22
•
Reinsert the stylet and reposition the lead using the procedures
previously discussed and repeat the lead evaluation process.
•
If testing results are unsatisfactory, further lead system repositioning
or replacement may be required.
Consider the following information:
•
Low stimulation threshold readings indicate a desirable safety margin,
since stimulation threshold may rise after implantation.
•
Initial electrical measurements may deviate from recommendations
because of acute cellular trauma. If this occurs, wait approximately 10
minutes and repeat testing. Values may be dependent on patient-
specific factors such as tissue condition, electrolyte balance, and drug
interactions.
•
Amplitude and duration measurements are not inclusive of current of
injury and are taken during the patient's normal baseline rhythm.
4.
Test for diaphragmatic stimulation by pacing the lead at a high voltage
output, using professional medical judgment to select the output voltage.
Adjust the lead configurations and lead position as necessary. PSA testing
at higher outputs may also be considered to better characterize stimulation
margins. Testing should be conducted for all lead placements.
5.
Once acceptable measurements are obtained, remove the pacing system
analyzer connections, and remove the stylet.
6.
Pinch the terminal boot levers and slide the Connector Tool off of the
proximal end of the lead.
7.
If additional repositioning and/or PSA measurements are necessary,
reattach the Connector Tool, ensuring the lead is fully inserted, and repeat
the evaluation process.
Connection to a Pulse Generator
Consult the applicable pulse generator physician's manual for more
instructions for connecting lead terminals to the pulse generator.
1.
Verify the stylet and any terminal pin accessories are removed prior to
connecting the lead to the pulse generator.
2.
Grasp the lead body in the labeled area distal to the terminal ring contacts
and fully insert the lead terminal into the pulse generator port until the
terminal pin is visible beyond the setscrew block. If the terminal pin is
difficult to insert, verify the setscrew is completely retracted. Visualization
of the terminal pin insertion indicator beyond the setscrew block may be
used to confirm that the terminal pin is fully inserted into the pulse
generator port.
NOTE:
If necessary, lubricate the entire lead terminal (area shown in Figure 9
DF4 Lead Terminal on page 22) sparingly with sterile water or sterile mineral oil
to make insertion easier.
Figure 9.
DF4 Lead Terminal
