Medtronic DTPC2D4 Patient Manual
MRI SureScan™
Cardiac Resynchronization Therapy
Debrillator
Patient Manual
MR Conditional
Caution: Federal law (USA) restricts this device to sale by or on
the order of a physician.
We are there when you need us.
The following list includes trademarks or registered trademarks of Medtronic in
the United States and possibly in other countries. All other trademarks are the
property of their respective owners.
CareLink, Medtronic, Medtronic CareAlert, Medtronic CareLink, SureScan
Information about you and your device
Your personal information
Your name
Your doctor’s name
Specialty Phone
Your doctor’s name
Specialty Phone
Your medications
Emergency contact information
Name/address/phone
Name/address/phone
3
Your heart device information
Type or model of heart device
Serial #
Lead 1 model
Serial #
Lead 2 model
Serial #
Lead 3 model
Serial #
Date of implant
Hospital where implanted
4
How to contact Medtronic
Contact us by phone
Our Patient Services group can answer any questions or concerns
about your heart device. To speak with a Patient Services Specialist, call
1-800-551-5544. Our sta is available Monday through Friday from 7:00 AM
to 6:00 PM (Central Time).
Contact us online
For up-to-date information about your heart device, visit
www.medtronic.com.
To submit questions, suggestions, or requests, use the online form at
www.medtronic.com/us-en/about/contact-us.html.
5
Contact us by mail or fax
Medtronic Inc.
Patient Services Department
Mail Stop MVS 14
8200 Coral Sea Street NE
Mounds View, MN 55112
Fax: 763-367-5809
Contacting Medtronic about your ID Card
To update information on your ID card or if you have questions about your
ID card, see “Your heart device ID card” on page 92.
6
Contents
How to contact Medtronic 5
Contact us by phone 5
Contact us online 5
Contact us by mail or fax 6
Contacting Medtronic about your ID Card 6
Chapter 1
Introduction 13
Chapter 2
Frequently asked questions 15
Chapter 3
Your heart has a natural rhythm 27
The anatomy of the heart 27
Electrical conduction in the heart 30
The heart is very sensitive to the body’s needs 32
How abnormal heart rhythms aect the heart 32
7
Heart failure – When the heart pumps poorly 33
Ejection fraction 36
Symptoms of heart failure 36
Tachyarrhythmia – When the heart beats too fast 37
Causes of tachyarrhythmias 38
Types of tachyarrhythmias 39
Bradycardia – When the heart beats too slowly 40
Chapter 4
About your heart device 43
What is a cardiac resynchronization therapy debrillator? 44
Your heart device 44
What does my heart device do? 47
What types of therapies does my heart device provide? 47
Therapy for an uncoordinated and irregular heart rhythm 48
Therapies for a fast or irregular heart rhythm 49
Therapy for a slow heart rhythm 51
What do the therapies feel like? 51
What is Medtronic CareAlert monitoring? 52
Conditions that Medtronic CareAlert monitoring can detect 53
Checking your Medtronic CareAlert status 54
8
How does my heart device communicate wirelessly? 55
Chapter 5
Your implant procedure and recovery 57
The implant procedure 58
Making the incision and inserting the leads 58
Testing the leads 59
Implanting the heart device and closing the incision 59
Possible risks after the implant procedure 59
Recovering after your implant surgery 61
Follow-up appointments 62
Chapter 6
Living life with your heart device 63
Food and medications 63
Your physical activity 64
Recreation and activities 64
Driving a car 65
What you need to know about electromagnetic compatibility (EMC) 66
Avoiding interference from electrical or magnetic items 68
Household and recreational items 69
Communications and electronics 73
9
Tools and industrial equipment 80
Industrial equipment that may require special precautions 81
Vehicles and related items 82
Security systems 84
Precautions about medical procedures 86
Medical procedures that are not recommended 86
Medical procedures that require some precautions 87
Acceptable medical procedures 90
Chapter 7
Registering your heart device 91
Heart device registration 91
Your heart device ID card 92
Keep your heart device ID card with you all the time 92
Requesting a new ID card or updating personal information 93
If you change your doctor 94
Medtronic heart device travel card 94
Chapter 8
Follow-up care 95
Follow-up appointments 96
Reviewing information saved by your heart device 97
10
Remote monitoring 97
Medtronic device manager 98
When to call your doctor or nurse 99
Replacement of your heart device 100
Chapter 9
Caring for yourself 101
Dealing with anxiety and getting support 102
What is a common source of stress for heart device patients and
families? 102
What are some other ways to relieve stress and get answers? 102
Shaping a positive attitude about living with a heart device 104
Medical care 105
Planning for an emergency 105
What your family and friends should know 106
Medtronic Warranty 109
Glossary 111
Index 121
11
12
Introduction
1
This manual is for people who are about to receive or already have a type
of heart device called a cardiac resynchronization therapy debrillator
(CRT-D)1. This manual describes your heart device and its therapies. It
also explains the implant procedure and what you can expect afterward.
Encourage your family and caregivers to review this manual.
If you have questions about your heart device that are not covered in
this manual, or you want more information about your heart device,
contact Medtronic Patient Services (see page 5). You can also visit
www.AsktheICD.com for general questions.
Your doctor or doctors should be your rst source of information about your
heart condition and your general health.
1
This heart device is also called a heart failure pacemaker with debrillation, a biventricular
heart device, or a three-lead heart device.
13
For Spanish translations of patient manuals, contact Medtronic Patient
Services (see page 5). Or go to www.medtronic.com to view or
download English and Spanish patient manuals.
Words in bold are dened in the glossary starting on page 111.
Introduction14
Frequently asked questions
2
New patients often have the same concerns about their heart devices. Here
are some of the questions new patients often ask.
Why do I need this heart device?
A cardiac resynchronization therapy debrillator is designed to relieve heart
failure symptoms for most patients. It improves the heart’s ability to pump
blood and oxygen to the body. This heart device does not prevent or cure
your heart condition. However, it should improve your quality of life and help
you get back to doing things that you haven’t been able to do for a while.
Heart medications and surgical procedures may be prescribed instead of,
or in addition to, a cardiac resynchronization therapy debrillator. Based on
your health condition, your doctor has determined that a heart device may
help to improve your symptoms.
Although your heart device is not a cure, it does help to protect you from
heart rhythms that can weaken or even endanger your health. Many
patients say that this heart device gives them and their families a sense of
15
security. See “Caring for yourself” on page 101 for guidance on dealing
with anxiety and other concerns.
Is it safe for me to have an MRI scan?
A magnetic resonance imaging (MRI) scan is a type of diagnostic that
creates an internal view of the body.
The energy elds present during an MRI scan may harm a traditional heart
device, which could endanger a patient’s health. However, your SureScan
heart device was designed to reduce these risks to a very low level so that
you can safely undergo MRI scans under specied conditions.
You can have an MRI scan if you meet the eligibility requirements that
Medtronic provides to your heart doctor. For example, your heart device
system must consist only of a Medtronic SureScan heart device and
SureScan leads. Your heart device ID card lists your heart device and lead
models.
Before you receive an MRI scan, your doctor will verify that you are eligible
and that your heart device system is functioning properly. Your doctor will
then turn on the SureScan feature. This feature disables the ability of your
heart device to deliver a therapy shock so that you may safely have an
MRI scan.
Frequently asked questions16
During the MRI scan, you are monitored to ensure your safety.
After the MRI scan, your doctor will turn o the SureScan feature. Your
heart device is again able to deliver a therapy shock, if needed.
If you have questions about your eligibility to receive an MRI scan, contact
your doctor or nurse. If any of your doctors have questions, they should
contact a Medtronic representative or Medtronic Technical Services.
Will I be able to drive?
Whether you will be able to drive depends on your individual heart
condition. A concern about driving is that you might faint if your heart starts
to beat dangerously fast. Many people with a heart device can resume
driving if their doctor approves and if allowed by the laws and insurance
regulations in their state. For more information, see “Driving a car” on
page 65. If you have concerns, talk with your doctor.
Will I be able to travel?
Most people who have a heart device can travel without taking special
precautions if they follow their doctor’s instructions.
Wherever you travel, your heart device monitors your heart and provides
therapy whenever it is needed. You can travel knowing that support for your
Chapter 2 17
heart device is available around the world. Your doctor may also be able to
check your heart device remotely.
It is unlikely that your heart device will trigger the security gates at airports
or other secure buildings. If it does, present your heart device ID card. If
a handheld screening wand is used, ask the security operator not to hold
it over your heart device or wave the wand back and forth over your heart
device. See “Security systems” on page 84 for more information.
A heart device travel card is available with instructions in several languages
for safe security scanning. The card is especially useful for international
travel. See page 94 for more information about the heart device travel
card and how to request one.
Can I walk through antitheft systems found in public places?
Yes, simply walk through the antitheft system at a normal pace. In some
cases, the systems located in stores, libraries, and other places may
temporarily interfere with your heart device if you stop near this equipment.
The interference stops when you move away from the equipment.
Can I use a mobile phone?
Yes, you can use mobile phones (including cellular phones and other
wireless phones). However, mobile phones may cause electrical
Frequently asked questions18
interference with your heart device when the phone is turned on and held
too close to your heart device. Also, some accessories for mobile phones
contain magnets that may cause interference, such as earbuds or cases
with magnetic clasps. Any eect is temporary, and simply moving the
phone or accessory away will return the heart device to its previous state of
operation.
To avoid interference between mobile phones or accessories and your
heart device, keep them at least 6 inches (15 centimeters) away from your
heart device. When using a mobile phone, hold it to the ear that is farthest
away from your heart device. Also, do not carry a mobile phone close to
your heart device, such as in a shirt pocket.
For more information about using mobile phones and other wireless
communication devices, see “Avoiding interference from electrical items or
magnets” on page 68.
Can I use a microwave oven and other electrical items?
Yes, you can use a microwave oven as well as major appliances, electric
blankets, and heating pads. See “Living life with your heart device” on
page 63 for information about electrical items and any restrictions or
cautions you should know about.
Chapter 2 19
Will my heart device need to be replaced?
Yes. Because your heart device operates using a battery sealed inside the
device, the entire heart device will need to be replaced when battery power
falls to a low level. The heart device battery typically lasts about 10 years.
How long your battery lasts depends on several factors. Some of these
factors include the type of heart device you have, the nature of your heart
condition, and how often your heart device provides therapy to your heart.
The battery power is checked at each follow-up appointment. Your doctor or
nurse will let you know when you need to have your heart device replaced.
How often will my doctor need to check my heart device?
When you go home after your implant surgery, your doctor will periodically
check your heart device. These follow-up appointments can be performed
at your clinic. Or, if your doctor prescribes remote monitoring, you can
send your heart device information directly to your doctor or clinic. For more
information about follow-up services, see “Follow-up care” on page 95.
How do I know if my heart device battery is still working?
The strength of your heart device battery is checked during your followup appointments, either in the clinic or through built-in device monitoring.
Medtronic CareAlert monitoring is a safety feature built into your heart
Frequently asked questions20
device that can be set up by your doctor. It alerts you with a beeping tone
when the battery power for your heart device is getting low. Because the
battery is sealed inside your heart device and cannot be recharged, your
heart device will need to be replaced when the battery power is low. For
more information, see “Replacement of your heart device” on page 100.
What if my heart device is making a beeping tone?
Your heart device may make a beeping tone if your doctor has enabled
Medtronic CareAlert monitoring. The beeping tone lets you know that
something needs attention from your doctor. For example, the device can
make a beeping tone when the number of therapies you have received has
increased or when the battery power of your heart device is low.
If your heart device detects one of these conditions, it makes a beeping
tone for up to 30 seconds, at least once a day. The alert continues until your
doctor or nurse checks your heart device. The beeping tone is designed to
get your attention, not to alarm you. If you hear beeping tones from your
heart device, call your doctor for instructions.
What if my heart device is making a steady tone?
Your heart device may make a steady tone if you are close to a strong
magnetic eld, such as the eld in a store’s anti-theft system. This tone
warns you to move away from the magnetic eld. For more information, see
Chapter 2 21
“What you need to know about electromagnetic compatibility (EMC)” on
page 66.
Will my device deliver a therapy shock during normal activity?
A therapy shock during normal activity is unlikely. Your heart device is
designed to respond to abnormal heart rates and rhythm patterns. Normal
exercise or physical activity should not trigger your heart device to deliver a
therapy shock. If a therapy shock happens, stop the activity and notify your
doctor. Your doctor may change the settings of your heart device to prevent
therapy shocks during your normal activities.
What is sudden cardiac arrest?
Sudden cardiac arrest occurs when the heart’s electrical system
malfunctions and the heart beats dangerously fast and irregularly. The
ventricles may utter or quiver, causing the heart to stop beating. The
symptoms of sudden cardiac arrest are immediate and dramatic and can
include a loss of consciousness, sudden collapse, and the lack of a pulse.
Sudden cardiac arrest is not the same as a heart attack. A heart attack
happens when a blood vessel in the heart suddenly becomes blocked. The
most common symptoms are chest pain or discomfort and shortness of
breath.
Frequently asked questions22
Can others feel a therapy shock if they are touching me?
If you receive a therapy shock, anyone touching you may feel the shock as
a muscle spasm or a tingle, although it is unlikely. A therapy shock can be
startling, but it will not hurt a person touching you.
What if I receive a therapy shock?
Ask your doctor or nurse what you should do if your heart device delivers
a therapy shock. Your doctor or nurse should give you specic instructions
about when to contact your doctor if you have received a therapy shock.
In general, follow these steps if you feel the symptoms of a rapid heart
rhythm or if you receive a therapy shock:
1. Stay calm and move to where you can lie down or sit comfortably.
2. Have someone stay with you until you feel better.
3. If you receive more than one therapy shock or if you remain
unconscious for more than 1 minute, have a companion call 911 for an
ambulance.
If you remain unconscious and you have no pulse, a companion
trained in cardiopulmonary resuscitation (CPR) should begin CPR
immediately. When your heart starts beating again, your companion
should stop CPR.
Chapter 2 23
Note: Anyone touching you during a therapy shock might feel your
muscles contract slightly. They also might see you jump with a sudden
start. A therapy shock will not harm a person touching you.
4. If you do not feel well after the shock, have someone call your doctor
and take you to the hospital emergency room.
5. Follow your doctor’s or nurse’s directions after receiving a shock. The
doctor or nurse may ask the following questions:
• What were you doing right before the shock?
• What symptoms did you notice before the shock?
• How did you feel right after the shock?
• How are you feeling right now?
Can I have sexual relations?
Most people resume sexual activity, based on their doctor’s instructions.
Physical activity is not likely to cause your heart device to deliver a shock.
But if a shock does happen during intercourse, stop and notify your doctor
just as you would if it happened during exercise. The shock will not hurt
your partner. Your partner may feel a tingle or a slight muscle spasm, but
nothing more.
Frequently asked questions24
How are my heart device and data secured?
Your heart device has built-in safeguards that protect your heart device and
your device data. In addition, the therapies provided by your heart device
can only be programmed by your doctor or nurse during an oce visit.
Chapter 2 25
26
Your heart has a natural rhythm
3
This chapter describes the anatomy of the heart and some common types
of abnormal heart rhythm conditions. To understand how your heart device
works, you need to know how the heart functions and how abnormal heart
rhythms can aect the heart.
This chapter includes these topics:
• The anatomy of the heart (see page 27)
• Electrical conduction in the heart (see page 30)
• How abnormal heart rhythms aect the heart (see page 32)
The anatomy of the heart
The heart is a st-sized pump that circulates blood throughout the body.
Arteries carry blood with oxygen and nutrients to all parts of the body. Veins
carry blood depleted of oxygen and nutrients back to the heart and the
lungs.
27
The heart is a large, hollow muscle divided into four chambers. The two
upper chambers are the right atrium and the left atrium. Atria, the plural of
atrium, refers to both the right atrium and the left atrium.
The lower chambers of the heart are the right ventricle and the left
ventricle. The septum is the muscled wall dividing the right and left sides of
the heart.
The right atrium draws blood in from the body and pumps it into the right
ventricle. The right ventricle then pumps the blood into the lungs to be
reoxygenated. The left atrium draws oxygen-rich blood in from the lungs
and pumps it into the left ventricle. The left ventricle then pumps the blood
out to the rest of the body.
Each chamber contracts by squeezing its muscles together. Each
contraction pushes blood from one chamber to the next chamber or out into
the body. Heart valves regulate the ow of blood between each chamber
and keep the blood owing in one direction. What we hear as a heartbeat is
actually the opening and closing of the valves.
After each chamber contracts completely, pushing out most of the blood, it
relaxes and lls with more blood again. In a healthy heart, each chamber
contracts in a coordinated eort with the other chambers of the heart. See
Figure 1.
Your heart has a natural rhythm28
Left atrium
Right atrium
Left ventricle
SeptumRight ventricle
Figure 1. Four chambers of the heart contract in a controlled sequence to
circulate blood throughout the body.
Chapter 3 29
Electrical conduction in the heart
Electrical impulses cause the cells of the heart to contract and relax. The
sinoatrial node (or SA node) generates these impulses. The SA node is
found on the upper inside wall of the right atrium.
When the SA node releases an electrical impulse, the impulse travels
across the top of the atria and down through the atria. The atria
contract from the top down, pushing blood into the ventricles. When the
electrical impulse reaches the lower wall of the atria, it stimulates the
atrioventricular node (or AV node). The AV node delays the impulses just
long enough for the atria to nish pushing blood into the ventricles. Then it
passes the impulse along organized thread-like paths into the ventricles.
Your heart has a natural rhythm30
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