24 Implantation
Precautionary Measures while Programming
Checking the
implant system
• After auto-initialization perform follow-up to see if the implant system is func-
tioning properly.
• Perform a pacing threshold test to determine the pacing threshold.
Monitoring the patient The patient could be subjected to critical states if, for example, inadequate param-
eters are set or due to telemetry interference during a temporary program.
• Continuously monitor the ECG and the patient's condition.
• Remove the programming head to a distance of at least 30 cm and the perma-
nent program will be reactivated immediately.
Manually setting
lead polarity
Due to the risk of an entrance/exit block, bipolar lead polarity (sensing/pacing)
should only be set if bipolar leads are implanted.
Setting the
triggered pacing mode
Triggered pacing modes perform pacing regardless of intrinsic cardiac events. To
prevent undersensing due to electromagnetic interference in special cases, a trig-
gered pacing mode can be displayed.
Avoiding
asynchronous pacing
High pacing rates with long refractory periods (a/v) can lead to intermittent, asyn-
chronous pacing. Such programming can be contraindicated in some cases.
Setting sensing • In order to avoid errors in manually set parameters, set automatic sensitivity
control.
• Unsuitable far-field protection can hinder pacemaker sensing (undersensing).
Setting the sensitivity A value set to < 2.5 mV/unipolar for implant sensitivity may result in noise caused
by electromagnetic fields.
• Therefore, it is recommended that a value of ≥ 2.5 mV/unipolar be set according
to paragraph 28.22.1 of the EN 45502-2-1 standard. Setting sensitivity values
< 2.5 mV/unipolar requires explicit clinical need. Values like this can only be set
and retained with physician supervision.
Preventing implant-induced
complications
• Measure the retrograde conduction time.
• If the function is not yet automatically set: activate PMT protection.
• Set the VA criterion.
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