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Pacemaker
Information and
PROGRAMM ER
Programming
Guide
9879E Software
Use to program the
following pacemakers
including the i series:
THERA®DR
THERA®D
THERA®VDD
THERA®SR
THERA®S
CAUTION: The Thera®VDD and Thera®VDD (i series) pacemakers
are not currently approved by the FDA.
Medtronic
¨
THERA¨Pacemaker Information
And Programming Guide
A Guide To Understanding Thera¨Pacemakers
And Using The 9760 and 9790 Programmers
© Medtronic, Inc. 1995
All Rights Reserved
Printed In USA
How To Use This Guide
The 9790/9760 Pacemaker Information and Programming Guide is the
reference manual of the two-manual set supporting the THERA®*
pacemakers. Each Thera pacemaker also has its own product information
manual packaged with the device. This guide provides comprehensive
information about the Thera pacing systems: Medtronic®Thera
pacemakers, 9760 and 9790 Programmers, and leads.**
Organization of this guide divides information about the Thera pacing
system into three major parts as follows:
Part I — This part describes the programmer capabilities. It provides
instructions on how to set up the programmer and apply its functions for
programming applicable pacemaker features and retrieving data.
Part II — This part describes all pacemaker parameters and features,
including pacing modes, rate response options, special therapy options,
diagnostic reporting features, and information for troubleshooting the
pacing system. It supplements the product information manual, which gives
information needed primarily at pacemaker implantation. In this part, the
clinical intent of Thera-specific features is described, as well as illustrations
of operation and programming considerations useful in the follow-up
setting.
NOTE: Part II provides all possible pacing and programming features for
the Thera pacemaker families without any specific reference to the models.
Refer to Part III to determine which features apply to specific Thera
pacemaker models.
Part III — This part includes quick-reference information organized by
topic or feature. To find information on a specific pacemaker model, look
under each topic. Of particular help are “Modes and Parameters” and
“Diagnostics,” which identify which features (presented in Part II) are
applicable to each Thera pacemaker model.
* Thera, CapSure, Marker Channel, Medtronic, MemoryMod, and Teletrace are all
trademarks of Medtronic, Inc.
**Lead information provided describes pacemaker compatibility. Details are provided in the
applicable lead technical manual.
iii
Table of Contents
Part I Using the Programmer
Chapter 1 - Using the Programmer with THERA¨Pacemakers 1-1
When to Use Part I of this Manual ...................................1-2
Conventions Used in Part I of this Manual..............................1-3
General Warnings and Precautions ...................................1-4
Display Screen Format and Interactive Features..........................1-5
A Guide to Using the Menu and Command Buttons .......................1-8
Chapter 2 - Procedures to Know Before You Begin 2-1
Using the Programming Head.......................................2-2
Programming Emergency Parameters .................................2-6
Interrogating the Pacemaker........................................2-7
Canceling the Programming Head Magnet..............................2-9
Printing Reports During a Patient Session .............................2-10
Printing Reports After a Session Has Ended............................2-13
Transferring Session Data to a Diskette ...............................2-13
Using the HELP Options .........................................2-16
Chapter 3 - Starting and Ending a Patient Session 3-1
Before You Begin ...............................................3-2
Turning the Programmer ON .......................................3-3
Selecting the Pacemaker Model .....................................3-4
Selecting the Desired Function ......................................3-7
Ending a Patient Session ..........................................3-9
Chapter 4 - Retrieving Pacing System Data 4-1
Displaying Present Parameter Settings ................................4-2
Displaying a Summary of Pacemaker Status ............................4-6
Displaying Battery and Lead Information .............................4-10
Displaying a Graph of Recorded Diagnostic Data........................4-13
Chapter 5 - Displaying and Printing the PatientÕs ECG and EGM 5-1
Printing the Patient’s ECG and EGM.................................5-2
Displaying the Patient’s ECG and EGM...............................5-5
v
Freezing the ECG Trace..........................................5-10
Displaying a Marker Channel™ Diagram .............................5-14
Chapter 6 - Programming Pacing Parameters 6-1
Programming Pacing Parameters ....................................6-2
Programming Additional Parameters.................................6-10
Chapter 7 - Determining and Evaluating Parameter Settings 7-1
Measuring Stimulation Thresholds ...................................7-2
Determining a Setting for Sensitivity.................................7-15
Determining Rate Response Parameter Settings .........................7-21
Programming Temporary Parameter Values............................7-30
Measuring Rate and AV Interval....................................7-33
Chapter 8 - Collecting and Retrieving Diagnostic Data 8-1
About the Diagnostics Function .....................................8-2
Types of Data You Can Record .....................................8-3
Recording Data From a Non-Paced Chamber...........................8-16
Programmable Parameter Options...................................8-18
About the Setup Options .........................................8-21
Programming the Pacemaker to Record Data ...........................8-23
Displaying a Graph of the Recorded Data .............................8-27
Printing the Diagnostic Data.......................................8-29
Clearing Recorded Data From the Pacemaker ..........................8-30
Chapter 9 - Programmer Setup Options 9-1
Setting the Time and Date .........................................9-2
Connecting an External Recorder or Monitor............................9-3
Using the CALIBRATE Option .....................................9-4
Setting Up Site Nominal Parameter Values .............................9-6
Setting the Artifact Display .......................................9-10
Part II Understanding Pacemaker Operation
Chapter 10 - Pacing Modes 10-1
Introduction ..................................................10-3
Mode Selection Decision Tree .....................................10-5
Mode Pertinency Tables..........................................10-6
DDDR Mode..................................................10-8
vi
DDD Mode ..................................................10-10
DDIR Mode .................................................10-12
DDI Mode...................................................10-14
DVIR Mode .................................................10-16
DVI Mode...................................................10-18
VDD Mode ..................................................10-20
AAIR/ADIR Modes............................................10-22
AAI/ADI Modes ..............................................10-24
VVIR/VDIR Modes............................................10-26
VVI/VDI Modes ..............................................10-28
AAT/VVT Modes .............................................10-30
DOOR/AOOR/VOOR Modes.....................................10-32
DOO/AOO/VOO Modes ........................................10-34
ODO/ OAO/ OVO Modes .......................................10-36
Chapter 11 - Rate Response Therapy Options 11-1
Rate Responsive Pacing ..........................................11-2
Activity Threshold..............................................11-4
Activity Rate Response ..........................................11-6
Acceleration and Deceleration Times ................................11-8
Rate Response Optimization......................................11-11
Chapter 12 - Pacemaker Timing 12-1
Rates .......................................................12-2
AV Intervals ..................................................12-8
Blanking Periods ..............................................12-14
Refractory Periods .............................................12-16
High Rate Atrial Tracking .......................................12-23
Chapter 13 - Lead/Cardiac Tissue Interface 13-1
Selecting Pacing Parameters.......................................13-2
Selecting Sensing Parameters ......................................13-5
Monitoring Lead Stability ........................................13-8
Transtelephonic Capture Verification with TMT .......................13-11
Chapter 14 - Special Therapy Options 14-1
Mode Switch..................................................14-2
Non-Competitive Atrial Pacing.....................................14-7
PMT Intervention ..............................................14-9
PVC Response................................................14-11
Ventricular Safety Pacing........................................14-13
Rate Drop Response............................................14-15
vii
Sleep Function................................................14-21
Single Chamber Hysteresis.......................................14-23
Chapter 15 - Telemetry Data 15-1
Parameter Summary.............................................15-2
Battery and Lead Information ......................................15-4
Marker Channel™ Telemetry ......................................15-6
Intracardiac Electrogram (EGM)....................................15-8
Extended Telemetry............................................15-10
Chapter 16 - Miscellaneous Operations 16-1
Magnet Mode Operation .........................................16-2
Temporary Programming .........................................16-5
Electrical Reset ................................................16-6
Elective Replacement Indicator (ERI) ................................16-8
Emergency Pacing ..............................................16-9
Chapter 17 - Diagnostics 17-1
Introduction to Diagnostics........................................17-2
Event Summary................................................17-4
Rate Histogram ................................................17-6
AV Conduction Histogram........................................17-8
High Rate Episode .............................................17-10
Rate Versus Time Trend.........................................17-14
viii
Chapter 18 - Troubleshooting the Pacing System 18-1
Troubleshooting Strategy .........................................18-2
Troubleshooting Electrical Problems.................................18-3
Troubleshooting Hemodynamic Problems .............................18-5
Handling, Storage, and Resterilization................................18-7
Pacemaker Longevity............................................18-8
Replacing the Pacemaker ........................................18-10
Patient Information and Service ...................................18-11
PART III THERA¨Reference Information
Section A - Basic Description, Radiopaque Identification, Mechanical
Dimensions, Lead Compatibility, and Pacemaker Connectors A-1
Basic Description ...............................................A-2
Radiopaque Identification .........................................A-4
Mechanical Dimensions ..........................................A-5
Lead Compatibility ..............................................A-7
Pacemaker Connectors ...........................................A-8
Section B - Shipping, Nominal, Electrical Reset, and
Emergency Parameters B-1
Shipping Parameter Settings .......................................B-2
Nominal Parameter Settings........................................B-4
Electrical Reset Parameter Settings ..................................B-6
Emergency Parameter Settings......................................B-9
Section C - Longevity Projections, Elective Replacement Indicator,
and Battery Specifications C-1
Longevity Projections ............................................C-2
Elective Replacement Indicator (ERI).................................C-8
Battery Specifications ............................................C-9
Section D - Magnet Mode Operations, Telemetry Functions,
Diagnostics, and Event Summaries D-1
Magnet Mode Operations .........................................D-2
Telemetry Functions .............................................D-3
Dual Chamber Pacemaker Diagnostics ................................D-4
Single Chamber Pacemaker Diagnostics...............................D-7
Event Summaries ...............................................D-9
Section E - Modes and Parameters, Programming Requirements and
Restrictions, and Timing Reference Table E-1
Dual Chamber Pacemaker Permanent Programmable Modes and Parameters.....E-2
Single Chamber Pacemaker Permanent Programmable Modes and Parameters....E-7
Programming Requirements and Restrictions ...........................E-9
Nonprogrammable Parameters .....................................E-12
Temporary Modes and Parameters ..................................E-13
Timing Reference Table .........................................E-14
Section F - General Warnings and Precautions F-1
General Warnings ...............................................F-2
General Precautions..............................................F-5
ix
Section G - Hospital, Medical, Home, and Job Environment Interference G-1
Hospital or Medical Environment Interference ..........................G-2
Home and Job Environment Interference ..............................G-5
General Recommendations ........................................G-6
Section H - General Pacing Indications H-1
Indications for Permanent Pacing in Acquired Atrioventricular Block in Adults . . H-2
Indications for Permanent Pacing After Myocardial Infarction ...............H-4
Indications for Permanent Pacing in Bifascicular and Trifascicular Block .......H-5
Indications for Permanent Pacing in Sinus Node Dysfunction ...............H-6
Indications for Permanent Pacing in Hypersensitive Carotid Sinus Syndrome and
Neurovascular Syndromes ........................................H-7
Indications for Permanent Pacing in Children ...........................H-8
Glossary I-1
Index J-1
x
Part I
USING THE
PROGRAMMER
Part I provides instructions for using the 9760 or 9790 programmer with
Æ
pacemakers, including the i series. Sections describe each of the
Thera
applicable programmer functions and present step-by-step procedures for
using these functions. The information in this section is organized in the
following order.
Introductory information (Chapter 1)
General procedures (Chapter 2)
Starting and ending a patient session (Chapter 3)
Retrieving pacing system data (Chapter 4)
Displaying and printing the patientís ECG and EGM (Chapter 5)
Programming pacing parameters (Chapter 6)
Determining and evaluating parameter settings (Chapter 7)
Using the diagnostic data recording function (Chapter 8)
Programming setup options, such as setting the time/date (Chapter 9)
Refer to Parts II and III for information about the operation of Thera
pacemakers.
CHAPTER 1
Using the Programmer
with THERA® Pacemakers
About This Chapter
This chapter introduces you to using the 9760 and 9790 programmers with
the TheraÆ and TheraÆ i series pacemakers by providing the following
information:
When to use Part I of this manual (see page 1-2).
The text format conventions used in Part I of this manual (see
page†1-3).
General warnings and precautions (see page 1-4).
The display screen format and interactive features (see page 1-5).
A guide to using the menu and command buttons (see page 1-8).
1-1
1-2 Using the Programmer
When to Use Part I of this Manual
Installation of the 9879E software adds several pacemaker family groups
to†the programming and follow-up capabilities of your 9760 or 9790 programmer. Several manuals now cover the use of your programmer, each
covering a specific set of pacemaker families and models.
Thera Pacemakers ó If you select one of the following Thera pacemaker models (note that they are listed on the front cover), refer to
Part†I of this manual for instructions on using the programmer. Refer
to†Parts II and III for specific Thera pacemaker information.
NOTE: Model numbers ending in the letter i designate the TheraÆ i
series of pacemakers. The instructions throughout Part I apply to both
the TheraÆ and the TheraÆ i series of pacemakers unless otherwise
noted.
_________________________________________________________
TheraÆ DR Models 7940, 7941, 7942
7950, 7951, 7952
7850, 7851, 7852
_________________________________________________________
7960i, 7961i, 7962i (i series)
TheraÆ
_________________________________________________________
TheraÆ
_________________________________________________________
TheraÆ
_________________________________________________________
TheraÆ
_________________________________________________________
Other Pacemaker Models ó If you select a pacemaker other than a
Thera model listed above, refer to the appropriate programming guide
supplied with the software presently installed in your programmer.
Refer to the front cover of the manual for a list of the pacemaker
families covered in that manual.
For detailed information on setting up the 9760 or 9790 programmer, refer
to the respective instruction manual, Programmer Description and Setup,
supplied with the programmer.
D Models 7944, 7945, 7946
7964i, 7965i, 7966i (i series)
VDD Model 8948
8968i (i series)
SR Models 8940, 8941, 8942
8960i, 8961i, 8962i (i series)
S Models 8944, 8945, 8946
8964i, 8965i, 8966i (i series)
Using the Programmer with TheraÆ Pacemakers 1-3
Conventions Used in Part I of this Manual
Part I uses the following text format conventions in the instructions for
using the programmer.
INTERROGATE
[
] Boldface small capitals within brackets denote an
on-screen button.
THRESHOLD TEST
1., 2., 3. Boldface numbers at the left column margin identify
Small italics
Boldface capitals without brackets denote a selectable screen option other than a button.
instructional steps.
This symbol identifies a single instructional
statement.
This symbol is used as a bullet indicating itemized
statements or paragraphs.
Small italics are used in side notes that pertain to an
adjacent figure.
1-4 Using the Programmer
General Warnings and Precautions
These warnings and precautions apply in general to using the 9760 and
9790 programmers.
Warnings
Pacemaker programming should be done only after careful study of the
pacemaker technical manual and the applicable portions of this manual and
after careful determination of appropriate parameter settings. Improper use
of the programmer could result in erroneous or inadvertent programming
and improper operation of the telemetry and measurement functions.
The 9760 and 9790 programmers must be used only for programming
Medtronic pacemakers listed as applicable units for the software being
used. Direct stimulation via energy coupling may occur if either programmer is used on other implanted devices. These programmers are not compatible with programmable devices of other manufacturers.
Precautions
Loss of Power ó If power to the programmer is unexpectedly lost, lifting
the programming head from over the patientís pacemaker cancels any
temporary parameters or functions in effect and restores the pacemaker to
its†permanently programmed state.
Unresponsive Screen ó In the unlikely event the programmer display
screen becomes unresponsive or ìlocked,î turn the programmer off, wait
5†seconds, then turn the programmer on. Normal programmer operation
should resume. Following successful completion of the self test, reselect
the†pacemaker model to continue with the application.
Programming Head ó Failure to correctly align the programming head
over the pacemaker could result in failure of a programming transmission
and failure to receive telemetry. The programming head should not be
positioned over an implanted pacemaker during electrocautery or defibrillation procedures. Refer to ìUsing the Programming Headî in Chapter 2
and ìMagnet Mode Operationî in Chapter 16 for specific information about
using the programming head.
Using the Programmer with TheraÆ Pacemakers 1-5
Display Screen Format and Interactive Features
This section describes the appearance of the programmer display screen
and†the scheme for selecting a function when you have selected one of the
model groups from the Thera family of pacemakers.
Display Screen Example
Below is an example of the screen format you will see when you use the
programmer with a Thera pacemaker.
Menu Buttons
Pacemaker ID
Screen Title
ECG Display
Function Display
Area
Command Buttons
Message Box
The main elements of this screen format are as follows:
Menu Buttons ó The menu buttons, which appear across the top of each
screen, provide direct access to the programmer functions. These buttons
replace the Main Menu screen, which applies to other pacemaker models.
Pacemaker ID ó Displays the pacemaker family name and model number.
Screen Title ó Title of the current screen generally appears in this
location.
1-6 Using the Programmer
ECG Display ó This box continuously displays a low-resolution trace of
the patientís ECG.
Function Display Area ó This area of the screen changes according to the
selected function. It displays the data, buttons, and options that apply to the
selected function.
Command Buttons ó Location of the [
[
INTERROGATE], and [PROGRAM] buttons is the same for all pacemaker
applications. The [
screens; other buttons appear when the command is applicable.
Message Box ó The message box continuously displays procedural
prompts and status messages including warnings and precautions, when
appropriate. It is important to read the information presented in the
Message Box whenever you are operating the programmer.
EMERGENCY] programming button appears on all
EMERGENCY], [CANCEL MAGNET],
Interactive Screen Features
The interactive display screen features that respond to application of the
ìselector penî are: 1) on-screen buttons and 2) options that appear in
boldface type.* The following are some examples of buttons and options.
Buttons appear as boldface words or
INTERROGATE
symbols enclosed within a heavy,
black rectangular border. Buttons
with labels ending in an ellipsis (...)
open a window of additional options.
Selectable options, which appear in
boldface type, include pacemaker
models, parameters, parameter
values, and menu options.
To select a button:
SETUP...
PARAMETERS
Thera DR 7940, 7941, 7942
Lower Rate
40 70 100
THRESHOLD TEST
PROGRAM
Without touching the screen, move the tip of the selector pen to a
position directly over the button; then press the pen against the screen.
If the button is a ìlockingî button (one that remains selected), the
button label will change to reverse video to indicate that it is selected.
If a procedure directs you to ìpress and holdî a button, you must press
the selector pen against the button and continue to press for as long as
you want the related operation to continue.
*The term ìselector penî refers to both the ìlight penî used with the 9760 programmer and
††the†ìtouch penî used with the 9790 programmer.
Using the Programmer with TheraÆ Pacemakers 1-7
To select an option:
Without touching the screen, move the tip of the selector pen to a
position directly over any part of the boldface option label (may be
a†word or number); then press the pen against the screen.
Audible Signals
Certain events in the operation of the programmer will result in an audible
signal of one or two tones, or ìbeeps.î These signals are intended to alert
the user to the success or failure of an action.
Single Beep = Success
A single beep following an Interrogate command indicates that the
interrogation was successful.
A single beep following a Program command indicates that the programming was confirmed.
Two Beeps = Failure
Two beeps following an Interrogate command indicate that the interrogation was not successful.
Two beeps following a Program command indicate that the programming was not confirmed.
Two Low-Tone Beeps
Two low-tone beeps sound when the selected command cannot be
executed.
Single Short Beep
A short beep that coincides with pressing the
INTERROGATE
PROGRAM
or
key on the programming head indicates that the programmer acknowledges
the keystroke. If the keystroke is inappropriate, two low-tone beeps will
sound.
1-8 Using the Programmer
A Guide to Using the Menu and
Command Buttons
Using the Menu Buttons
Menu Buttons
DATA
TESTS/ECG
Except for [
selecting a menu button at the top of the
screen displays a menu of related function
options. A check mark (ê) next to a
displayed option (see example at right)
indicates that option is currently selected.
NOTE: To close the menu without making a selection, ìclickî the selector
pen anywhere on the display screen outside the menu box.
Listed below is a description of the options accessible with each of the
menu buttons. Refer to the listed chapter for the procedure associated with
each option.
Retrieving Pacing System Data ó See Chapter 4.
Selecting the [
Displaying the Patientís ECG and EGM ó See Chapter 5.
END SESSION
DATA
] menu button displays options for:
Viewing a summary of interrogated data.
Viewing measured real-time values of battery and lead data.
Viewing a graph of accumulated diagnostic data.
] and [
FREEZE
],
TESTS/ECG
Selecting the [
adjusting the patientís ECG and the EGM and Marker Channelô signals
received from the pacemaker via telemetry. The ECG display includes an
option for inhibiting the output of the patientís pacemaker.
Conducting Pacing System Tests ó See Chapter 7.
Selecting the [
Measuring stimulation thresholds.
Determining a setting for pacemaker sensitivity.
Determining a setting for Activity Threshold and Rate Response.
Programming temporary parameter settings.
TESTS/ECG
TESTS/ECG
] menu button displays an option for viewing and
] menu button also displays options for:
Using the Programmer with TheraÆ Pacemakers 1-9
Measuring rate and AV interval.
Conducting electrophysiologic studies if 9877A software is installed.
Instructions are covered in a supplement supplied with the software.
PARAMETERS
PARAMETERS
END SESSION
SPECIAL
FREEZE
Programming Parameter Settings ó See Chapter 6.
Selecting the [
PARAMETERS] menu button displays options for:
Programming pacing parameters and viewing present settings.
Accessing additional parameter options including Extended Telemetry,
Transtelephonic Monitor, Serial Number, and Status Reset.
Setting Up the Diagnostics Function ó See Chapter 8.
Selecting the [
PARAMETERS] menu button also displays an option for
programming the pacemaker to record the selected type of diagnostic data.
Ending the Patient Session ó See Chapter 3.
Selecting the [
END SESSION] menu button lets you end the patient session
and return to the pacemaker model selection screen.
Special Options ó See Chapters 2 and 9.
Selecting the [
SPECIAL
] menu button provides access to the following
options:
A Position Head Assist option related to using the programming head
(Chapter 2).
A Calibrate option that sends a Marker Channel or EGM reference
signal to an externally connected recorder or monitor (Chapter 9).
Freezing the ECG Trace ó See Chapter 5.
PRINT
HELP
Selecting the [
FREEZE] menu button freezes a 10-second segment of the
patientís ECG and provides the option for viewing a Marker Channel
diagram if the pacemaker is operating in a permanently programmed dual
chamber or VDD mode.
Printing Reports ó See Chapter 2.
Selecting the [
PRINT] menu button displays options for printing the various
data reports generated during the patient session.
Viewing Help Information ó See Chapter 2.
Selecting the [
HELP] menu button displays options for viewing information
about the currently displayed screen and other subjects related to using the
programmer.
1-10 Using the Programmer
Using the Command Buttons
Listed below is a description of each of the command buttons located at the
bottom of the display screen. Refer to the listed chapter for the procedure
associated with using a particular command button.
Programming Emergency Parameters ó See Chapter 2.
EMERGENCY
CANCEL
MAGNET
Selecting the Emergency command overrides any function and immediately
programs the pacemaker to a fixed set of permanent values that provide
high output pacing in the VVI mode.
Canceling the Programming Head Magnet ó See Chapter 2.
Selecting the Cancel Magnet command cancels the effect of the program-
ming head magnet and allows the pacemaker to operate in its permanently
programmed state while the programming head is in position. For example,
operation of a pacemaker permanently programmed to the DDD mode will
change from the DOO magnet mode to the DDD mode when this command
is executed.
INTERROGATE
INTERROGATE
ALL
PACING
PARAMETERS
(not pictured)
PROGRAM
Interrogating the Pacemaker ó See Chapter 2.
Selecting the Interrogate command from a particular function screen
retrieves from the pacemaker the data related to that function.
Interrogating All Data ó See Chapter 2.
The Interrogate All command retrieves all data (parameter, battery/lead, and
diagnostic) from the pacemaker. This button appears only on the Pacing
Parameters screen.
Returning to the Pacing Parameters Screen
On screens other than the Pacing Parameters screen, this button appears in
place of [
INTERROGATE ALL
]. Selecting this button returns you directly to
the Pacing Parameters screen.
Programming Command ó (Covered in the respective procedures).
This command executes a temporary or permanent programming transmis-
sion based on the procedure being conducted. This button appears only
when programming is allowed.
CHAPTER 2
Procedures to Know
Before You Begin
About This Chapter
This chapter covers some procedures that you might use at any point during
a patient session. You should be familiar with these procedures before you
begin a patient session. These procedures include:
Using the programming head (see page 2-2).
Programming Emergency parameters (see page 2-6).
Interrogating the pacemaker (see page
Canceling the effect of the programming head magnet (see page
Printing reports during a patient session (see page
Printing reports after a patient session has ended (see page 2-13).
Transferring session data to a computer diskette (see page 2-13).
Using the HELP options (see page
2-16
2-7
).
).
).
2-10
).
2-9
2-1
2-2 Using the Programmer
Using the Programming Head
In many of the procedures described in the following chapters, you will be
directed to position the programming head over the patientís pacemaker.
Always position the programming head prior to executing any command that results in a programming or telemetry interaction between
the programmer and the pacemaker.
Improper positioning of the programming head could result in the
inability to program the pacemaker or to receive telemetry.
Positioning the Programming Head
CAUTION: Do not position the programming head over an implanted
pacemaker during electrocautery or defibrillation procedures.
IMPORTANT: Pacemaker operation will return to its permanently programmed settings about 2 seconds after you remove the programming head
from its position over the pacemaker.
For an implanted pacemaker, the programming head should be held directly
against the patientís skin with the face of the programming head parallel to
the pacemaker. Optimum position of the programming head may not be
directly centered over the pacemaker.
9760 Programmer
Position Head Indicator Light
Light Array
Position the programming head over the
pacemaker such that the Position Head
indicator light on the head goes out.
Refer to ìMagnet Mode Operationî in
Chapter 16 for specific information
about positioning the programming
head.
9790 Programmer
Position the programming head so that
the amber light in the light array on the
head goes out and one or more green
lights come on. Move the head to the
position that lights the greatest number
of green lights. This is the optimum
position.
Procedures to Know Before You Begin 2-3
NOTE: Both programmers also have a programming head position indicator light located near the display screen:
On the 9760 programmer, this indicator light is located above the
upper†right corner of the screen. This indicator light goes out when a
telemetry link with the pacemaker has been established.
On the 9790 programmer, the indicator light is located near the upper
left corner of the screen. This indicator light also goes out when a
telemetry link with the pacemaker has been established ó or it may
change from amber to green ó see Using the POSITION HEAD
ASSIST Option below).
Using the POSITION HEAD ASSIST Option
The Position Head Assist function facilitates using the programming head
position lights to locate the optimum head position over the patientís pacemaker. This function is particularly useful under conditions that adversely
affect the communication link between the programmer and pacemaker.
NOTE: When the Assist function is enabled (ìEnhancedî option), continuous interaction between the programmer and pacemaker can cause extraneous artifacts to appear at 250 ms intervals on the patientís ECG trace. The
9790 programmer automatically filters these artifacts so they do not appear;
the 9760 programmer does not. Although these artifacts can obscure pacing
artifacts or small details on the ECG trace, they have no effect on the pacing
operation of the pacemaker.
9790 Programmer
If you are using a 9790 Programmer, the default setting for the Assist
function is Enhanced. That is, the Assist function will already be in effect
when you start a patient session. If this function results in extraneous
artifacts on other monitoring devices connected to the patient, you can
turn†the Assist function off by selecting the ìNormalî option as described
below.
NOTE: If the Assist function is enabled, the programming head position
indicator on the 9790 programmer display panel changes from amber to
green when the programming head is properly positioned. If the Assist
function is disabled, the amber light goes out when the programming head
is positioned. The light array on the programming head operates the same
with or without the Assist function.
2-4 Using the Programmer
9760 Programmer
If you are using a 9760 Programmer, the default setting for the Assist
function is Normal. That is, the Assist function will not be in effect when
you start a patient session. If you have trouble receiving telemetry or
obtaining a programming confirmation, enabling the Assist function can
facilitate locating a proper programming head position. As stated above,
this function results in the appearance of extraneous artifacts on the
patientís ECG.
Procedure for Selecting the Position Head Assist Setting
Position Head Assist
Option
1. Select [
2. Select
SPECIAL
POSITION HEAD ASSIST
] from the menu buttons at the top of the screen.
from the options displayed.
3. From the window showing two buttons:
Select [
ENHANCED
Or select [
NORMAL
] to enable the Assist function.
] to disable the Assist function.
Procedures to Know Before You Begin 2-5
Programming Head 9760 Programmer
Programming Head 9790 Programmer
Using
The
PROGRAM
PROGRAM
INTERROGATE
and
same function as the [
and
PROGRAM
INTERROGATE
Keys
keys on the programming head have the
INTERROGATE
] and [
] buttons that appear on
the display screen. Whenever the instructions in this manual direct you to
select the [
PROGRAM
INTERROGATE
] or [
] button on the screen, you can
press the corresponding key on the programming head instead, if it is more
convenient.
INTERROGATE Key
INTERROGATE Key
PROGRAM Key
PROGRAM Key
2-6 Using the Programmer
Programming Emergency Parameters
The Emergency programming command is a safety feature that overrides
all†other functions and immediately programs the pacemaker to preset
emergency values intended to provide pacing support under a variety of
conditions. This programming cancels any temporary function in effect and
restores magnet mode operation.
Emergency values are permanent settings that provide higher-than-normal
energy output. It is not intended that the pacemaker be left at these settings.
Emergency Button
Emergency Values
Pacing Mode VVI
Rate 70 ppm
V. Refractory Period 330 ms
V. Pulse Amplitude 7.5 V
V. Pulse Width 1.5 ms
V. Sensitivity 2.8 mV
V. Pace Polarity Unipolar
V. Sense Polarity Unipolar
Single Chamber Hysteresis OFF
EMERGENCY
The [
] button appears in the lower left corner of all function
screens.*
Ï
To program Emergency parameters:
1. Position the programming head over the pacemaker.
2. Select the [
EMERGENCY
] button.*
3. Hold the programming head steady until a confirmation message
appears. If programming is not confirmed, verify that the programming
head is properly positioned and then reselect [
*If you are using a 9790 programmer, you can press the square red button on the left side of
††the display panel as an alternative to the on-screen [
EMERGENCY
EMERGENCY
] button.
].
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