•
External de
fi
brillation.
It can take up to 15 seconds for sensing to recover after an external shock is
delivered. In non-emergency situations, for pacemaker dependent patients, consider programming the
pulse generator to an asynchronous pacing mode and programming the Respiratory Sensor to Off prior to
performing external cardioversion or de
fi
brillation.
Avoid placing a pad (or paddle) directly over any subcutaneous leads.
External de
fi
brillation or cardioversion can damage the pulse generator. To help prevent damage to the
pulse generator, consider the following:
•
Avoid placing a pad (or paddle) directly over the pulse generator. Position the pads (or paddles)
as far from the pulse generator as possible.
•
Position the pads (or paddles) in a posterior-anterior orientation when the device is implanted in
the right pectoral region or an anterior-apex orientation when the device is implanted in the left
pectoral region.
•
Set energy output of external de
fi
brillation equipment as low as clinically acceptable.
Following external cardioversion or de
fi
brillation, verify pulse generator function ("Post-Therapy Pulse
Generator Follow Up" on page 19).
•
Lithotripsy.
Extracorporeal shock wave lithotripsy (ESWL) may cause electromagnetic interference with
or damage to the pulse generator. If ESWL is medically necessary, consider the following to minimize the
potential for encountering interaction:
•
Focus the ESWL beam at least 15 cm (6 in) away from the pulse generator.
•
Depending on the pacing needs of the patient, program the Brady Mode to Off or a
non-rate-responsive VVI mode.
•
Program the Tachy mode to Off to prevent inappropriate shocks.
16
