BIOTRONIK Idova 7 Manual Tecnico página 13

Avoiding critical parameter settings
No modes and parameter combinations that pose a risk to the patient should be set.
• Prior to setting rate adaptation, determine the patient's capacity for strain.
• Check compatibility and effectiveness of parameter combinations after making
settings.
Checking for electrodes suitable for the shock path
Three different shock paths can be set. Two of these form an electrical path to the
housing of the implanted device.
• For the RV -> SVC shock path, a second shock coil must be available
(dual shock coil).
Monitoring the patient when setting asynchronous modes
The asynchronous modes V00 and D00 can only be set if tachyarrhythmia sensing is
deactivated. This would leave the patient without sensing and therefore without ICD
therapy.
• Continually monitor the patient.
• Keep an external defibrillator ready.
Setting sensing
Manually set parameters can be unsafe. For example, unsuitable far-field protection
may impede sensing of intrinsic pulses.
• Note automatic sensitivity control.
Preventing device-induced complications
BIOTRONIK devices feature several functions to prevent device-induced complications
to the greatest extent possible:
• Measure the retrograde conduction time.
• Set PMT protection.
• Set the VA criterion.
Preventing conduction of atrial tachycardia
BIOTRONIK devices feature several functions to prevent conduction of atrial tachy-
cardia to the ventricle(s):
• Set mode switching for indicated patients.
• Set the upper rate and the refractory periods to prevent abrupt ventricular rate
switching.
• Give preference to Wenckebach response and avoid 2:1 behavior.
• Set all parameters so as to prevent constant changing between atrial and ventric-
ular-controlled modes.
Observing the shock impedance limit
The implanted device could be damaged if the shock impedance is too low.
• The shock impedance must be > 25 Ω.
Preventing recurrence after therapy shock
After a therapy shock, pacing can be performed with a post-shock program if there is
no intrinsic rhythm.
Permanent program
DDD, DDI, AAI
VDD, VDI
VVI and OFF
• The following post-shock program parameters can be adjusted: post-shock dura-
tion, basic rate, rate hysteresis, ventricular pacing, LV-T-wave protection, trig-
gering, AV delay (fixed, not dynamic).
• The default settings for the post-shock program are as follows:
A and RV: 7.5 V, 1.5 ms
LV: settings from the permanent program
Phrenic nerve stimulation that cannot be terminated
In rare cases, chronic phrenic nerve stimulation cannot be terminated by reprogram-
ming the available left ventricular pacing configuration or using other measures.
• Set a right ventricular mode both in the permanent program as well as the ATP, in
the post-shock program and for mode switching if need be.
12
Post-shock program
DDI
VDI
VVI