Medtronic 7290CX Reference Guide
ONYX™ VR 7290Cx
Single Chamber Implantable Cardioverter Defibrillator
(VVEV-VVIR) with 9999 software
System Reference Guide
Caution: Federal Law (USA) restricts this device to sale by or on
the order of a physician (or properly licensed practitioner).
Onyx™ VR Model 7290Cx
System Reference Guide
A guide to the operation
and programming of the
Onyx™ VR Model 7290Cx
Implantable Cardioverter
Defibrillator with
Model 9999 software
1
The following are trademarks of Medtronic:
Active Can, Medtronic CareLink, Flashback, Marker Channel, Medtronic,
Onyx, Patient Alert, QuickLink, Quick Look, T-Shock
1
Table of contents
1. Quick reference
Table of contents
Introduction ix
Abbreviations and Acronyms xi
Primary capabilities 1-2
Physical characteristics 1-5
Electrical characteristics 1-6
Magnet application 1-11
Emergency settings 1-12
Programmable parameters overview 1-13
Detection parameters 1-14
Therapy parameters 1-15
Bradycardia pacing parameters 1-17
Automatic Capacitor Formation parameters 1-18
Data collection parameters 1-19
Patient Alert monitoring system parameters 1-20
Patient Information parameters 1-21
EP studies parameters 1-22
Fixed parameters 1-24
Notes 1-25
2. Emergency therapy
Therapy overview 2-2
Effect on system operation 2-2
On-screen and display panel buttons 2-3
Emergency defibrillation 2-4
Emergency cardioversion 2-5
Emergency Fixed Burst pacing 2-6
Emergency VVI pacing 2-7
3. System overview
System description 3-2
Detection and therapy overview 3-4
Disabling detection and therapies 3-6
4. Tachyarrhythmia detection
Sensing 4-2
VF detection 4-5
VT detection 4-8
Combined Count detection 4-11
VT Stability option 4-13
Onyx VR System Reference Guide v
Table of contents
EGM Width criterion 4-15
FVT detection 4-21
Termination and redetection 4-26
5. Tachyarrhythmia therapies
High voltage therapy overview 5-2
Defibrillation 5-8
Cardioversion 5-15
Antitachycardia pacing therapy overview 5-19
Programming ATP therapies 5-21
Burst pacing 5-23
Ramp pacing 5-25
Ramp+ pacing 5-27
Smart Mode 5-29
Progressive Episode Therapies 5-32
6. Bradycardia pacing
Pacing mode 6-2
Bradycardia pacing parameters 6-4
Post Shock Pacing parameters 6-7
Rate responsive pacing 6-9
Hysteresis 6-15
Ventricular Rate Stabilization 6-18
7. Programmer and software
Setting up and using the programmer 7-2
Using the programmer display screen 7-12
Starting a patient session 7-22
Programming parameter values 7-25
Live Rhythm Monitor 7-27
Recording live waveforms 7-42
Printing reports 7-46
Preferences 7-51
Changes This Session 7-54
Ending a patient session 7-55
8. Conducting system tests
System tests overview 8-2
Underlying Rhythm test 8-3
Pacing Threshold test 8-4
Lead Impedance test 8-6
EGM Width test 8-9
Manual EGM Amplitude test 8-13
Test Charge/Dump 8-15
vi Onyx VR System Reference Guide
Capacitor Formation 8-17
9. EP studies
EP studies overview 9-2
Delivering inductions 9-5
T-Shock induction 9-7
50 Hz Burst induction 9-8
Manual Burst induction 9-8
PES induction 9-9
Delivering manual therapies 9-10
Manual ATP (Antitachycardia Pacing) therapies 9-12
10. Data collection
Data collection overview 10-2
Quick Look 10-4
Setting up data collection 10-6
Counter data 10-10
Episode Data 10-14
Patient Information 10-27
Battery and Lead Measurements 10-31
Device Status Indicators 10-33
Saving and retrieving ICD data 10-35
Table of contents
11. Patient Alert monitoring system
Patient Alert setup 11-2
Instructions for the patient 11-7
Instructions for clinic personnel 11-9
Patient Alert event log 11-10
12. Implant and follow-up
Pre-Implant information 12-2
Operative set-up 12-3
Surgical approach 12-5
Sensing and pacing measurements 12-7
Defibrillation testing 12-8
Placing the ICD 12-14
Replacing the ICD 12-15
Pre-discharge evaluation 12-16
Follow-up recommendations 12-17
A. Appendix A - Warnings and precautions
General warnings A-2
Sterilization, storage, and handling A-2
Implantation and ICD programming A-3
Onyx VR System Reference Guide vii
Table of contents
Lead evaluation and lead connection A-4
Follow-up testing A-5
ICD explant and disposal A-6
Environmental and medical therapy hazards A-7
Home and occupational environments A-9
B. Appendix B - Parameter interlocks
Bradycardia pacing parameter interlocks B-2
Detection parameter interlocks B-3
Resolving Tachy/Brady parameter interlocks B-4
G. Glossary
I. Index
viii Onyx VR System Reference Guide
Introduction
Introduction
Before implanting the ICD, it is strongly recommended that you follow
these instructions:
■
Refer to the product Implant Manual (included in the ICD package) for
information about ICD indications.
■
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 information
packaged with the ICD.
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.
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.
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.
Onyx VR System Reference Guide ix
1
Introduction
References
Automatic defibrillation was invented and patented in 1953 by Dr. F.
Zacouto, who designed an external device that delivered a defibrillation
impulse to the heart upon detection of very rapid ECG activity in
combination with the absence of arterial pulsations.
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 CardioverterDefibrillator. 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.
x Onyx VR System Reference Guide
1
Notice
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.
Abbreviations and Acronyms
ATP Antitachycardia Pacing
BOL Beginning of Life
bpm beats per minute
CNID Combined (VT and VF) Number of Intervals to Detect
CV Cardioversion
DF/Defib Defibrillation
ECG Electrocardiogram
EGM Electrogram
EOL End of Life
ERI Elective Replacement Indicator
FDI Fibrillation Detection Interval
FTI Fast Ventricular Tachycardia Detection Interval
FVT Fast Ventricular Tachycardia
ICD Implantable Cardioverter-Defibrillator
J joules
-1
min
ms milliseconds
mV millivolts
NID Number of Intervals to Detect
PES Premature Electrical Stimulation
POR Power On Reset
ppm paces or pulses per minute
PVC Premature Ventricular Contraction
RCNID Combined (VT and VF) Number of Intervals to Redetect
RNID Number of Intervals to Redetect
RR R-R interval; a ventricular interval
SVT Supraventricular Tachycardia
TDI Tachycardia Detection Interval
Vvolts
V. Ventricular
VF Ventricular Fibrillation
VF NID VF Number of Intervals to Detect
VF RNID VF Number of Intervals to Redetect
reciprocal minutes; for example, pacing pulses per minute
Abbreviations and Acronyms
Onyx VR System Reference Guide xi
1
Abbreviations and Acronyms
VRS Ventricular Rate Stabilization
VT Ventricular Tachycardia
VT NID VT Number of Intervals to Detect
VT RNID VT Number of Intervals to Redetect
xii Onyx VR System Reference Guide
1
Quick reference
1
Primary capabilities 1-2
Physical characteristics 1-5
Electrical characteristics 1-6
Magnet application 1-11
Emergency settings 1-12
Programmable parameters
overview 1-13
Detection parameters 1-14
Therapy parameters 1-15
Bradycardia pacing
parameters 1-17
Automatic Capacitor
Formation parameters 1-18
Data collection parameters 1-19
Patient Alert monitoring
system parameters 1-20
Patient Information
parameters 1-21
EP studies parameters 1-22
Fixed parameters 1-24
Notes 1-25
Onyx VR System Reference Guide 1-1
1
Quick reference
Primary capabilities
Primary capabilities
39 cc Active Can device, 77 g (see page 1-5).
Tachyarrhythmia detection
■
Ventricular fibrillation and ventricular tachycardia detection (VF, VT, and FVT)
■
Single chamber VT Stability criterion
■
Single chamber EGM Width criterion
Tachyarrhythmia therapy
■
Up to six each automatic VF, VT, and FVT therapies
■
Ventricular defibrillation and cardioversion, 30 J delivered (see Table 1-7)
■
50% tilt biphasic waveform (see “Waveform” on page 5-7)
■
Burst, Ramp, and Ramp+ antitachycardia pacing
■
Smart Mode disables ineffective ATP therapies
■
Progressive Episode Therapies ensures increasingly aggressive therapy sequencing
Pacing management
■
Rate responsive bradycardia pacing up to 150 ppm (min-1): VVIR mode
■
Ventricular Rate Stabilization after short ventricular intervals
■
Single chamber hysteresis
1-2 Onyx VR System Reference Guide
1
Patient management
■
Audible Patient Alert monitoring system
■
Automatic, painless pacing and HV lead impedance testing
■
Programmer-assisted EGM Amplitude Test (see page 8-13)
■
Patient Information that can be entered, viewed, and printed via the programmer
■
Two simultaneous real-time EGMs: ventricular/far-field
■
Two channels stored EGM: ventricular/far-field
■
Marker Channel telemetry
■
256 Kbyte data storage – two EGMs, Markers, and Flashback Memory of V-V intervals
■
Save-to-Disk and Read-from-Disk patient data features
Tab le 1- 1. Onyx VR data collection summary
Tachy episodes
SVT/NST episodesa50 SVT/NST episodes: SVT text, stored EGM, intervals,
EGM capacity 12 minutes (2 channels) or 22 minutes (1 channel)
EGM sources Four options: ventricular near-field or far-field
EGM options Store before onset; Store during charging
Flashback Memory 1000 V-V intervals: before latest VF, before latest VT,
Detection counters Lifetime total, Since cleared, and Since last session
Episode counters - VF, FVT, and VT
a
150 VF/VT/FVT episodes: text, stored EGM, intervals,
QRS Snapshot
QRS Snapshot
b
b
, NST episode summary
and before interrogation
- Non-sustained tachy episodes and SVTs
- Single PVCs and PVC runs
- Rate stabilizations, pulses and runs
- Percentage paced/sensed rhythm
Quick reference
Primary capabilities
Therapy Efficacy
Counters
Counts for each VF, FVT, VT Therapy:
- Delivered
- Successful
- Unsuccessful
- Intervention
Total number of aborted shocks
Patient Alert Events Up to 10 log entries: text and date for the first time an
alert is triggered between clearing the log entries.
a
All tachy, NST, and SVT episode data is stored in the same block of memory.
b
For VT episodes, when EGM Width criterion is On or Passive.
Onyx VR System Reference Guide 1-3
1
Quick reference
Primary capabilities
Other features
■
Direct replacement for DF-1/IS-1 systems, including all Medtronic “C,” “CX,” and “D” ICDs
■
Medtronic icon-based programmer software interface
■
Quick Look programming summary, with QuickLink to stored episodes and observations
■
Chart ready full-size report printing (Refer to the reference manual provided with your programmer)
■
Non-invasive EP Study functions: ventricular inductions/manual therapies.
■
Auto-Resume feature automatically resumes detection after an induction (see “Auto-Resume” on
page 9-3)
■
Smart Auto Cap Formation extends the formation timer after therapeutic charging
1-4 Onyx VR System Reference Guide
1
Physical characteristics
Tabl e 1-2. Onyx VR physical characteristics
Volume 39 cc
Mass 77 g
H x W x D
Surface area of device can 69.0 cm
Radiopaque IDb
Materials in contact with human
tissue
Battery Lithium silver vanadium oxide
Connector configuration One IS-1 connector for pacing and sensing,
a
c
Quick reference
Physical characteristics
69.3 mm x 50.8 mm x 13.5 mm
2
PRP
Titanium/polyurethane/silicone rubber
Two DF-1 connectors for high voltage
therapy, Active Can electrode
SVC
(HVX)
IS-1 V
RV
(HVB)
DF-1
Can (HVA)
a
This measurement refers to the thickness (depth) of the can; grommets may protrude slightly
beyond the surface.
b
Engineering series number follows the radiopaque code.
c
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.
Onyx VR System Reference Guide 1-5
1
Quick reference
Electrical characteristics
Electrical characteristics
Longevity
Table 1-3 below provides longevity estimates based on accelerated battery discharge data and device
modeling with the following programmed values:
■
60 ppm (min-1) pacing rate
■
2 V pacing pulse amplitude
■
0.6 ms pacing pulse width
■
30 J delivered therapy energy
■
six-month automatic capacitor formation intervals
Note: The EGM pre-storage feature is set to Off.
1
Tab le 1- 3. Onyx VR Projected longevity in years with 2 V pacing pulse
Percent
pacing
0% Semi-annual 7.0 7.0
15% Semi-annual 6.9 7.0
50% Semi-annual 6.6 6.7
100% Semi-annual 6.1 6.5
1.
With two-month extensions per 30 J charge (maximum of 12 months between formations). Therapeutic charging is in addition to
capacitor formations.
amplitude and 0.6 ms pacing pulse width
Therapeutic shock
frequency
Quarterly 6.4 6.4
Quarterly 6.3 6.3
Quarterly 6.0 6.2
Quarterly 5.7 6.0
500 Ω pacing
impedance
900 Ω pacing
impedance
1-6 Onyx VR System Reference Guide
1
Quick reference
Electrical characteristics
Table 1-4 below provides longevity estimates based on accelerated battery discharge data and device
modeling with the following programmed values:
■
60 ppm (min-1) pacing rate
■
3 V pacing pulse amplitude
■
0.4 ms pacing pulse width
■
30 J delivered therapy energy
■
six-month automatic capacitor formation intervals
1
Note: The EGM pre-storage feature is set to Off.
.
Tabl e 1-4. Onyx VR projected longevity in years with 3V pacing pulse
amplitude and 0.4 ms pacing pulse width
Percent
pacing
0% Semi-annual 7.0 7.0
15% Semi-annual 6.7 6.9
50% Semi-annual 6.0 6.5
100% Semi-annual 5.4 6.0
Therapeutic shock
frequency
500 Ω pacing
impedance
900 Ω pacing
impedance
Quarterly 6.4 6.4
Quarterly 6.2 6.3
Quarterly 5.6 6.0
Quarterly 5.0 5.5
1.
With two-month extensions per 30 J charge (maximum of 12 months between formations). Therapeutic charging is in addition to
capacitor formations.
Onyx VR System Reference Guide 1-7
1
Quick reference
Electrical characteristics
The following factors result in decreased longevity:
■
an increase in pacing rate, pacing amplitude or pulse width, the ratio of bradycardia paced to sensed
events, or the charging frequency
■
a decrease in pacing impedance
■
using the pre-onset EGM storage feature or Holter telemetry.
To maximize ICD longevity:
■
Optimize pacing rate and output parameters for the patient.
■
Set the delivered energy value for the first programmed high voltage therapy to a value lower than
maximum energy.
■
Set the automatic capacitor formation interval to a longer value (unless a shorter interval is required
to maintain clinically acceptable charge times).
■
Use the pre-onset EGM storage feature and Holter telemetry only for short periods of time.
Battery voltage
Battery voltage appears on the programmer display and on printed reports. For more information, see
“Replacement indicators” on page 12-18 and “Preparing the ICD for implant” on page 12-4.
Tab le 1- 5. Battery voltage Indicators
Elective Replacement (ERI)
a
≤ 2.55 V
Pacing mode and rate (magnet and non-magnet) as programmed
End of Life (EOL)
b
≤ 2.40 V
Pacing mode and rate (magnet and non-magnet) as programmed
a
The minimum time between ERI and End of Life is three months, assuming 100% VVI pacing
at 60 ppm (min
b
When the battery reaches EOL, immediate replacement is recommended. See also “Charge
Circuit Inactive” on page 5-4.
-1
), 3 V, 0.4 ms; 510 Ω pacing load; and six 30 J charges.
1-8 Onyx VR System Reference Guide
1
Quick reference
Electrical characteristics
Charge time
The high voltage capacitors charge more rapidly just following a capacitor formation, when they are fully
formed. Between formations, the capacitors gradually deform, resulting in longer charge times toward the
end of the formation interval. See “Using Automatic Capacitor Formation to manage charge time” on
page 8-17 for information on managing charge time. Also, see “Test Charge/Dump” on page 8-15 for
instructions on using the Test Charge feature to measure charge time. Table 1-6 provides typical full
energy charge times at BOL and ERI based on the time interval since the last capacitor formation. A full
energy charge is any charge to full energy (either via a capacitor formation or therapy delivery).
Tab le 1- 6. Typical Full Energy (30 J Delivered) charge times
Capacitors
fully formed
At Beginning of Life
(BOL)
Near Elective
Replacement Indicator
(ERI)
a
Typical values for stated conditions, actual charge time performance may vary.
6 seconds ≈ 1 second
14 seconds ≈ 1 seconds
1 month after
capacitor
formation
longer than
fully formed
longer than
fully formed
a
6 months
after
capacitor
formation
≈ 2 seconds
longer than
fully formed
≈ 5 seconds
longer than
fully formed
Onyx VR System Reference Guide 1-9
1
Quick reference
Electrical characteristics
High voltage therapy energy
Table 1-7 compares delivered energy levels to energy levels stored by the device.
Note: The stored energy of the device is derived from the peak capacitor voltage and is always greater
than the energy delivered by the device.
Tab le 1- 7. Comparing programmed (actual delivereda) and storedb energy levels
Programmed (Actual
Delivered) Energy (J)
0.4 0.5 .09 9 11 1.94
0.6 0.8 .13 10 12 2.16
0.8 1.0 .17 11 13 2.38
1.0 1.2 .22 12 14 2.59
1.2 1.5 .26 13 15 2.81
1.4 1.7 .30 14 16 3.02
1.6 2.0 .35 15 18 3.24
1.8 2.2 .39 16 19 3.46
2 2.4 .43 18 21 3.89
3 3.6 .65 20 24 4.32
4 4.7 .86 22 26 4.75
5 5.9 1.08 24 28 5.18
6 7.1 1.30 26 31 5.62
7 8.3 1.51 28 33 6.05
8 9.4 1.73 30 35 6.48
a
Energy and voltage delivered at connector block into a 75 Ω load.
b
Energy stored at end of charge on capacitor.
c
Typical charge time at BOL, with fully formed capacitors.
Stored
Energy (J)
Charge
Time
c
(sec)
Programmed (Actual
Delivered) Energy (J)
Stored
Energy (J)
Charge
Time
c
(sec)
1-10 Onyx VR System Reference Guide
1
Quick reference
Magnet application
Magnet application
Applying a magnet closes a reed switch within the ICD. When the magnet is removed, the ICD returns to
its programmed operations.
Tab le 1- 8. Effects of magnet application
Pacing Mode As programmed
Pacing Rate and Interval As programmed
VF, VT, and FVT Detection and
Therapy
Patient Alert
Audible Tones
a
The programming head contains a magnet which can suspend detection. However, if the
Resume option in the programmer has been enabled, detection will remain enabled.
b
The alert sounds only if the Patient Alert is programmed On for any alert except POR. A POR
alert causes an alarm every 20 hours, even if Patient Alert is programmed to Off.
b
Suspended
(30 seconds or less)
Continuous tone (alarm OK)
On/Off intermittent tone (seek follow-up)
High/Low dual tone (urgent follow-up)
a
Onyx VR System Reference Guide 1-11
1
Quick reference
Emergency settings
Emergency settings
The table below lists the values that can be selected for the ICD emergency therapy parameters. Default
values are highlighted in bold, italicized text. The Notes column lists letters that correspond to notes on
page 1-25.
Tabl e 1-9. Emergency therapy parameters
Parameter Selectable values (and default value)Notes
Defibrillation
Energy (J) 10, 11, . . ., 16,
Pathway AX→B
Cardioversion
Energy (J) 0.4, 0.6, . . ., 1.8,
Pathway AX→B
Fixed Burst
Pacing Interval (ms) 100, 110, . . ., 350,
Pulse Amplitude (V) 8
Pulse Width (ms) 1.6
18, 20, . . ., 30
2, 3, . . ., 16
18, 20, . . ., 30
360, 370, . . ., 600
VVI Pacing
Pacing Mode VVI
Lower Rate (ppm, min
Vent. Rate Stabilization Off
Hysteresis Off
Sensitivity As programmed
Pulse Amplitude (V) 8
Pulse Width (ms) 1.6
Pace Blanking (ms) 320
Post Shock Pace Blanking (ms) 320 A.
-1
)70
1-12 Onyx VR System Reference Guide
1
Programmable parameters overview
Quick reference
Programmable parameters overview
The tables that follow (Table 1-10 to Table 1-17) list the values that can be selected for all ICD
programmable parameters. As applicable, these tables also indicate the Medtronic nominal value, the
POR value, and the shipped value for each parameter.
Medtronic nominal values – These values are suggested settings for parameters under nominal
conditions. Medtronic nominal values, if applicable, are indicated in the Programmable Values column in
bold, italicized text.
POR values – These are the values to which the ICD resets parameters after a power-on reset (POR). If
a POR occurs, the ICD sounds a high-urgency Patient Alert tone every 20 hours. See the “Power-On
Reset recovery procedure” on page 10-34.
Shipped values – These are the programmed parameter values when the ICD is shipped from Medtronic.
The Notes column in each table lists letters that correspond to notes on page 1-25. These include
exceptions or clarifications that relate to the values listed in the programmable parameter tables.
Onyx VR System Reference Guide 1-13
1
Quick reference
Detection parameters
Detection parameters
Table 1-10. Detection parameters
Parameter Programmable values
(and Medtronic Nominal)
VF Detection parameters
Detection Enable On, Off On Off
Interval (ms) 240, 250 . . . 320,
330, 340, . . ., 400
Initial NID 12/16, 18/24, 24/32,
30/40, 45/60, 60/80,
75/100, 90/120,
105/140, 120/160
Redetect NID 6/8, 9/12, 12/16, 18/24,
21/28, 24/32, 27/36, 30/40
V. Sensitivity (mV) 0.15, 0.3, 0.45, 0.6,
0.9, 1.2
FVT Detection parameters
Detection Enable Off, via VF, via VT Off Off
Interval (ms) 200, 210, . . ., 600 — — C., F.
V. Sensitivity (mV) 0.15, 0.3, 0.45, 0.6,
0.9, 1.2
POR
value
320 320 C.
18/24 18/24 B.
12/16 12/16
0.3 0.3 D., E.
0.3 0.3 D., E.
Shipped
value
Notes
VT Detection parameters
Detection Enable On, Off Off Off
Interval (ms) 280, 290, . . ., 400,
Initial NID 12, 16, . . ., 52,
Redetect NID 4, 8, 12, . . ., 52 12 12
V. Sensitivity (mV) 0.15, 0.3, 0.45, 0.6,
VT Stability criterion parameters
VT Stability (ms) Off, 30, 40, . . ., 100 Off Off C.
EGM Width criterion parameters
EGM Width Enable On, Passive, Off Off Off G.
Slew threshold (mV/sec) 18, 24, 30, . . ., 144 30 30
Width threshold (ms) 24, 28, 32, . . ., 80, . . ., 152 80 80
1-14 Onyx VR System Reference Guide
1
400 400 C.
410, 420, . . ., 600
16 16
76, 100
0.3 0.3 D., E.
0.9, 1.2
Quick reference
Therapy parameters
Therapy parameters
Table 1-11. Therapy parameters (Sheet 1 of 2)
Parameter Programmable values
(and Medtronic Nominal)
VF therapy parameters
Therapy Status On, Off On (all) On (all)
Energy (J) 0.4, 0.6, . . ., 1.8,
2, 3, . . ., 16,
18, 20, . . ., 30
Pathway AX→B, B→AX AX→B
Reconfirm VF Yes , No Yes Yes L.
VT and FVT therapy parameters
Cardioversion therapy parameters
Therapy Status On, Off — —
Energy (J) 0.4, 0.6, . . ., 1.8,
2, 3, . . ., 16,
18, 20, . . ., 30
Pathway AX→B, B→AX — — I.
POR
value
30 (all) 30 (all) I., J., K.
(all)
— — I., K.
Shipped
value
AX→B
(all)
Notes
I.
Burst Pacing therapy parameters
Therapy Status On, Off — —
Initial # Pulses 1, 2, . . ., 6, . . ., 15 — — I.
R-S1 Interval
(% of R-R)
Pacing Interval Decrement (ms) 0, 10, . . ., 40 — —
# Sequences 1, 2, 3, . . ., 10 — —
Smart Mode On, Off ——M.
50, 53, 56, 59,
63, 66, . . ., 84,
88, 91, 94, 97
—— I.
Onyx VR System Reference Guide 1-15
1
Quick reference
Therapy parameters
Table 1-11. Therapy parameters (Sheet 2 of 2)
Parameter Programmable values
Ramp Pacing therapy parameters
Therapy Status On, Off — —
Initial # Pulses 1, 2, . . ., 8, . . ., 15 — — I., X.
R-S1 Interval
(% of R-R)
Pacing Interval Decrement (ms) 0, 10, . . ., 40 — — I.
# Sequences 1, 2, 3, . . ., 10 — —
Smart Mode On, Off ——M.
Ramp+ Pacing therapy parameters
Therapy Status On, Off — —
Initial # Pulses 1, 2, 3, . . ., 15 — — I.
R-S1 Interval
(% of R-R)
S1-S2 Interval
(% of R-R)
S2-Sn Interval
(% of R-R)
# Sequences 1, 2, . . ., 5, . . ., 10 — —
Smart Mode On, Off ——M.
(and Medtronic Nominal)
50, 53, 56, 59,
63, 66, . . ., 84,
88, 91, 94, 97
50, 53, 56, 59,
63, 66, . . ., 75, . . ., 84,
88, 91, 94, 97
50, 53, 56, 59,
63, 66, 69, . . ., 84,
88, 91, 94, 97
50, 53, 56, 59,
63, 66, . . ., 84,
88, 91, 94, 97
POR
value
— — I., X.
—— I.
—— I.
—— I.
Shipped
value
Notes
Shared Parameters for Tachyarrhythmia therapies
Shared by all Automatic ATP therapies I.
V. Pulse Width (ms) 0.03, 0.06,
V. Amplitude (V) 1, 2, . . ., 6, 8 88
V. Pace Blank (ms) 150, 160, . . ., 240, . . ., 440 240 240
ATP Minimum Interval (ms) 150, 160, . . ., 200, . . ., 400 200 200
Shared by all VF, VT, and FVT therapies
Progressive Episode
Therapies Enable
0.1, 0.2, . . ., 1.6
On, Off Off Off
1-16 Onyx VR System Reference Guide
1
1.6 1.6
Bradycardia pacing parameters
Bradycardia pacing parameters
Tab le 1- 12. Bradycardia pacing parameters (Sheet 1 of 2)
Parameter Programmable values
Pacing Mode VVIR, VVI VVI VVI
Lower Rate (ppm, min
Upper Sensor Rate
(ppm, min
Sensitivity (mV) 0.15, 0.3, 0.45, 0.6,
Pulse Width (ms) 0.03, 0.06,
Pulse Amplitude (V) 1, 2, 3, . . ., 6, 8 8 3
Pace Blanking (ms) 150, 160, . . ., 200,
-1
)
-1
) 34, 35, 40, . . ., 60,
(and Medtronic Nominal)
70, 75, . . ., 105,
109, 115, 120
80, 85, . . ., 105,
109, 115, 120, 125, 130, 136,
140, 146, 150
0.9, 1.2
0.1, 0.2, . . ., 0.4,
0.5, 0.6, . . . , 1.6
210, 220, . . ., 440
POR
value
65 40 H.
120 120 H.
0.3 0.3 D., E.
1.6 0.4
320 200
Quick reference
Shipped
value
Notes
Post-Shock Pacing parameters
Pulse Width (ms) 0.03, 0.06,
Pulse Amplitude (V) 1, 2, 3, 4, 5, 6, 886
Pace Blanking (ms) 150, 160, . . ., 200,
Rate Response Pacing parameters
Rate Response 1, 2, . . ., 7, 8, 9, 10 7 7
Activity Threshold Low, Medium Low,
Activity Acceleration (sec.) 15, 30, 60 30 30
Activity Deceleration (min.) Exercise, 2.5, 5, 10 5 5
Hysteresis
Enable-Rate (bpm, min
-1
) Off, 34, 40, 50, 60, 70, 80 Off Off N.
0.1, 0.2, . . ., 1.6
210, 220, . . ., 440
Medium,
Medium High, High
1.6 1.6
320 200
High Medium
Onyx VR System Reference Guide 1-17
1
Quick reference
Automatic Capacitor Formation parameters
Tabl e 1 -12. Bradycardia pacing parameters (Sheet 2 of 2)
Parameter Programmable values
(and Medtronic Nominal)
Ventricular Rate Stabilization parameters
Enable On, Off Off Off
Interval Increment (ms) 50, 60, . . ., 150,
160, 170, . . ., 400
Minimum Interval (ms) 500, 550, . . ., 900 500 500
POR
value
150 150
Automatic Capacitor Formation parameters
Table 1-13. Automatic Capacitor Formation parameters
Parameter Programmable values
Automatic Capacitor Formation
Interval (months)
(and Medtronic Nominal)
Off, 1, 2, . . ., 6 6OffO.
POR
value
Shipped
Shipped
value
value
Notes
Notes
1-18 Onyx VR System Reference Guide
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