•
Proper programming of the shock vector.
If the shock vector is programmed to RVcoil>>RAcoil and
the lead does not have an RA coil, shocking will not occur.
•
Programming for supraventricular tachyarrhythmias (SVTs).
Determine if the device and
programmable options are appropriate for patients with SVTs because SVTs can initiate unwanted
device therapy.
•
AV Delay.
To ensure a high percentage of biventricular pacing, the programmed AV Delay setting
must be less than the patient’s intrinsic PR interval.
•
Adaptive-rate pacing.
Rate Adaptive Pacing should be used with care in patients who are unable to
tolerate increased pacing rates.
•
Ventricular refractory periods (VRPs) in adaptive-rate pacing.
Adaptive-rate pacing is not limited by
refractory periods. A long refractory period programmed in combination with a high MSR can result in
asynchronous pacing during refractory periods since the combination can cause a very small sensing
window or none at all. Use Dynamic AV Delay or Dynamic PVARP to optimize sensing windows. If you
are entering a
fi
xed AV Delay, consider the sensing outcomes.
•
Atrial Tachy Response (ATR).
ATR should be programmed to On if the patient has a history of atrial
tachyarrhythmias. The delivery of CRT is compromised because AV synchrony is disrupted if the ATR
mode switch occurs.
•
Threshold test.
During a manual LV Threshold test, RV Backup Pacing is unavailable.
•
Left ventricular pacing only.
The clinical effect of LV pacing alone for heart failure patients has not
been studied.
•
Shock waveform polarity.
For IS-1/DF-1 leads, never change the shock waveform polarity by physically
switching the lead anodes and cathodes in the pulse generator header—use the programmable Polarity
feature. Device damage or nonconversion of the arrhythmia post-operatively may result if the polarity
is switched physically.
11
