Medtronic 7274 Reference Guide
MARQUIS
Dual Chamber Implantable Cardioverter Defibrillator
™
DR 7274
Reference Manual
Caution: Federal law (USA) restricts this device to sale by or on
the order of a physician or properly licensed practitioner.
MARQUIS DR 7274
0
Reference Manual
A guide to the operation and programming
of the Model 7274 Marquis DR Dual Chamber
Implantable Cardioverter Defibrillator
0
The following are trademarks of Medtronic:
Active Can
®
, Cardiac Compass, Checklist, Decision Channel, Flashback®, GEM®,
Leadless™ ECG, Marker Channel, MARQUIS, Patient Alert, PR Logic, Quick
Look, QuickLink, RapidRead, T-Shock
Table of contents
Introduction xv
Using this manual xv
Contacting technical support xv
Customer education xv
References xvi
Notice xvi
Abbreviations and acronyms xvii
Part I Quick overview
1 Quick reference 3
Physical characteristics 4
Magnet application 5
Longevity projections 6
Replacement indicators 8
Typical charge times 10
High voltage therapy energy 10
Stored data and diagnostics 11
New and enhanced features 14
Patient management 14
Tachyarrhythmia detection 15
Tachyarrhythmia therapy 16
Bradycardia pacing 16
EP studies 17
2 The Marquis DR system 19
System overview 20
Detecting and treating tachyarrhythmias 21
Treating bradycardia 22
Monitoring for real-time and stored data 22
Conducting electrophysiologic tests 22
Alerting the patient to system events 22
Indications and usage 23
Contraindications 23
Patient screening 23
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Table of contents
3 Emergency therapy 25
Delivering emergency therapies 26
Effect on system operation 26
Aborting an emergency therapy 26
On-screen and display panel buttons 27
Temporary parameter values 27
How to deliver emergency 30 joule defibrillation 28
How to deliver emergency cardioversion 28
How to deliver emergency fixed burst pacing 29
How to deliver emergency VVI pacing 30
Part II Device implant and patient follow-up procedures
4 Implanting the ICD 33
Overview 34
Preparing for an implant 34
Equipment for an implant 34
Sterile supplies 35
How to prepare for implanting 35
Replacing an ICD 36
How to explant and replace an ICD 37
Positioning the leads 37
Using transvenous leads 37
Using epicardial leads 38
Surgical incisions 39
Testing sensing and pacing thresholds 39
Parameters 40
Considerations 40
Connecting the leads to the ICD 40
How to connect the lead to the device 41
Testing defibrillation operation and effectiveness 42
High voltage implant values 42
Binary search protocol 43
How to prepare for defibrillation threshold testing 44
How to perform defibrillation threshold testing 45
Positioning and securing the ICD 46
How to position and secure the device 46
Completing the implant procedure 47
Marquis DR 7274 Reference Manual
How to complete programming the device 47
5 Conducting a patient follow-up session 49
Patient follow-up guidelines 50
Verifying the status of the implanted system 50
Verifying accurate detection and appropriate therapy 51
Considerations 51
Verifying effective bradycardia pacing 52
Considerations 53
Part III Configuring the ICD for the patient
6 Detecting tachyarrhythmias 57
Detection overview 58
Suspending tachyarrhythmia detection 60
Setting up sensing 61
Parameters 61
Considerations 61
How to program sensitivity 63
Details about sensing 64
Detecting VF episodes 66
Parameters 66
Considerations 67
Restrictions 68
How to program VF detection 68
Details about VF detection 68
Detecting VT episodes 70
Parameters 70
Considerations 70
Restrictions 71
How to program VT detection 72
Details about VT detection 72
Detecting FVT episodes 76
Parameters 76
Considerations 76
Restrictions 77
How to program FVT detection 78
Details about FVT detection 78
Detecting tachyarrhythmia episodes with Combined Count 81
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Table of contents
Details about Combined Count detection 81
Monitoring episodes for termination or redetection 84
Parameters 84
Considerations 84
How to program redetection parameters 85
Details about episode termination and redetection 85
Enhancing detection with PR Logic criteria 88
Parameters 88
Considerations 89
Restrictions 90
How to program the PR Logic detection criteria 91
Details about PR Logic pattern and rate analysis 91
Details about the PR Logic detection criteria 95
Enhancing VT detection with the Stability criterion 97
Parameters 97
Considerations 97
How to program Stability 98
Details about Stability 98
Detecting double tachycardias 100
Details about double tachycardia detection 100
Detecting prolonged tachyarrhythmias with High Rate Timeout 101
Parameters 101
Considerations 101
How to program High Rate Timeout 102
Details about High Rate Timeout 102
Key terms 103
7 Treating tachyarrhythmia episodes 109
Treating VF with defibrillation 110
Parameters 110
Considerations 111
Restrictions 112
How to program VF therapies 112
Details about VF therapy 112
Treating VT and FVT with antitachycardia pacing 120
Parameters for all ATP therapies 120
Parameters for Burst therapy 121
Parameters for Ramp therapy 121
Parameters for Ramp+ therapy 122
Marquis DR 7274 Reference Manual
Table of contents
Considerations 122
Restrictions 123
How to program ATP therapies 123
Details about ATP therapies 124
Treating VT and FVT with cardioversion 130
Parameters 130
Considerations 131
Restrictions 132
How to program cardioversion therapies 132
Details about cardioversion therapy 133
Optimizing therapy with Smart Mode and Progressive Episode
Therapies 139
Parameters 139
Considerations 139
Restrictions 140
How to program Smart Mode 140
Details about Smart Mode 141
How to program Progressive Episode Therapies 142
Details about Progressive Episode Therapies 142
Key terms 143
vii
8 Treating bradycardia 147
Providing basic pacing therapy 148
Parameters 148
Considerations 149
Restrictions 151
How to program bradycardia pacing parameters 151
Details about basic bradycardia pacing 152
Dual-chamber pacing 154
Parameters 154
Considerations 156
Details about dual-chamber pacing 156
Programming considerations for atrial rates 161
Single chamber pacing 164
Parameters 164
Considerations 164
Details about single chamber pacing 165
Enhancing pacing for optimal cardiac output 167
Parameters 167
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Table of contents
Considerations 169
Restrictions 170
How to program Rate Response 170
Details about Rate Responsive Pacing 171
How to program Rate Adaptive AV 175
Details about Rate Adaptive AV 175
How to program Single Chamber Hysteresis 176
Details about Single Chamber Hysteresis 177
How to program Ventricular Rate Stabilization 178
Details about Ventricular Rate Stabilization 178
Adjusting the pacing rate with Mode Switch 180
Parameters 180
Considerations 180
Restrictions 181
How to program Mode Switch 182
Details about Mode Switch 182
Preventing competitive atrial pacing 184
Parameters 184
Considerations 184
How to program Non-Competitive Atrial Pacing 185
Details about Non-Competitive Atrial Pacing 185
Detecting and preventing pacemaker-mediated tachycardia 189
Parameters 189
How to Program PVC Response and PMT Intervention 190
Details about PVC Response 190
Details about PMT Intervention 191
Providing Ventricular Safety Pacing 193
Parameters 193
Restrictions 193
How to program Ventricular Safety Pacing 194
Details about Ventricular Safety Pacing 194
Providing pacing after high voltage therapies 196
Parameters 196
Considerations 196
How to program pacing after high voltage therapies 197
Details about Post Shock Pacing parameters 197
Key terms 198
Marquis DR 7274 Reference Manual
9 Optimizing charge time and device longevity 203
Optimizing charge time 204
Parameters 204
Considerations 204
How to evaluate charging performance 205
Details about managing charge time 205
Optimizing device longevity 207
Considerations 207
Key terms 208
Part IV Evaluating and managing patient treatment
10 Using the programmer 211
Connecting the programmer hardware 212
Using an external printer 213
To view a list of supported printers 214
Materials you will need 214
To connect the printer to your programmer 216
Using the programming head 218
During an episode in progress 218
During marker transmissions 218
How capacitor charging affects the light array 219
Alternative program and interrogate buttons 219
Display screen features 219
Programmer status bar display 220
Live Rhythm Monitor window 221
Task area 222
Command bar 224
Tool palette 224
Buttons 226
Setting programmer preferences 226
How to set the programmer time and date 227
How to set audio preferences 227
How to select a different language 228
How to check the software version number 229
How to set printing preferences 229
How to set reports preferences 230
Starting and ending patient sessions 230
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Marquis DR 7274 Reference Manual
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Table of contents
How to start a patient session 231
How to end a patient session 232
Automatic interrogation 232
Viewing live waveforms 233
Parameters 233
How to use the Adjust window 234
How to use the waveform adjustment button bar 235
Details about the live rhythm monitor 235
Recording live waveforms 240
Printing a report while recording live ECG 241
Saving and retrieving device data 242
Considerations 242
How to save ICD data to a disk 243
How to read ICD data from a disk 243
Saving data to a disk 245
Data file names 245
Reading device data from diskette 245
Printing reports 246
How to print a report 247
Print Queue 247
Key terms 248
11 Using system evaluation tools 249
A summary of system evaluation tools 250
Automatic daily measurements 250
Taking a quick look at device activity 251
How to use Quick Look 251
Quick Look observations 252
Using the Patient Alert feature 253
Parameters 253
Considerations 255
How to program the Patient Alert feature 258
Instructing the patient 258
Viewing the Patient Alert events 259
How to view the Patient Alert events 260
Streamlining follow-ups with Checklist 261
How to select and use a checklist 262
How to create, edit, and delete a checklist 263
Marquis DR 7274 Reference Manual
Table of contents
Key terms 264
12 Setting up and viewing collected data 265
A summary of data collection 266
Setting up data collection 267
Parameters 267
Considerations 268
How to set up data collection 269
Details about data collection parameters 269
How to clear collected data 273
Collecting lead performance data 274
Daily lead impedance and EGM amplitude measurements 274
Sensing integrity counter 275
Viewing the episode and therapy efficacy counters 275
How to view and print counter data 276
Details about the episode and therapy efficacy counters 277
Therapy counters 279
Viewing episode data 280
How to view episode data 281
Details about episode data 282
How to view an Interval Plot 284
How to view an EGM Strip 285
How to display the episode text information 287
Viewing Flashback Memory 288
How to view the Flashback Memory 289
Viewing battery and lead status data 290
How to view battery and lead status data 292
Viewing lead performance trends 292
How to view lead performance trend graphs 293
Using Cardiac Compass to view long term clinical trends 294
How to print a Cardiac Compass report 296
Details on Cardiac Compass trend data 296
Viewing and entering patient information 301
How to view and enter new patient information 303
Displaying and printing patient information 303
Automatic device status monitoring 304
Device status indicator warnings 304
How to respond to an electrical reset 305
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Marquis DR 7274 Reference Manual
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Table of contents
13 Testing the system 311
14 Conducting Electrophysiologic Studies 323
Key terms 306
Testing overview 312
Evaluating the underlying rhythm 312
Considerations 312
How to Perform an Underlying Rhythm test 313
Measuring pacing thresholds 313
Parameters 314
Considerations 315
How to perform a Pacing Threshold Test 315
Measuring lead impedance 316
Considerations 316
How to perform a Lead Impedance test 316
Details about the Lead Impedance test 317
Measuring EGM Amplitude 318
Parameters 318
Considerations 318
Restrictions 319
How to perform an EGM Amplitude test 320
Testing the device capacitors 320
Considerations 320
How to perform a Charge/Dump test 321
Key terms 322
EP Study overview 324
Inducing VF with T-Shock 326
Parameters 326
Considerations 327
Restrictions 327
How to deliver a T-Shock induction 328
Details about T-Shock
induction 328
Inducing VF with 50 Hz Burst 329
Parameters 329
Considerations 330
How to deliver a 50 Hz Burst induction 331
Details about 50 Hz Burst induction 332
Inducing an arrhythmia with Manual Burst 332
Marquis DR 7274 Reference Manual
Parameters 332
Considerations 333
How to deliver a Manual Burst induction 334
Details about Manual Burst induction 334
Inducing an arrhythmia with PES 335
Parameters 335
Considerations 336
How to deliver a PES induction 337
Details about PES induction 337
Delivering a manual therapy 338
Parameters for manual defibrillation and cardioversion 338
Parameters for manual ATP therapies 338
Considerations 340
How to deliver a manual therapy 340
Details about manual therapies 340
Key terms 341
15 Solving system problems 343
Overview 344
Solving sensing problems 345
Solving tachyarrhythmia detection problems 347
Solving tachyarrhythmia therapy problems 348
Solving bradycardia pacing problems 349
Responding to device status indicators 351
Key terms 352
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xiii
Part V Appendices
A Warnings and precautions 357
General warnings 358
Storage and handling 358
Resterilization 359
Device implantation and ICD programming 359
Lead evaluation and lead connection 361
Follow-up testing 362
Explant and disposal 363
Medical therapy hazards 363
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Table of contents
Home and occupational environments 365
BDevice Parameters367
Emergency settings 368
Detection parameters 369
Therapy parameters 371
Bradycardia pacing parameters 373
System maintenance parameters 376
Data collection parameters 377
System test and EP study parameters 378
Fixed parameters 381
Patient information parameters 383
Programmer symbols 384
Parameter Interactions Window 385
Parameter interlocks 386
Index 387
Marquis DR 7274 Reference Manual
Introduction
Using this manual
Before implanting the ICD, it is strongly recommended that you:
■
Refer to the product literature packaged with the ICD for
information about prescribing the ICD.
■
Thoroughly read this manual and the technical manuals for the
leads used with the device.
■
Discuss the procedure and the ICD system with the patient
and any other interested parties, and provide them with any
patient information packaged with the ICD.
Contacting technical support
Medtronic employs highly trained representatives and engineers
located throughout the world to serve you and, upon request, to
provide training to qualified hospital personnel in the use of
Medtronic products.
Introduction
xv
In addition, Medtronic maintains a professional staff of consultants
to provide technical consultation to product users. For medical
consultation, Medtronic can often refer product users to outside
medical consultants with appropriate expertise.
For more information, contact your local Medtronic representative,
or call or write Medtronic at the appropriate address or telephone
number listed on the back cover.
Customer education
Medtronic invites physicians to attend an education seminar on
the complete ICD system. The course includes indications for use,
an overview of ICD system functions, implant procedures, and
patient management.
Marquis DR 7274 Reference Manual
xvi
Introduction
References
Notice
The primary reference for background information is Zacouto FI,
Guize LJ. Fundamentals of Orthorhythmic Pacing. In: Luderitz B,
ed. Cardiac Pacing Diagnostic and Therapeutic Tools. New York:
Springer-Verlag; 1976: 212-218.
See these additional references for more background information:
■
Singer I, Ed. Implantable Cardioverter-Defibrillator. Armonk,
NY: Futura Publishing Co. 1994.
■
Singer I, Barold SS, Camm AJ, Eds. Nonpharmacological
Therapy of Arrhythmias for the 21st Century: The State of the
Art. Armonk, NY: Futura Publishing Co. 1998.
■
Estes M, Manolis AS, Wang P, Eds. Implantable
Cardioverter-Defibrillators. New York, NY: Marcel Dekker, Inc.
1994.
■
Kroll MW, Lehmann MH, Eds. Implantable
Cardioverter-Defibrillator Therapy: The Engineering-Clinical
Interface. Norwell, MA: Kluwer Academic Publishers 1996.
This software is provided as an informational tool for the end user.
The user is responsible for accurate input of patient information
into the software. Medtronic makes no representation as to the
accuracy or completeness of the data input into the software.
MEDTRONIC SHALL NOT BE LIABLE FOR ANY DIRECT,
INDIRECT, INCIDENTIAL OR CONSEQUENTIAL DAMAGES TO
ANY THIRD PARTY WHICH RESULTS FROM THE USE OF THE
INFORMATION PROVIDED IN THE SOFTWARE.
Marquis DR 7274 Reference Manual
Abbreviations and acronyms
Atrial
A-
Atrial Fibrillation
AF
Abbreviations and acronyms
xvii
AFib/AFlutter
Atrial Refractory Period
ARP
Antitachycardia Pacing
ATP
Atrial Vulnerable Period
AVP
Beginning of Life
BOL
beats per minute
bpm
Combined (VT and VF) Number of Intervals to Detect
CNID
Cardioversion
CV
DF/Defib
Electrocardiogram
ECG
Electrogram
EGM
End of Life
EOL
Elective Replacement Indicator
ERI
Fibrillation Detection Interval
FDI
Fast Ventricular Tachycardia Detection Interval
FTI
Fast Ventricular Tachycardia
FVT
Atrial Fibrillation and/or Atrial Flutter
Defibrillation
Implantable Cardioverter Defibrillator
ICD
joules
J
-1
reciprocal minutes; for example, pacing pulses per minute
min
milliseconds
ms
millivolts
mV
NCAP
NID
NST
Non-Competitive Atrial Pacing
Number of Intervals to Detect
Non-sustained Tachycardia
Marquis DR 7274 Reference Manual
xviii
Abbreviations and acronyms
Premature Atrial Contraction
PAC
Paced A-V Delay
PAV
Programmed Electrical Stimulation
PES
Pacemaker-Mediated Tachycardia
PMT
an atrial interval
P-P
paces or pulses per minute
ppm
an interval between a P-wave and the subsequent R-wave
P-R
Post Ventricular Atrial Blanking period
PVAB
PVARP
PVC
RAAV
RNID
R-P
R-R
SAV
ST/Sinus Tach
SVT
TDI
V
V-
VF
VF NID
VRS
VSP
Post Ventricular Atrial Refractory Period
Premature Ventricular Contraction
Rate Adaptive A-V delay
Number of Intervals to Redetect
an interval between an R-wave and the subsequent P-wave
a ventricular interval
Sensed A-V Delay
Sinus Tachycardia
Supraventricular Tachycardia
Tachycardia Detection Interval
volts
Ventricular
Ventricular Fibrillation
VF Number of Intervals to Detect
Ventricular Rate Stabilization
Ventricular Safety Pacing
Ventricular Tachycardia
VT
VT NID
Marquis DR 7274 Reference Manual
VT Number of Intervals to Detect
Quick overview
Part I
Marquis DR 7274 Reference Manual
Physical characteristics 4
Magnet application 5
Longevity projections 6
Replacement indicators 8
Typical charge times 10
High voltage therapy energy 10
Stored data and diagnostics 11
New and enhanced features 14
Quick reference
1
1
Marquis DR 7274 Reference Manual
4
Chapter 1
Physical characteristics
Physical characteristics
Table 1-1. ICD physical characteristicsa
Volu m e 36 cc
Mass 75 g
b
H x W x D
Surface area of device can 66 cm
Radiopaque IDc
Materials in contact with
human tissue
d
68.3 mm x 50.8 mm x 13.9 mm
2
PKC
Titanium / polyurethane / silicone rubber
Battery Lithium silver vanadium oxide
Connectors Two IS-1 connectors for pacing and
sensing, Two DF-1 connectors for high
voltage therapy, Active Can electrode
(programmable)
Device Port Connector
Typ e
Software
Name
SVC DF-1 HVX
A
V
SVC
RV
RV DF-1 HVB
Can n/a HVA, Can
V IS-1 bipolar
A IS-1 bipolar
Can
74lead.eps
Suture holes
74Suture.eps
a
Measurements are nominal values based on CAD (computer aided design)
model measurements and are rounded to the nearest unit.
b
Grommets may protrude slightly beyond the can surface.
c
Engineering series number follows the radiopaque code.
d
These materials have been successfully tested for the ability to avoid biological
incompatibility. The device does not produce an injurious temperature in the
surrounding tissue.
Marquis DR 7274 Reference Manual
Magnet application
Bringing a magnet close to the device triggers changes in device
operation as shown in Table 1-2. When the magnet is removed,
the device returns to its programmed operations.
Table 1-2. Effects of magnet application on the device
Pacing mode as programmed
Pacing rate and interval as programmed
VF, VT, and FVT detection suspended
Quick reference
5
Magnet application
a
b
Patient Alert audible tones
(20 seconds or less)
with programmable alert(s) enabled:
■
continuous tone (Test)
■
on/off intermittent tone (seek follow-up)
■
high/low dual tone (urgent follow-up)
c
with programmable alerts disabled:
■
no tone
■
high/low dual tone (urgent follow-up)
a
Rate response adjustments are suspended while a Patient Alert tone sounds.
b
Detection resumes if telemetry is established and the application software is
running, or it resumes after the application software has started.
c
The Test tone does not sound if “VF Detection/Therapy Off” is the only alert
enabled.
Marquis DR 7274 Reference Manual
6
Chapter 1
Longevity projections
Longevity projections
Longevity estimates are based on accelerated battery discharge
data and device modeling at 60 ppm (min
■
2.5 V pacing pulse amplitude, 0.4 ms pacing pulse width, and
-1
) pacing rate, with:
30 J delivered therapy energy (see Table 1-3)
■
3 V pacing pulse amplitude, 0.4 ms pacing pulse width, and
30 J delivered therapy energy (see Table 1-4)
This model assumes default automatic capacitor formation
setting. As a guideline, each full energy charge decreases device
longevity by approximately 24 days.
Device longevity is affected by how certain features are
programmed, such as EGM pre-storage. For more information,
see “Optimizing device longevity” on page 207.
Considerations for using EGM pre-storage
When the EGM pre-storage feature is programmed off, the device
starts to store EGM following the third tachyarrhythmia event and
also provides up to 20 seconds of information before the onset of
the tachyarrhythmia, including:
■
AA and VV intervals
■
Marker Channel
■
interval plot Flashback
When the EGM pre-storage feature is programmed on, the device
also collects up to 20 seconds of EGM information before the
onset of the arrhythmia.
In a patient who uniformly repeats the same onset mechanisms,
the greatest clinical benefit of pre-onset EGM storage is achieved
after a few episodes are captured.To maximize the effectiveness
of the EGM pre-storage feature and optimize device longevity,
consider these programming options:
■
Turn pre-storage on to capture possible changes in the onset
mechanism following significant clinical adjustments, for
example, device implant, medication changes, and surgical
procedures.
■
Turn pre-storage off once you have successfully captured the
information of interest.
Marquis DR 7274 Reference Manual
Quick reference
Longevity projections
Table 1-3. Projected longevity in years with 2.5V pacing amplitude and
0.4 ms pulse width
Maximum
energy
Percent
pacing
charging
frequency
EGM
a
pre-storage
0% Semi-Annual Off
On
Quarterly Off
On
15% Semi-Annual Off
On
Quarterly Off
On
50% Semi-Annual Off
On
Quarterly Off
On
100% Semi-Annual Off
On
Quarterly Off
On
a
Maximum energy charging frequency may include full energy therapy shocks or
capacitor formations.
b
The data provided for programming EGM pre-storage on is based on a 6 month
period (two 3-month follow-up intervals) over the life of the device. Additional use
of EGM pre-storage reduces longevity by approximately 25% or 3 months per
year.
500 ohm
pacing
impedance
b
DDD VVI DDD VVI
8.6 8.6 8.6 8.6
8.5 8.5 8.5 8.5
7.5 7.5 7.5 7.5
7.3 7.3 7.3 7.3
8.3 8.5 8.5 8.6
8.1 8.4 8.3 8.5
7.2 7.4 7.3 7.5
7.0 7.3 7.1 7.3
7.5 8.2 8.0 8.5
7.4 8.0 7.9 8.2
6.6 7.1 7.0 7.3
6.5 7.0 6.8 7.1
6.7 7.7 7.5 8.1
6.5 7.5 7.3 8.0
6.0 6.8 6.6 7.1
5.8 6.5 6.4 6.9
900 ohm
pacing
impedance
7
Marquis DR 7274 Reference Manual
8
Chapter 1
Replacement indicators
Table 1-4. Projected longevity in years with 3V pacing amplitude and
0.4 ms pulse width
500 ohm
pacing
impedance
b
DDD VVI DDD VVI
Percent
pacing
Maximum
energy
charging
frequency
EGM
a
pre-storage
0% Semi-Annual Off 8.6 8.6 8.6 8.6
On 8.5 8.5 8.5 8.5
Quarterly Off 7.5 7.5 7.5 7.5
On 7.3 7.3 7.3 7.3
15% Semi-Annual Off 8.1 8.5 8.4 8.6
On 8.0 8.3 8.2 8.4
Quarterly Off 7.1 7.3 7.3 7.5
On 6.9 7.2 7.1 7.3
50% Semi-Annual Off 7.2 8.0 7.8 8.3
On 7.0 7.8 7.6 8.1
Quarterly Off 6.4 7.0 6.8 7.2
On 6.2 6.8 6.7 7.0
100% Semi-Annual Off 6.2 7.3 7.1 8.0
On 6.0 7.1 7.0 7.7
Quarterly Off 5.5 6.5 6.3 6.9
On 5.4 6.3 6.1 6.8
a
Maximum energy charging frequency may include full energy therapy shocks or
capacitor formations.
b
The data provided for programming ECG pre-storage on is based on a 6 month
period (two 3-month follow-up intervals) over the life of the device. Additional use
of EGM pre-storage reduces longevity by approximately 25% or 3 months per
year.
900 ohm
pacing
impedance
Replacement indicators
Battery voltage and messages about replacement status appear
on the programmer display and on printed reports. Table 1-5 lists
the Elective Replacement Indicator (ERI) and the End of Life
(EOL) conditions.
Marquis DR 7274 Reference Manual
Quick reference
Replacement indicators
Table 1-5. Replacement indicators
Elective Replacement (ERI) ≤ 2.62 V
End of Life (EOL) 3 months after ERI
ERI date – The programmer displays the date when the battery
reached ERI on the Quick Look and Battery and Lead
Measurements screens.
Temporary voltage decrease – The battery voltage temporarily
decreases following a high voltage charge. If a battery
measurement is taken immediately after a high voltage charge,
the ERI or EOL indicator may be displayed. However, this is a
temporary status which will return to normal when the battery has
recovered from the charge.
EOL indication – If the programmer indicates that the device is at
EOL, replace the device immediately.
Post-ERI conditions – EOL device status is defined as three
months following an ERI indication assuming the following
post-ERI conditions: 100% DDD pacing at 60 ppm (min
-1
), 3 V,
0.4 ms; 500 Ω pacing load; and six 30 J charges. EOL may be
indicated before the end of three months if the device exceeds
these conditions.
9
Marquis DR 7274 Reference Manual
10
Chapter 1
Typical charge times
Typical charge times
The most recent capacitor charge time appears on the
programmer display and on printed reports and can be evaluated
using the Charge/Dump test (see Table 1-6).
Ta bl e 1 -6 . Ty p ic ala full energy charge times
At Beginning of Life (BOL) 5.9 seconds
At Elective Replacement (ERI) 7.5 seconds
a
These charge times are typical when the capacitors are fully formed.
High voltage therapy energy
The stored energy of the device is derived from the peak capacitor
voltage and is always greater than the energy delivered by the
device. Table 1-7 compares the programmed energy levels
delivered by the device to the energy levels stored in the
capacitors before delivery.
Marquis DR 7274 Reference Manual
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