Medtronic 7288 Reference Guide

INTRINSIC™/INTRINSIC

™

7288/7287

Dual Chamber Implantable Cardioverter Defibrillator (VVE-DDDR)

Reference Manual

Caution: Federal Law (USA) restricts this device to sale by or on the order of a physician (or properly licensed practitioner).

INTRINSIC™/INTRINSIC

™

7288/7287

Reference Manual

A guide to the operation and programming of the Intrinsic Model 7288 and Intrinsic 30 Model 7287 Dual Chamber Implantable Cardioverter Defibrillators

The following are trademarks of Medtronic:

Active Can, Cardiac Compass, Checklist, Flashback, Intrinsic, Leadless ECG, MVP, Marker Channel, Medtronic, Medtronic CareLink, PR Logic, Patient Alert, Quick Look, QuickLink

Table of Contents

Introduction 11

Part I Quick overview 15

1 Quick reference 17

1.1 New to Intrinsic 18

1.2 Physical characteristics 18

1.3 Magnet application 20

1.4 Longevity projections 21

1.5 Replacement indicators 23

1.6 Typical charge times 23

1.7 High voltage therapy energy 24

1.8 Stored data and diagnostics 26

2 The Intrinsic system 29

2.1 System overview 30

2.2 Indications and usage 33

2.3 Contraindications 33

2.4 Patient screening 33

3 Emergency therapy 35

3.1 Delivering emergency therapies 36

3.2 Delivering an emergency defibrillation therapy 37

3.3 Delivering an emergency cardioversion therapy 38

3.4 Delivering emergency fixed burst pacing 39

3.5 Enabling emergency VVI pacing 40

Part II Device implant and patient follow-up

procedures 43

4 Implanting the device 45

4.1 Overview 46

4.2 Preparing for an implant 46

4.3 Replacing a device 48

4.4 Positioning the leads 49

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Table of Contents

Part III Configuring the device for the patient 67

4.5 Testing sensing and pacing thresholds 51

4.6 Connecting the leads to the device 52

4.7 Testing defibrillation operation and effectiveness 54

4.8 Positioning and securing the device 58

4.9 Completing the implant procedure 58

5 Conducting a patient follow-up session 61

5.1 Patient follow-up guidelines 62

5.2 Verifying the status of the implanted system 62

5.3 Verifying accurate detection and appropriate therapy 63

5.4 Verifying effective bradycardia pacing 64

6 Detecting tachyarrhythmias 69

6.1 Detection overview 70

6.2 Setting up sensing 73

6.3 Detecting VF episodes 78

6.4 Detecting VT episodes 81

6.5 Detecting FVT episodes 87

6.6 Detecting tachyarrhythmia episodes with Combined Count 92

6.7 Monitoring episodes for termination or redetection 94

6.8 Enhancing detection with PR Logic criteria 98

6.9 Enhancing VT detection with the Stability criterion 106

6.10 Detecting double tachycardias 108

6.11 Detecting prolonged tachyarrhythmias with High Rate Timeout 109

7 Treating tachyarrhythmia episodes 113

7.1 Treating VF with defibrillation 114

7.2 Treating VT and FVT with antitachycardia pacing 123

7.3 Treating VT and FVT with cardioversion 133

7.4 Optimizing therapy with Smart Mode and Progressive Episode Therapies 141

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Table of Contents

8 Treating bradycardia 147

8.1 Providing basic pacing therapy 148

8.2 Dual chamber pacing 152

8.3 Single chamber pacing 162

8.4 MVP (Managed Ventricular Pacing) 165

8.5 Enhancing pacing for optimal cardiac output 170

8.6 Adjusting the pacing rate with Mode Switch 184

8.7 Preventing competitive atrial pacing 186

8.8 Detecting and preventing pacemaker-mediated tachycardia 192

8.9 Providing Ventricular Safety Pacing 196

8.10 Providing pacing after high voltage therapies 200

9 Optimizing charge time and device longevity 203

9.1 Optimizing charge time 204

9.2 Optimizing device longevity 207

Part IV Evaluating and managing patient treatment 209

10 Using the programmer 211

10.1 Setting up and using the programmer 212

10.2 Display screen features 213

10.3 Viewing and programming device parameters 218

10.4 Starting and ending patient sessions 222

10.5 Viewing live waveform traces 225

10.6 Recording live waveform strips 232

10.7 Saving and retrieving device data 234

10.8 Printing reports 238

11 Using system evaluation tools 245

11.1 A summary of system evaluation tools 246

11.2 Taking a quick look at device activity 247

11.3 Using the Patient Alert feature 249

11.4 Streamlining follow-ups with Checklist 256

12 Setting up and viewing collected data 261

12.1 A summary of data collection 262

12.2 Setting up data collection 263

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Table of Contents

12.3 Collecting lead performance data 267

12.4 Viewing the episode and therapy efficacy counters 269

12.5 Viewing episode data 272

12.6 Viewing Flashback Memory 280

12.7 Viewing battery and lead status data 281

12.8 Viewing lead performance trends 283

12.9 Using Cardiac Compass to view long ter m clinical trends 285

12.10 Viewing and entering patient information 292

12.11 Automatic device status monitoring 295

13 Testing the system 297

13.1 Testing overview 298

13.2 Evaluating the underlying rhythm 298

13.3 Measuring pacing thresholds 299

13.4 Measuring lead impedance 302

13.5 Measuring EGM amplitude 303

13.6 Testing the device capacitors 305

14 Conducting Electrophysiologic Studies 307

14.1 EP Study overview 308

14.2 Inducing VF with T-Shock 309

14.3 Inducing VF with 50 Hz Burst 313

14.4 Inducing an arrhythmia with Manual Burst 315

14.5 Inducing an arrhythmia with PES 318

14.6 Delivering a manual therapy 320

15 Solving system problems 325

15.1 Overview 326

15.2 Solving sensing problems 326

15.3 Solving tachyarrhythmia detection problems 328

15.4 Solving tachyarrhythmia therapy problems 329

15.5 Solving bradycardia pacing problems 330

15.6 Responding to device status indicators 331

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Appendices 333

A Warnings and precautions 335

A.1 General warnings 336

A.2 Storage and handling 336

A.3 Resterilization 337

A.4 Device operation 338

A.5 Lead evaluation and lead connection 339

A.6 Follow-up testing 340

A.7 Explant and disposal 340

A.8 Medical therapy hazards 341

A.9 Home and occupational environments 343

B Device parameters 345

B.1 Emergency settings 346

B.2 Detection parameters 347

B.3 Therapy parameters 348

B.4 Pacing parameters 350

B.5 System maintenance parameters 353

B.6 Data collection parameters 354

B.7 System test and EP study parameters 355

B.8 Fixed parameters 357

B.9 Patient information parameters 359

B.10 Programmer symbols 360

B.11 Parameter interlocks 361

Table of Contents

Glossary 363

Index 371

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Introduction

About this manual

Introduction

This manual describes the operation and intended use of the Intrinsic Model 7288 and Intrinsic 30 Model 7287 systems.

In these systems, both devices provide ventricular tachyarrhythmia detection and therapy and a full range of dual-chamber bradycardia pacing modes and associated features. Unless otherwise noted, all information in this manual applies to both devices.

The full delivered energy is different for Intrinsic Model 7288 devices and Intrinsic 30 Model 7287 devices. Intrinsic devices can be programmed to deliver a full energy of up to 35 J. Intrinsic 30 devices can be programmed to deliver up to 30 J. Throughout the manual, the term "full-energy" refers to either 35 J or 30 J, depending on the device model.

Programmer hardware and screen images

The screen image examples in this document show the Medtronic CareLink Model 2090 programmer screen. Wherever possible, these screen images show the application for an Intrinsic Model 7288 device.

The information provided in this manual about using the programmer assumes the Medtronic CareLink Model 2090 Programmer is used. For information about using the Model 9790C Programmer, see the

Manual

Manual conventions

Throughout this document, the word “device” refers in general to both Intrinsic and Intrinsic 30 devices.

The nominal value for that parameter.

On-screen buttons are shown with the name of the button surrounded by brackets: [Button Name].

symbol in parameter tables indicates the Medtronic

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

9790/9790C Programmer Instruction

Introduction

Additional literature

Technical support

Before implanting the device, it is strongly recommended that you take the following actions:

Refer to the product literature packaged with the device for

•

information about prescribing the device.

Thoroughly read the technical manuals for the leads used

•

with the device.

Discuss the procedure and the device with the patient and

•

any other interested parties, and provide them with any patient information packaged with the device.

Medtronic employs highly trained representatives and engineers located throughout the world to ser ve you and, upon request, to provide training to qualified hospital personnel in the use of Medtronic products.

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 appropr iate 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 educational seminar on the device. The course describes indications for use, system functions, implant procedures, and patient management.

References

The primary reference for background information is Zacouto FI, Guize LJ. Fundamentals of Orthorhythmic Pacing. In: Luderitz B,

Cardiac Pacing Diagnostic and Therapeutic Tools.

ed. Springer-Verlag; 1976: 212-218.

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

New York:

Notice

Introduction

See these additional references for more background information:

Estes M, Manolis AS, Wang P, Eds.

•

Cardioverter-Defibrillators

Inc. 1994.

Kroll MW, Lehmann MH, Eds.

•

Cardioverter-Defibrillator Therapy: The Engineering-Clinical Interface

Singer I, Ed.

•

NY: Futura Publishing Co. 1994.

Singer I, Barold SS, Camm AJ, Eds.

•

Therapy of Arrhythmias for the 21st Century: The State of the Art

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, INCIDENTAL OR CONSEQUENTIAL DAMAGES TO ANY THIRD PARTY WHICH RESULTS FROM THE USE OF THE INFORMATION PROVIDED IN THE SOFTWARE.

. Norwell, MA: Kluwer Academic Publishers 1996.

Implantable Cardioverter-Defibrillator

. Armonk, NY: Futura Publishing Co. 1998.

. New York, NY: Marcel Dekker,

Implantable

. Armonk,

Nonpharmacological

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Quick overview

Part I

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

1Quick reference

1.1 New to Intrinsic 18

1.2 Physical characteristics 18

1.3 Magnet application 20

1.4 Longevity projections 21

1.5 Replacement indicators 23

1.6 Typical charge times 23

1.7 High voltage therapy energy 24

1.8 Stored data and diagnostics 26

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Chapter 1

New to Intrinsic

1.1 New to Intrinsic

MVP (Managed Ventricular Pacing) – The MVP modes promote

intrinsic conduction by reducing unnecessary right ventricular pacing. The MVP modes are indicated by AAIR<=>DDDR and AAI<=>DDD on the mode selection screen. These modes provide atrial-based pacing with ventricular backup. For loss of AV conduction, the device switches to DDDR or DDD mode. Periodic checks are performed, and if AV conduction resumes, the device switches back to AAIR or AAI mode.

1.2 Physical characteristics

Table 1-1. Device physical characteristics

Volume

Intrinsic

Intrinsic 30

Mass

Intrinsic

Intrinsic 30

H x W x D

Surface area of device can

Radiopaque ID

Materials in contact with human tissue

Intrinsic

Intrinsic 30

Intrinsic

Intrinsic 30

Intrinsic PUB

Intrinsic 30 PUA

38 cm

36 cm

76 g

75 g

68 mm x 51 mm x 15 mm

68 mm x 51 mm x 14 mm

67 cm

66 cm

Titanium/polyurethane/silicone rubber

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

1Quick reference

Physical characteristics

Table 1-1. Device physical characteristicsa(continued)

Battery Lithium silver vanadium oxide

Connectors Two IS-1 connectors for pacing and

Measurements are nominal values based on CAD (computer aided design) model measurements and are rounded to the nearest unit.

Grommets may protrude slightly beyond the can surface.

Engineering series number follows the radiopaque code.

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.

Table 1-2. Lead connections

Device port Connector type Software name

SVC DF-1 HVX

RV DF-1 HVB

Can n/a HVA; Can

V IS-1 bipolar

A IS-1 bipolar

sensing, Two DF-1 connectors for high voltage therapy, Active Can electrode (programmable)

—

Figure 1-1. Lead connections

1 DF-1 connector port, SVC (HVX) 2 DF-1 connector port, RV (HVB) 3 Device Active Can electrode, Can (HVA) 4 IS-1 connector port, V 5 IS-1 connector port, A

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Chapter 1

Magnet application

Figure 1-2. Suture holes

1.3 Magnet application

Bringing a magnet close to the device triggers changes in device operation as shown in Table 1-3. When the magnet is removed, the device returns to its programmed operations.

Table 1-3. Effects of magnet application on the device

Pacing mode as programmed

Pacing rate and interval as programmed

VF, VT, and FVT detection suspended

Patient Alert audible tones (20 s or less)

with programmable alerts enabled:

continuous tone (Test)

•

on/off intermittent tone (seek

•

follow-up) high/low dual tone (urgent

•

follow-up)

with programmable alerts disabled:

no tone

•

high/low dual tone (urgent

•

follow-up)

Rate response adjustments are suspended while a Patient Alert tone sounds.

Detection resumes if telemetry is established and the application software is running, or it resumes after the application software has started.

The Test tone does not sound if “VF Detection/Therapy Off” is the only alert enabled.

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

1Quick reference

Longevity projections

1.4 Longevity projections

1.4.1 Intrinsic Model 7288 longevity projections

Longevity estimates are based on accelerated battery discharge data and device modeling with EGM pre–storage off and a 60 ppm pacing rate. The estimates provided in Table 1-4 apply to a delivered therapy energy of 35 J and pacing pulses having a

0.4 ms pulse width and either a 2.5 V or 3 V amplitude.

This model assumes default automatic capacitor formation setting. As a guideline, each full-energy charge decreases device longevity by approximately 31 days.

Table 1-4. Intrinsic Model 7288: Projected longevity in years with 0.4 ms pulse width and 60 ppm pacing rate

Maximum

Pacing

DDD, 0%

energy charging frequency

Semi-annual Off

Pre-arrhythmia EGM storage

Quarterly Off

DDD, 50%

Semi-annual Off

Quarterly Off

AAI<=>DDD (MVP mode), 50% atrial, 5% ventricular

Semi-annual Off

Quarterly Off

DDD, 100%

Semi-annual Off

Quarterly Off

Maximum energy charging frequency may include full-energy therapy shocks or capacitor formations.

The data provided for programming Pre-arrhythmia EGM on is based on a 6 month period (two 3 month

follow-up intervals) over the life of the device. Additional use of Pre-arrhythmia EGM reduces longevity by approximately 27% or 3 months per year.

500pacing impedance

2.5 V 3.0 V 2.5 V 3.0 V

8.5 8.5 8.5 8.5

8.3 8.3 8.3 8.3

7.1 7.1 7.1 7.1

7.0 7.0 7.0 7.0

7.4 7.1 7.9 7.6

7.2 6.9

6.4 6.1 6.7 6.5

6.2 6.0 6.5 6.4

7.6 7.4 7.9 7.8

7.4 7.2

6.5 6.4 6.7 6.6

6.4 6.2 6.6 6.5

6.6 6.1 7.3 6.9

6.4 5.9 7.2 6.8

5.7

5.4 6.3 6.0

5.6 5.2 6.2 5.9

900pacing impedance

7.7

7.4

7.6

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Chapter 1

Longevity projections

1.4.2 Intrinsic 30 Model 7287 longevity projections

Longevity estimates are based on accelerated battery discharge data and device modeling with EGM pre–storage off and a 60 ppm pacing rate. The estimates provided in Table 1-5 apply to a delivered therapy energy of 30 J and pacing pulses having a

0.4 ms pulse width and either a 2.5 V or 3 V amplitude.

This model assumes default automatic capacitor formation setting. As a guideline, each full-energy charge decreases device longevity by approximately 24 days.

Table 1-5. Intrinsic 30 Model 7287: Projected longevity in years with 0.4 ms pulse width and 60 ppm pacing rate

Maximum

Pacing

DDD, 0%

energy charging frequency

Semi-annual Off

Pre-arrhythmia EGM storage

Quarterly Off

DDD, 50%

Semi-annual Off

Quarterly Off

AAI<=>DDD (MVP mode), 50% atrial, 5% ventricular

Semi-annual Off

Quarterly Off

DDD, 100%

Semi-annual Off

Quarterly Off

Maximum energy charging frequency may include full-energy therapy shocks or capacitor formations.

The data provided for programming Pre-arrhythmia EGM on is based on a 6 month period (two 3 month

follow-up intervals) over the life of the device. Additional use of Pre-arrhythmia EGM reduces longevity by approximately 25% or 3 months per year.

500pacing impedance

2.5 V 3.0 V 2.5 V 3.0 V

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

7.5

7.2 8.0 7.8

7.4 7.0 7.9 7.6

6.6 6.4 7.0 6.8

6.5 6.2 6.8 6.7

7.8 7.6 8.1 7.9

7.6 7.4 7.9 7.8

6.8 6.7 7.0 6.9

6.7 6.5 6.9 6.8

6.7 6.2

6.5 6.0 7.3 7.0

6.0

5.5

5.8 5.4 6.4 6.1

900pacing impedance

7.5

7.1

6.6 6.3

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

1.5 Replacement indicators

Battery voltage and messages about replacement status appear on the programmer display and on printed reports. Table 1-6 lists the Elective Replacement Indicator (ERI) and the End of Life (EOL) conditions.

Table 1-6. 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, 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.

1Quick reference

Replacement indicators

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, 3 V, 0.4 ms;

pacing load; and six full-energy charges. EOL may be

500 indicated before the end of three months if the device exceeds these conditions.

1.6 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 1-7 and Table 1-8).

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Chapter 1

High voltage therapy energy

Table 1-7. Intrinsic Model 7288: typicalafull energy charge times

At Beginning of Life (BOL)

At Elective Replacement (ERI)

These charge times are typical when the capacitors are fully formed.

Table 1-8. Intrinsic 30 Model 7287: typicalafull energy charge times

At Beginning of Life (BOL)

At Elective Replacement (ERI)

These charge times are typical when the capacitors are fully formed.

1.7 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 1-9 compares the programmed energy levels delivered by the Intrinsic to the energy levels stored in the capacitors before delivery. Table 1-10 makes the same comparison for the Intrinsic 30 device.

7.0 s

8.9 s

5.9 s

7.5 s

Table 1-9. Intrinsic Model 7288: delivered (programmed) and stored energy levels

Energy ( J)

Delivereda/ Programmed Stored

35 39 7.0

32 37 6.4

30 34 6.0

28 32 5.6

26 30 5.2

25 29 5.0

24 27 4.8

22 25 4.4

20 23 4.0

18 21 3.6

16 19 3.2

15 17 3.0

14 16 2.8

13 15 2.6

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Charge Timec( s)

Delivereda/ Programmed Stored

Energy ( J)

10 12 2.0

9 10.5 1.8

8 9.3 1.6

6 7.1 1.2

4 4.8 0.8

3 3.6 0.6

2 2.4 0.4

1.8 2.2 0.4

1.6 2.0 0.3

1.4 1.7 0.3

1.2 1.5 0.2

1.0 1.2 0.2

8.2 1.4

5.9 1.0

Charge Timec( s)

1Quick reference

High voltage therapy energy

Table 1-9. Intrinsic Model 7288: delivered (programmed) and stored energy levels (continued)

Energy ( J)

Delivereda/ Programmed Stored

12 14 2.4

11 13 2.2

Charge Timec( s)

Delivereda/ Programmed Stored

Energy ( J)

Charge

Timec( s)

0.8 1.0 0.2

0.6 0.8 0.1

0.4 0.5 0.1

Energy delivered at connector block into a 75

Energy stored at end of charge on capacitor.

Typical charge time at Beginning of Life (BOL) with fully formed capacitors, rounded to the nearest tenth

of a second.



load.

Table 1-10. Intrinsic 30 Model 7287: delivered (programmed) and stored energy levels

Energy ( J)

Delivereda/ Programmed Stored

Charge Timec( s)

Delivereda/ Programmed Stored

30 35 5.9

28 33 5.6

26 31 5.2

24 28 4.7

22 26 4.4

20 24 4.0

18 21 3.5

16 19 3.2

15 18 3.0

14 16 2.7

13 15 2.5

12 14 2.4

11 13 2.2

10 12 2.0

9 11 1.9

Energy delivered at connector block into a 75

Energy stored at end of charge on capacitor.

Typical charge time at Beginning of Life (BOL) with fully formed capacitors, rounded to the nearest tenth of a second.



load.

Energy ( J)

Charge

Timec( s)

8 9.4 1.6

8.3 1.4

6 7.1 1.2

5.9 1.0

4 4.7 0.8

3 3.6 0.6

2 2.4 0.4

1.8 2.2 0.4

1.6 2.0 0.3

1.4 1.7 0.3

1.2 1.5 0.3

1.0 1.2 0.2

0.8 1.0 0.2

0.6 0.8 0.1

0.4 0.5 0.1

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Chapter 1

Stored data and diagnostics

1.8 Stored data and diagnostics

Table 1-11. Stored data and diagnostics

Episode data

Tachy episodes 150 VF/VT/FVT episodes: intervals, text, EGM

EGM capacity for tachy episodes 14 minutes of dual-channel EGM, or 23.5 minutes of

SVT/NST episodes 50 SVT/NST episodes: intervals, text, EGM (the device

EGM capacity for SVT/NST episodes

Brady episodes 53 mode switch episodes

EGM sources 9 options: atrial/ventricular/far-field

EGM options Store before onset; Store during charging

Flashback memory 2000 intervals (containing both A-A and V-V): before latest

Counter data

Detection counters Lifetime total, since cleared, and since last session

Episode counters Episodes:

Therapy efficacy counters Counts for each VF, FVT, VT Therapy:

Other stored data

Patient Alert events Up to 10 log entries: text and date for the first time an alert

single-channel EGM

does not usually store detailed episode records for NST episodes)

2 minutes of dual-channel EGM, or 3.6 minutes of single-channel EGM

VF, before latest VT, and before interrogation

•

Percentage pacing:

•

Additional counters:

•

Total number of aborted shocks

is triggered between interrogations

VF, FVT, and VT Atrial Fibrillation/Atrial Flutter episodes Sinus Tach episodes Other 1:1 SVT episodes NST episodes Mode switch episodes

AS-VS, AS-VP, AP-VS, AP-VP percentages

Single PVCs and PVC runs Rate stabilization pulses and runs

Delivered Successful Unsuccessful Intervention (manually aborted)

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Table 1-11. Stored data and diagnostics (continued)

1Quick reference

Stored data and diagnostics

Battery and lead measurements Battery voltage, last capacitor formation, last charge, lead

Lead performance trends 14 days of daily measurements plus 80 weeks of weekly

Cardiac Compass trends 14 months of measurement trends:

impedance, EGM amplitude measurements, last high voltage therapy, and sensing integrity counter

minimum and maximum measurements:

Lead impedance: atrial pacing, ventricular pacing,

•

defibrillation pathway, and SVC lead (if used) EGM amplitude: atrial (P-waves), ventricular

•

(R-waves)

VT and VF episodes per day

•

High voltage therapies delivered per day

•

Ventricular rate during VT or VF

•

Episodes of non-sustained tachycardia per day

•

Heart rate variability

•

Total daily time in AF or AT

•

Ventricular rate during AF or AT

•

Percent pacing per day

•

Patient activity

•

Average day and night ventricular heart rate

•

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

2The Intrinsic system

2.1 System overview 30

2.2 Indications and usage 33

2.3 Contraindications 33

2.4 Patient screening 33

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

Chapter 2

System overview

2.1 System overview

The Intrinsic and Intrinsic 30 Dual Chamber Implantable Cardioverter Defibrillator (ICD) systems are implantable medical device systems that automatically detect and treat episodes of ventricular fibrillation, ventricular tachycardia, fast ventricular tachycardia, and bradyarrhythmia. The device system includes three major components:

ICD

•

The ICD senses the electrical activity of the patient’s heart via the sensing electrodes of the implanted atrial and ventricular leads. It then analyzes the heart rhythm based on selectable sensing and detection parameters. If the device detects a tachyarrhythmia, it delivers defibrillation, cardioversion, or antitachycardia pacing therapy to the patient’s heart. If the device identifies a bradyarrhythmia, it delivers bradycardia pacing therapy to the patient’s heart.

Leads

•

The ICD can be used with transvenous or epicardial defibrillation leads. The lead system should consist of bipolar or paired unipolar1pacing/sensing leads in each chamber of the hear t and one or two high voltage cardioversion/defibrillation electrodes. You can program the Active Can device case as a high voltage electrode. The pacing and sensing electrodes in each chamber sense cardiac activity and deliver pacing stimuli.

Programmer and software

•

The Medtronic programmer and application software (Model 9997 for Intrinsic and Model 9996 for Intrinsic 30) allow you to perform the following tasks:

– configure the detection, therapy, and bradycardia features

for your patient

– perform electrophysiological studies and system tests

– monitor, display, or print patient cardiac activity

information

– view patient and device diagnostic data

With an appropriate unipolar to bipolar adapter kit.

INTRINSIC™/INTRINSIC™30 7288/7287 Reference Manual

+ 360 hidden pages

Medtronic 7288 Reference Guide

Specifications and Main Features

Frequently Asked Questions

User Manual