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Medtronic Adapta Series User Manual

Medtronic Adapta Series
354 pages
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ADAPTA
®
/VERSA
®
/SENSIA
®
/
RELIAâ„¢
Adapta ADDR01/03/06
Adapta S ADDRS1
Adapta L ADDRL1
Adapta ADD01
Adapta ADVDD01
Adapta ADSR01/03/06
Versa VEDR01
Sensia SEDR01
Sensia L SEDRL1
Sensia SED01
Sensia SESR01
Sensia SES01
Relia REDR01
Relia RED01
Relia RESR01
Relia RES01
Relia REVDD01
Pacemaker Reference Guide

Table of Contents

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Medtronic Adapta Series Specifications

General IconGeneral
Device TypePacemaker
ModelAdapta Series
ManufacturerMedtronic
Rate ResponseYes
Wireless TelemetryYes
MRI CompatibilityConditional
TherapyPacing
ModeAAI, VVI, DDD
ProgrammabilityFully programmable
Battery TypeLithium-based
Battery LongevityUp to 10 years (depending on model and usage)

Summary

How to Use This Guide

Information contained in two guides

Details on the two separate guides providing information on pacemakers and programming.

About the Pacemaker Reference Guide

Overview of the Pacemaker Reference Guide's scope and content.

About the Pacemaker Programming Guide

Overview of the Pacemaker Programming Guide's scope and content.

New nomenclature for product battery life terms

Explanation of new nomenclature for product battery life terms based on CENELEC standard.

Pacing Modes

Introduction

Provides an introduction to pacemaker modes as an aid to pacing mode selection.

Rationale for Mode Selection

Guidance on selecting pacing modes, recommending TherapyGuide for suggestions.

Indications

Information on the indicated uses for Medtronic Adapta/Versa/Sensia/Relia pacemakers.

Contraindications

Information on contraindications for pacemaker use and specific modes.

DDDR Mode

Description of the DDDR pacing mode, including tracking and sensor-indicated rates.

DDD Mode

Description of the DDD pacing mode, including atrial synchronous and AV sequential pacing.

DDIR Mode

Description of the DDIR pacing mode, featuring dual chamber, sensor-driven pacing.

AAIR / ADIR Modes

Description of AAIR and ADIR modes for atrial-based rate responsive pacing.

Rate Response

Introduction to Rate Responsive Pacing

Explains rate response for cardiac pacing support at submaximal and maximal rates.

Preset Rate Response at Implant

Details on how pacemakers operate in rate responsive modes until implant detection is complete.

Rate Profile Optimization Operation

Describes how Rate Profile Optimization adapts rate response levels using sensor rate profiles.

Activity Sensor Operation

Explains how activity sensor-based pacing is controlled by programmable parameters.

Pacemaker Timing

Rates

Overview of programmable rates controlling pacemaker timing.

AV Intervals

Determines time between atrial event and ventricular stimulus delivery.

Rate Adaptive AV

Mimics physiologic response by shortening AV intervals as heart rate increases.

Blanking Periods

Disables sensing for programmable or nonprogrammable intervals to block unwanted signals.

Refractory Periods

Intervals where sensed events do not affect timing operations, preventing inappropriate signals.

High Rate Atrial Tracking

Describes pacemaker behavior at high atrial rates, determined by TARP and Upper Tracking Rate.

Lead/Cardiac Tissue Interface

Implant Detection

A 30-minute period verifying lead connection by measuring impedance and activating features.

Automatic Polarity Configuration

Pacemakers automatically configure pacing and sensing polarities via the Lead Monitor feature.

Lead Monitor

Measures lead impedances and enables switching bipolar pacing/sensing to unipolar if needed.

Capture Management and Diagnostic

Monitors pacing thresholds and automatically adjusts output for optimal capture.

Sensing Assurance and Diagnostic

Automatically adjusts sensitivities to maintain an adequate sensing margin for sensed events.

Special Therapy Options

Mode Switch and Diagnostic

Programmable feature to prevent tracking of paroxysmal atrial tachycardias.

Managed Ventricular Pacing (MVP)

Promotes intrinsic conduction by reducing unnecessary RV pacing, providing atrial-based pacing with RV backup.

Non-Competitive Atrial Pacing

Prevents triggering atrial tachycardias by atrial pacing stimulus within the relative refractory period.

PMT Intervention

Automatic feature to detect and interrupt pacemaker-mediated tachycardias (PMTs).

PVC Response

Prevents tracking of retrograde P waves generated by PVCs, helping prevent PMTs.

Ventricular Safety Pacing

Programmable feature to prevent ventricular asystole due to inappropriate inhibition of pacing.

Sinus Preference

Improves hemodynamics by providing preference to sinus activation over sensor-driven pacing.

Rate Drop Response and Diagnostic

Provides backup pacing and prevents symptoms from significant heart rate drops.

Telemetry Data

Establishing Telemetry

Process of establishing telemetry by positioning the programming head over the implant site.

Parameter Summary

Overview of telemetered programmed parameters, battery status, and device identification.

Battery and Lead Information

Telemetered values for battery parameters, pacing outputs, and leads for system assessment.

Marker Channel Telemetry

Provides depictions of paced and sensed events aiding pacemaker timing evaluation.

Intracardiac Electrograms

Real-time waveform of cardiac activity detected by leads, configurable for atrial, ventricular, or dual EGM.

Miscellaneous Operations

Magnet Mode Operation

Describes how the pacemaker switches to an asynchronous mode and paces at the magnet rate.

Temporary Programming

Parameters can be programmed temporarily for diagnostic purposes or effect testing.

Electrical Reset

A safety feature that resets device parameters to provide basic functionality upon exposure to extreme conditions.

Recommended Replacement Time (RRT/ERI)

Establishes time for scheduled device replacement when battery is nearly depleted.

Diagnostics

Introduction to Diagnostics

Overview of the two types of diagnostics: automatic and clinician-selected.

Heart Rate Histograms

Shows heart rate distribution and percentage of paced/sensed beats for evaluating rate response.

AV Conduction Histograms

Counts and collects AV conduction sequences, classifying them by rate range and sequence type.

Sensor Indicated Rate Profile

Records sensor rates, classifying them by rate ranges for evaluating Rate Profile Optimization.

High Rate Episodes

Detects episodes of atrial or ventricular tachycardia, recording summary and detailed data.

Troubleshooting the Pacing System

Troubleshooting Strategy

General steps for troubleshooting pacemaker problems: define, identify cause, correct.

Troubleshooting Electrical Problems

Identifies potential causes of electrical problems like undersensing, oversensing, and noncapture.

Troubleshooting Hemodynamic Problems

Identifies common causes of hemodynamic problems such as pacemaker syndrome and inappropriate rate response.

Pacemaker Description

Model Number Designator

Explains the four attributes defining model family, pacing capability, battery type, and lead type.

Radiopaque Codes

Identifies pacemaker models using radiopaque code blocks displayed on X-rays.

Physical Dimensions

Provides physical dimensions (height, length, width, mass, volume) for various pacemaker models.

Preset Parameter Settings

Shipping and Nominal Settings

Details shipping parameter settings and Medtronic nominal parameter settings for various series.

Electrical Reset Settings

Lists parameter settings for partial and full electrical resets.

Emergency Settings

Defines emergency pacing parameters (VVI mode, high output) for pacemaker-dependent patients.

Longevity Projections

Projected Service Life

Estimates pacemaker service life from implant to RRT/ERI based on model and serial number prefix.

Recommended Replacement Time (RRT/ERI)

Establishes the time for scheduled device replacement when battery is nearly depleted.

Battery Specifications

Lists the types of batteries used in Adapta/Versa/Sensia/Relia pacemakers and their capacities.

Telemetry and Diagnostic Values

Magnet Mode Operations

Details Magnet Mode operations in dual and single chamber pacemaker modes.

Telemetry Functions

Includes Marker Channel, Extended Telemetry, Electrograms, Battery/Lead info, and Patient data telemetry.

Automatic Diagnostics

Describes automatic diagnostics collected by the pacemaker, with programmable parameters.

Clinician-Selectable Diagnostics

Details clinician-selected diagnostics programmed via Data Collection/Setup for detailed data analysis.

Parameter Values and Restrictions

Programmable Modes and Parameters

Details all programmable parameters, including modes, rates, and features.

Rate Response Programming Guidelines

Provides guidelines for adjusting ADL Response and Exertion Response parameters via Optimization.

Implant Information

Warnings

Covers device operation warnings, pacemaker-dependent patient considerations, and medical therapy hazards.

Precautions

Includes guidelines for handling, storage, medical treatments, and environments.

Potential Complications

Lists potential issues like battery depletion, component failure, sensor issues, and EMI effects.

Replace a Device

Steps for replacing a pacemaker, including lead evaluation and connector checks.

Patient Counseling Information

Topics for clinician discussion with patients before discharge, including symptoms and activity.

Glossary

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