes for Section 4.1 - 4.2 108
4.4 Programming the Selection AFm 902, Diamond,
4.5 Programming the Vita DDDR, Vita DDD
4.6 Notes for Section 4.4 - 4.5 151
Medtronic applications 86
head magnet 87
Diamond 3, Ruby 3, Topaz 3 and Jade 3 90
Diamond II,Ruby II, Topaz II and Jade II 134
and Vita VVIR 144
5. Appendices 177
5.1 Emergency operation 177
5.1.1 Emergency programming
during follow-up 177
5.1.2 Emergency programming
in the Vitatron desktop 178
5.1.3 Emergency settings 178
5.2 Adjusting programmer settings 181
5.2.1. Setting programmer preferences 181
5.2.2 Adjusting time and date 182
5.2.3 Checking software release numbers 183
5.2.4 Memory contents file 183
5.3 Display messages 184
5.3.1 Error message 185
5.3.2 Application messages 186
5.3.3 New or changed application messages 187
2
Programming Guide
1. Introduction
This manual describes Vitatron software models VSA02 version 9.1
(for the 9790c programmer) and VSC02 version 9.1 (for the Vitatron
CareLink programmer). These support the following pacemakers*:
Clarity DDDR and Clarity SSIR
Diamond, Diamond II and Diamond 3
Ruby II and Ruby 3
Topaz II and Topaz 3
Jade II and Jade 3
Vita DDDR and Vita 2 DDDR
Vita DDD
Vita VVIR and Vita 2 SSIR
Selection AFm 902**
Visa DR, Visa D, Visa SR and Visa S
Legacy II D, Legacy DR and Legacy II DR
Legacy II S and Legacy II SR
Legacy D
Legacy SR Atrial and Legacy SR Ventricular
Legacy S Atrial and Legacy S Ventricular
*Note:
For programming details on Legacy and Visa pacemakers, refer to the
applicable technical manual and programming guide.
**Caution: After the first interrogation with the 9.0 or 9.1 version of the
Vitatron software VSA02 or VSC02, the Selection AFm 902 pacemaker is no
longer compatible with VSA02 or VSC02 releases before 9.0.
For further technical data and programming details on the pacemakers listed above, refer to the relevant product information manual
delivered with the pacemaker.
3Programming Guide
Introduction
Some application messages may differ from the messages described
in the Product Information Manual that was delivered with the
pacemaker. Please refer to section 5.3.3 for an overview of new
and changed messages.
Note:
This Programming Guide describes how to use either a Medtronic/
Vitatron 9790c or Vitatron CareLink programmer (further referred to as
the programmer) with Vitatron pacemakers. This is possible provided
a programming head is connected and the appropriate software is
installed. For technical information about the programmer itself,
please refer to the documentation that was provided with it.
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Programming Guide
2. The screen layout
In this section, the Vitatron desktop is discussed. This is the first
screen that appears after start-up, provided Vitatron software was
used during the last patient follow-up.
In addition, the general screen layout is explained and the menu
options available during a follow-up or tutorial session are discussed.
In some applications, the screens may look slightly different but they
will have a structure similar to that described below.
2.1 The Vitatron desktop
After setting up the programmer and switching it on, the Vitatron logo
appears briefly during start-up (provided that a Vitatron application
was last used during the previous follow-up). This is followed by the
Vitatron desktop, shown below:
The top line shows the Vitatron logo. The control panel (see section
2.2.) contains three icons: Select Model, Programmer and (if installed)
Analyzer.
5Programming Guide
2.1 The Vitatron desktop
Under Programmer you can adjust the programmer preferences,
change date and time in the programmer, retrieve software information or access memory contents files. See Appendix 5.2.
Pressing Select Model activates the Vitatron desktop and allows you to
choose between tutorial sessions for dual chamber, single chamber or
Selection series pacemakers or to launch other (future) applications.
Note that Select Model is always active after start-up.
The bottom line normally contains two buttons: Auto-Identify and
Vitatron > Medtronic.
[Auto Identify]
Pressing this button starts automatic recognition and interrogation of
the pacemaker.
[Vitatron to Medtronic]
Used to go from Vitatron to Medtronic applications.
If the Medtronic lead analysis software and hardware are installed on
the programmer, the Vitatron desktop will contain the Analyzer icon.
Clicking it will start the analyzer program. After ending the analyzer
program the programmer will restart the Vitatron desktop. For more
information about the analyzer please refer to the documentation
provided with it.
6 Programming Guide
2.2 General screen layout
The Vitatron software screens have the following general layout:
2.2 General screen layout
Top line
ECG area
Control panel
Button line
Main window
Top line
The top line always shows the Vitatron logo and, if applicable, the
name of the pacemaker being programmed or interrogated, as well as
the programmed pacing mode.
Note:
When using a Vitatron CareLink programmer a 'task bar' is visible
above the top line of the display. The functions included in this task
bar are described in the Medtronic/Vitatron CareLink Programmer
Reference Guide, which is provided with the programmer.
ECG area
In this area, the patient's ECG is displayed, provided the ECG leads are
attached and the ECG function is switched on (see section 3.2.).
ECG control area
This area contains the Adjust button which you can use to change ECG
settings (see section 3.2.).
Main window
This area shows all screens pertaining to the currently active application.
7Programming Guide
2.2 General screen layout
Control panel
In the control panel you will find icons that represent various
submenus: Data, Parameters, Tests, Patient, Reports.
Button line
General push buttons, such as Emergency and End Session,are
positioned in the button line at the bottom of the display.
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Programming Guide
2.3 Menu options
During tutorial sessions or follow-ups you can select certain menu
options. These are explained below.
Data
The Data menu enables you to retrieve the Status screen. Also, it provides Holter and Histogram selection and read-out options, as well as
data from the Counters function and Battery and Lead Measurements.
Parameters
The Parameters menu allows permanent or temporary programming of
parameters and functions.
Tests
In the Tests menu you can measure pacing thresholds, perform sens-
ing tests and VA or QT interval tests, initiate Fast Learn procedure,
start AOO Burst Pacing and turn ECG markers on or off, if applicable.
2.3 Menu options
Patient
The Patient menu is used to enter patient and pacing system data into
the pacemaker.
Reports
With Reports you can make a printout of various items, such as status
list and measurements. You can also save pacemaker data onto a
3.5 inch diskette.
Press the appropriate icon to access the desired menu.
9Programming Guide
2.4 Vitatron tutorial
2.4 Vitatron desktop tutorial
On completion of start-up, the Vitatron desktop is shown. From here
you can activate tutorial sessions that allow you to
familiarize yourself with programming procedures.
> To start a tutorial, select the desired model group from the list at the
top of the screen. Then select the desired pacemaker and press Demo
in the Vitatron desktop.
A Clarity DDDR tutorial is explained below.
> Select Clarity DDDR and press the Demo button. The status screen is
displayed.
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Programming Guide
2.4 Vitatron tutorial
Note:
The Status screen appears at the start of a follow-up. It can be
recalled at a later stage of the programming session by pressing the
Data icon and selecting Status. See section 3.6.1.
The Status screen shows the main parameters and their programmed
values, measurement data, and results from counters if applicable. It
is not possible to change values in this screen. To leave this screen,
press the 'close' button (see below).
Close button
The top right corner of each menu contains a 'close' button. On pressing this button in the status screen, the window disappears and the
programmer displays the main menu screen shown below.
11Programming Guide
2.4 Vitatron tutorial
Note:
To enter any other screen directly, without using the 'close' button,
you can select the appropriate icon while the programmer is still displaying the current menu screen.
This way of going from one screen to another directly is possible in all
menus. However, boxed values must first be programmed or
cancelled. The main menu screen shows several icons in the control
panel on the right, each representing a submenu with pacemaker programming and interrogation options.
During a follow-up, the Cancel Magnet/Activate Magnet button at the
bottom of the screen switches the magnet mode off or on respectively.
At the top of the screen you can check during the follow-up whether
the magnet is active or inactive (see section 3.17).
> Now press the Parameters icon to open the Parameters Therapy menu.
12 Programming Guide
2.4 Vitatron tutorial
The programmer displays the programmed value of each parameter in
a highlighted box to its right.
> Press the value box for ventricular amplitude.
The currently programmed parameter value is indicated by means of
a boxed P to the right of that value.
> Select 2.5 V by pressing with the touch pen on the value 2.5.
The value selection window disappears and a dark border around the
value box indicates that the value is pending.
13Programming Guide
2.4 Vitatron tutorial
Note:
If on opening the value selection window for a certain parameter you
decide not to select a new value, press outside the value selection
window to close it without changing anything.
Programming Night Rate Drop provides another example of a value
selection window appearing on the display. The > symbol at the right
of the value box indicates that on pressing this value box, a submenu
appears on the display.
> Press the Night Rate Drop value box.
14 Programming Guide
2.4 Vitatron tutorial
> Press the left End Night value box.
> Press the upward-pointing arrow displayed on the right of the End
Night time to select an End Night time of 7.00. Then press the Night
Rate Drop value box and press 10 in the list of options that is
subsequently displayed.
> Press the OK button to return to the Parameters Therapy screen.
Pressing Cancel takes you back to the Parameters Therapy screen without selecting new values.
Now both Night Rate Drop and Ventricular Amplitude have pending
values, as indicated by the dark border around the value box.
15Programming Guide
2.4 Vitatron tutorial
> You can program the pending values by pressing the Program button
(you can return to the currently programmed settings by pressing the
Undo Pending button).
Upon pressing Program you will see the dark borders around the pend-
ing values disappear, which means they have been permanently programmed. Refer to section 3.13 for information on temporary
programming.
> To program the parameters to nominal values, press Nominals... first.
Selecting the first option, Standard Settings, programs the pacemaker
to the delivery settings defined by Vitatron and mentioned in the
applicable Product Information manual delivered with the pacemaker
concerned.
The second option, Setting at Start of Session, resets all parameters
changed so far to the values that were in effect at the start of this
tutorial.
> Press Setting at Start of Session, then OK. The programmer shows all
parameter values boxed indicating that they are pending. For permanent programming of these settings, press the Program button.
This completes programming the tutorial pacemaker back to its settings at the start of the session.
16 Programming Guide
2.4 Vitatron tutorial
> Press the Reports icon.
> Press the selection box for Print Selection. A list from which you can
select items for printing now appears.
> Select Status list and Histogram by selecting the appropriate boxes.
> Press Print Preview.
Pressing Print Preview will show what the printout is going to look like.
You can view text which does not fit on one window by scrolling
through it. See section 2.5 for an explanation of the scrolling
technique.
> Press OK to leave the Print Preview window.
17Programming Guide
2.4 Vitatron tutorial
> Now press Print to obtain a printout of the selected items.
> Press the 'Close' button to leave the Reports menu.
> To end the tutorial session, press the End tutorial button. This takes
you back to the Vitatron desktop.
Emergency
> If you suddenly need to program emergency settings, press the Emer-
gency button on the bottom left of the display. This button is always
active after a pacemaker has been interrogated.
18
If the programming head is not applied to the pacemaker correctly
and the Emergency button is pressed, a message box appears. In a
patient follow-up, emergency operation starts as soon as the programming head is correctly positioned over the pacemaker and communication is established.
> In this example, the message disappears after pressing Cancel.
Emergency programming can also be performed by pressing the red
Emergency button left of the screen on the display panel. The
emergency procedure that is started by pressing this button is the
same as described for the on-screen emergency button.
More information on the Emergency procedure is presented in
Appendix 5.1.
Programming Guide
2.5 Scrolling
Text displayed by the programmer, e.g. histogram or Holter information or a print preview, may be too long to fit in one window. In this
case, the programmer displays an activated scroll bar on the right of
it. This enables you to scroll through the text. See below for an example of how to use the scrolling technique.
> Press the Reports icon in the main menu, select Print Selection and
then Status List and press Print Preview.
2.5 Scrolling
Scroll button
Scroll box
Scroll shaft
Scroll button
Along the right side of the Print Preview window, a dark grey vertical
bar is displayed. This is called the scroll bar. It consists of four parts:
the scroll shaft, the scroll box and two scroll buttons. The scroll box
can move up and down through the scroll shaft. The scroll box
indicates the relative position of the information displayed in the
window. If the scroll box is positioned at the top of the scroll shaft,
the first part of the available information is shown. If the scroll box is
positioned at the bottom of the scroll shaft, the last part of the available information is shown.
Scroll bars may appear vertically, such as the one discussed above, or
horizontally. In a horizontal scroll box, you can retrieve all available
information by scrolling from left to right.
19Programming Guide
2.5 Scrolling
1. Press scroll buttons
2. Press scroll shaft
There are 3 ways to move the scroll box.
Move the scroll box down through the scroll shaft by pressing the
lower scroll button once. Each time the scroll button is pressed, the
information displayed moves up one line.
Press the lower scroll button again to move up one more line. Repeat
this until all information has been displayed.
You may press the upper scroll button to bring information shown
earlier back into view.
Press inside the scroll shaft below or above the scroll box. This brings
the next or previous screen page into view.
3. Drag the scroll box
Drag the scroll box. Position the tip of the touch pen on the scroll box
and then move the pen in the desired direction without taking the
pen tip off the screen.
The information displayed in the window moves in and out of view
along with the scroll box. Press OK to leave the window.
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Programming Guide
3. Follow-up
3.1 Start-up and auto-identify
In this chapter you will find information on how to program and
interrogate a Vitatron pacemaker (see the beginning of this Programming Guide for the applicable models). A number of 'How to ...'
sections cover the most frequent programmer actions as performed
during a patient follow-up.
Figures provide examples of the programmer screen display during a
Clarity DDDR follow-up. These screens may look slightly different in
sessions with other pacemaker models but will have a similar structure.
21Programming Guide
3.1 Start-up
3.1.1 Start-up
Turn the programmer on using the ON/OFF switch. The Vitatron logo
start-up screen appears briefly during start-up, provided Vitatron software has been installed and provided the last follow-up was carried
out on a Vitatron pacemaker.
On completion of start-up, the Vitatron desktop is displayed.
If the programmer shows a Medtronic screen layout at start-up, this
means that during the last patient follow-up a Medtronic implantable
pulse generator was programmed or interrogated. Press the Medtronic
to Vitatron switch to enter the Vitatron mode.
The model selection screen features various icons and buttons: Freeze,
Strips, Adjust, Select Model, Programmer, Analyzer(if installed) Start, Demo,
Auto-Identify, and the Vitatron to Medtronic switch. For a description of
the Select Model, Programmer and Analyzer functions see chapter 2.
For a description of the Freeze and Adjust functions see section 3.2.
22
Programming Guide
3.1.2 Selecting Auto-Identify
> Press the Auto-Identify button to start the automatic pacemaker recog-
nition procedure.
Note that this procedure does not start unless Auto-Identify is pressed.
If the programming head is not positioned correctly the programmer
displays a warning message.
3.1 Start-up
> Position the programming head to continue the automatic model
selection procedure.
For information on correct positioning of the programming head,
see the programmer manual. On pressing Cancel the programmer
returns to the model selection screen.
Note:
The P (Program) button on the programming head serves as an alternative to the Program command that appears on the display screen.
The I (Interrogate) button on the programming head corresponds to
the Auto-Identify button on the screen. Both the Interrogate button
and the on-screen Auto-Identify button can be used to start the automatic pacemaker recognition procedure.
For convenience, you may press the Interrogate or Program button on
the programming head instead of selecting the corresponding option
from the display.
23Programming Guide
3.1 Start-up
Program
Interrogate
Upon completion of the automatic pacemaker recognition procedure,
the programmer displays the status window showing the main
parameters of the recognized pacemaker. The pacemaker model is
displayed at the top of the screen.
24
Note:
You cannot program parameters in this window. Press the Parameters
icon to change parameter values and to select options. You may also
press one of the other icons to perform any of the related programmer
actions. Press the Print button to obtain a printout of the status
window.
Programming Guide
3.1 Start-up
Auto identify unsuccessful
If the programmer recognizes the pacemaker as being a Vitatron
model, but cannot interrogate or program it a message to this effect
will appear. It could be that a software upgrade is needed. In such
cases it is always recommended that you contact your Vitatron representative
If the pacemaker is a Medtronic model, you must press the Vitatron to
Medtronic switch in the bottom right corner of the screen to enter
Medtronic applications.
If during a patient follow-up the programming head is applied to a
different pacemaker, the programmer will restart the automatic pacemaker recognition procedure.
25Programming Guide
3.2 How to use the built-in ECG recorder
3.2 How to use the built-in ECG recorder
This section contains information on using the built-in ECG recorder.
For instructions on attaching the ECG cable and connecting the ECG
leads please refer to the programmer manual.
3.2.1 Using the ECG in the Vitatron desktop
When you switch the programmer on and the Vitatron desktop
appears the displayed ECG options and the ECG layout differ slightly
from those that are presented once a pacemaker has been
interrogated. Although the desktop options are not described extensively in this manual, the main difference is that in the Vitatron desktop it is possible to freeze and display the last 15 seconds of the
displayed ECG and subsequently analyze it using on-screen calipers.
The control buttons control the frozen ECG viewing window by letting
you move each of the two vertical cursors appearing in the window to
any desired position. The cursors thus act as calipers allowing you to
measure the time interval between events. The caliper measurement
is displayed in milliseconds in the upper-left corner of the window.
The ECG can be displayed in a minimised format, in which only one
lead is displayed in the ECG window at the top of the screen. It can
also be displayed in a full screen format, in which all three leads are
displayed simultaneously. In the top right corner of the ECG window, a
square push button is displayed to switch from one ECG format to the
other.
26
Programming Guide
3.2 How to use the built-in ECG recorder
The ECG window is automatically opened in its minimized format
when the programmer is switched on.
3.2.2 Using the ECG during follow-up
Once a pacemaker has been interrogated the ECG function can be
switched OFF and ON in the Adjust ECG menu.
> To open this menu, press the Adjust button on the right of the screen.
As long as the Adjust ECG window is opened, the ECG is displayed in
the full screen format.
27Programming Guide
3.2 How to use the built-in ECG recorder
The Adjust ECG menu also includes the following parameters:
Top line, Sweep speed, Filter, Amplitude, Artifact Display, Artifact Level and
Artifact Lead.
Below is an explanation of how to adjust these settings:
Top line
You can select ECG lead I, II, or III. If the ECG is shown in the
minimized format, the selected lead is the only one displayed. If the
ECG is shown in the full screen format, the selected lead is displayed
on top, and the other two leads are displayed below.
28
Sweep speed
The Sweep speed option controls the sweep speed of the on-screen
ECG recorder, expressed in mm/s. Available values are 12.5, 25, 50, and
100 mm/s.
Filter
The Filter function controls the filtering of ECG signals by switching
between two different band widths.
Filter ON: bandwidth is 0.5 to 40 Hz
Filter OFF: bandwidth is 0.005 to 100 Hz
With the Filter switched on, clarity of the displayed and printed ECG
may be improved in the presence of interference.
Programming Guide
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