User's Manual

ManualsBrandsSORIN CRM ManualsElectronicsImplantable cardioverter defibrillator with RF wireless communication availability

Table Of Contents

1. General description
2. Indications
3. Contraindications
4. Warnings and precautions
- 4.1. Risks related to medical environment
- 4.2. Sterilization, storage and handling
- 4.3. Implantation and device programming
- 4.4. Lead evaluation and lead connection
- 4.5. Generator explant and disposal
5. Adverse events
- 5.1. MSP study
- 5.2. Potential adverse events
6. Clinical studies
- 6.1. MSP clinical study
7. Patient selection and treatment
- 7.1. Individualization of treatment
- 7.2. Specific patient populations
8. Patient counselling information
9. Declaration of conformity
10. Physician guidelines
- 10.1. Physician training
- 10.2. Directions for use
- 10.3. Maintaining device quality
11. Patient information
12. How supplied
- 12.1. Sterility
- 12.2. Warranty and replacement policy
13. Device description
14. Implant procedure
- 14.1. Necessary equipment
- 14.2. Packaging
  - 14.2.1. Contents
- 14.3. Optional equipment
- 14.4. Before opening the package
- 14.5. Prior to implantation
- 14.6. Device placement
- 14.7. Choosing the type of lead
- 14.8. Shock configuration (+ -> -)
- 14.9. Measurement of thresholds at implant
- 14.10. Leads connection
- 14.11. Device implantation
- 14.12. Tests and programming
15. Special modes
- 15.1. Safety mode (nominal values)
- 15.2. Magnet mode
- 15.3. Response in the presence of disturbance
- 15.4. Detection characteristics in the presence of electromagnetic fields
- 15.5. Protection against short-circuits
16. Main functions
- 16.1. Automatic lead measurements
- 16.2. Atrial tachyarrhythmia management
- 16.3. Ventricular tachyarrhythmia management
- 16.4. Pacing
- 16.5. Sensing
- 16.6. Follow-up function
- 16.7. Remote Monitoring function
17. Patient follow-up
- 17.1. Follow-up recommendations
- 17.2. Holter Function
  - Stored Tachyarrythmia Episodes:
  - Therapy history
- 17.3. Recommended Replacement Time (RRT)
- 17.4. Explantation
- 17.5. Defibrillator identification
18. Supplemental Information
- 18.1. Adverse events in the SafeR (AAI <> DDD) study
  - Table 1: Summary of Symphony safety data during study
- 18.2. SafeR (AAI <> DDD) clinical study
19. Physical characteristics
- 19.1. Materials used
20. Electrical characteristics
- 20.1. Table of delivered shock energy and voltage
- 20.2. Battery
- 20.3. Longevity
21. Programmable parameters
- 21.1. Antibradycardia pacing
- 21.2. Ventricular tachyarrhythmia detection
- 21.3. Ventricular tachyarrhythmia therapies
- 21.4. Remote alerts and warnings
22. Non programmable parameters
23. Limited warranty
24. Patents
25. Explanation of symbols

14. IMPLANT PROCEDURE

14.9. MEASUREMENT OF THRESHOLDS AT IMPLANT

Pacing and sensing thresholds should be measured at implant.

Pacing thresholds:

Acute thresholds should be lower than 1 V (or 2 mA) for a 0.35 ms pulse width, in both

ventricles and in the atrium.

Sensing thresholds:

For appropriate right ventricular sensing, the amplitude of the R-wave should be greater

than 5 mV.

For appropriate atrial sensing, the amplitude of the P-wave should be greater than 2 mV.

Pacing impedance measurements:

Right ventricular, left ventricular and atrial pacing impedances should range from 200 to

3000 ohms (refer to the lead characteristics, especially if high impedance leads are used).

Please refer to the leads user manuals for more details on the expected electrical

performances of the leads.

14.10. LEADS CONNECTION

Implant the ventricular leads, then the atrial lead.

Each lead must be connected to the corresponding connector port. The position of each

connector is indicated on the casing.

Tighten only the distal inserts.

To connect each lead, proceed as follows:

1. Clean the lead terminal pins thoroughly, if necessary (device replacement).

2. Lubricate the lead terminal pins with sterile water, if necessary.

3. Do not insert a lead connector pin into the connector block without first visually verifying

that the lead port is not filled with any obstacle.

4. Insert the screwdriver into the pre-inserted screw socket of the appropriate port (in order

to allow excess air to bleed out and to make the insertion of the lead pin easier).

5. Insert the lead pin all the way into the port (check that the pin protrudes beyond the distal

insert).

6. Tighten, check the tightness and ensure the lead pin still protrudes beyond the distal

insert, and has not move.

1. Do not tighten the pre-inserted screws when there is no lead (this could damage the

connector).

2. Do not loosen the screws before inserting the connector (subsequent risk of being unable

to reinsert the screw).

3. When mineral oil or sterile water is used to make lead insertion easier, the screwdriver

should remain inserted into the pre-inserted screw socket when checking the tightness.

SORIN – PLATINIUM CRT-D – U459A

CAUTION: