User Manual Part 2

5-2
PACING THERAPIES
DEVICE PR OGRAMMING RECOMMENDATIONS
DEVICE PROGRAMMING RECOMMENDATIONS
It is important to program device parameters to the appropriate settings to
ensure optimal CRT delivery. Please consider the following guidelines in
conjunction with the patient’s specific condition and therapy needs.
CAUTION: This device is intended to provide biventricular pacing therapy.
Programming the device to provide RV-only pacing, or programming the RV
pace amplitude below the pacing threshold (resulting in LV-only pacing), is not
intended for the treatment of heart failure. The clinical effects of LV-only or
RV-only pacing for the treatment of heart failure have not been established.
Pacing mode––Program a dual-chamber tracking mode (VDD or DDD).
Adaptive-rate pacing modes are intended for patients who exhibit chronotropic
incompet ence and who would benefit by increased pacing rates concurrent
with physical activity ("Brady Mode" on page 5-7).
Pacing chamber––Program to BiV (nominal) unless medical discretion dictates
the selection of a different pacing chamber ("Ventricular Pacing Chamber" on
page 5-14).
BiV Trigger––Program to On unless there is a medical contraindication.
LRL––Program below a sinus rate normally reached while still providing an
appropriate rate for bradycardia support ("Lower Rate Limit (LRL)" on page
5-10).
MTR––Program high enough to ensure 1:1 AV synchrony. A MTR at 130 ppm
is recom mended unless m edical discre tio n dictates otherwise ("Maximu m
Tracking Rate (MTR)" on page 5-11).
Pacing output––Program for a minimum 2x voltage safety margin for each
ventricular c hamber based on the capture thresholds ("Pace Threshold Test"
on page 6-8).
Paced AV Delay––The Paced AV Delay setting should be individualized for
each patient to ensure consistent CRT delivery. Several methods are available
to determine the Paced AV Delay setting, including:
• Intrinsic QRS duration assessment
• Echocard iog ram
• Pulse pressure monitoring
- DRAFT -