LATITUDE Programming System Model 3300 Application In-Service 2020 PDF download

Pacing System Analyzer (PSA) Application In-Service 1

Connections

Patient Connections Inductive Telemetry Wand Model 6395 S-ICD Telemetry Wand Model 3203 Connection Port (for future use) Patient ECG Cable Model 3153 PSA Cable A / RV Model 6763 PSA Cable LV Model 6763

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Physician Connections Power (ON / OFF) Button is green when the Programmer is ON USB 2.0 Port (3)

USB 3.0 Port (1) Ethernet Port Verify proper adapter if video screen uses VGA or HDMI connection

DisplayPort Out AC Power Connection

Connectivity and Power a

b

Verify Desired Power and Connectivity

• Lightning bolt (a) appears inside the black battery symbol if the programmer is attached to AC power and battery charge is provided • When unplugged to AC power, battery icon changes color at different levels of charge: 25-100% charged 10-24%charged <10%charged

• Check for (b) Bluetooth connectivity on the Main Screen prior to selecting Quick Start or the PSA application to ensure Bluetooth printing capability, or connect USB cable to USB printer 3

Note: When powering ON the LATITUDE™ Programming System, it may take up to one minute for the software to load and during this time the screen may be flashing or blank

Main Screen: Power Supply Indicator • If the Programmer is connected to external AC power, the internal battery (Model 6753) will be charging, whether the Programmer is ON or OFF • Depending on age of the battery, a full charge should last for approximately 2 hours of normal operation • Messages will display on the Programmer screen at different levels of battery depletion

Connected to AC Power

25%

4

5%

Not Connected to AC Power

25%

5%

Startup Work Flow a

Device Interrogation

• • • •

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Interrogate the device via Quick Start button before starting the PSA application Device application button (a) will then be visible at upper right of startup screen next to PSA button Saved PSA data will be associated within the device being implanted During the implant case, toggle between the PSA and PG application as desired

Startup Work Flow

Data Management

c

b

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• •

Select (b) Data tab Select method to Save, either (c) Hard Drive or USB Drive

Startup Work Flow f

•

Enter and Program (d) Patient Information and any preferred device settings

•

Check device (e) Battery and reform capacitor if a high-voltage device

•

Select (f) PSA application

d d

e

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PSA application remains active until Programmer is powered OFF

Select PSA Setting and Lead Traces

h g

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•

Select (g) PSA traces

•

Choose (h) Gain settings using the Up or Down arrows

PSA Main Screen Layouts (a) Lead Traces panel • 3-chamber pacing and sensing • Displays real-time EGMs and markers (b) Magnify and Additional Settings • Gain, surface filter, markers, pacing spikes a (c) Lead Trace button (d) Current of Injury (e) PSA Real-time Log (f) PSA Pacing and Amplitude panel • Enables / disables pacing • Mode adjusts accordingly (g) PSA Settings button (h) More Tests button (i) Test Results button (j) PSA Test Chamber Measurements panel

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b c d e

j

f

g

h

i

Lead Trace Panel ECG / EGM Full Screen Display

From the PSA Main Screen the Magnify button enlarges the lead trace area

(a) Gain • Select the appropriate value to adjust the surface gain of the traces that are captured on printouts; range: AUTO, 0.5, 1, 2, 5, 10, 20 mm/mV

(b) Calibrate button • Transmits a 1 mV calibration pulse to the ECG display to establish a reference point to evaluate amplitudes (c) Baseline button • Forces the trace back to the baseline

a a a a b c

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Lead Trace Panel ECG / EGM Full Screen Display

(d) Trace Speed • Select the desired speed on the ECG display: 0 (stop), 25, or 50 mm/s (e) PSA Markers • When in a PSA application session, select the check box to enable the PSA markers

d

e

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f

g

(f) Surface Filters • Select the check box to minimize noise on the surface ECG (g) Pacing Spikes • Select the check box to show detected pacing spikes, annotated by a marker on the top waveform

Lead Trace Panel

PSA Markers Parameter AS (AS) AP RVS RVP LVS LVP

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Measurement Atrial Sense after refractory Atrial Sense during refractory Atrial Pace Right Ventricular Sense after refractory Right Ventricular Pace Left Ventricular Sense after refractory Left Ventricular Pace

Dual Chamber Devices, PSA Cable Connections

Dual Chamber Pacemaker

Dual Chamber DF4 ICD Model 6763 PSA Cables

Model 7001EZ-4 Connector Tool RA

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RV

BiV Quadripolar PSA Cable Connections

BiV Quadripolar CRT-D

Model 4625 Quadripolar Connector Tool White cables

V- / V+ or LV1 & LV2 Gray cables

RA LV RV

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A- / A+ or LV3 & LV4

BiV Quadripolar PSA Cable Connections c

b

d a

For LV Unipolar Connection: (a) Move the A+ (red) clip of the A / RV cable to a temporary indifferent electrode as the can (b) Check the box “Use the A+ connection ...”

13 Bipolar 13 Bipolar LV Lead Vectors

(c) Check the desired Can electrode (d) Click Accept To end a unipolar configuration, select the

4 Unipolar desired bipolar LV configuration and the “Use the A+ connection ...” LV Lead Vectors deselect box; this results in normal operation of the atrial lead anode

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LV Impedance Parameter Ranges

*The specified tolerance does not apply to LV lead impedance measurements using the LV PSA cable in combination with either the RV or RA cables. Clinical decisions using LV lead impedance values should be based on measurements using the LV PSA cable only.

Impedance

Voltage

100 - 3000 Ω 0.5 - 7.5 volts

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Pulse Width Tolerance 0.4 to 2.0 ms ± 25%*

PSA Cable Connections (Model 6697)

Optional Remington Cables (Disposable) LV PSA cable RA / RV PSA cable A port

V port

RA LV3 & LV4 (A port)

RV

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LV

LV1 & LV2 (V port)

PSA Settings

PSA Nominal Settings

a

NOTE: Verify PSA Settings prior to beginning lead testing, making modifications as necessary

Noise Filter

If noise is evident on electrogram trace, turn ON (a) Filter for (b) 50Hz or 60Hz frequencies b

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This feature is nominally OFF.

Sensing

Typical Method for P/R Wave Amplitude Measurements

• Select desired (a) Surface ECG / PSA Lead a Traces based on lead connected • If testing (b) LV Lead, ensure Pace / Sense configuration is set from the PSA Test Chamber Measurements panel • Go to the (c) PSA Settings and Output (PW and amplitude) panel and turn OFF pacing to all channels where no leads are connected • Disable (c) Pacing and enable sensing in the channel you want to measure (alternatively, c decrease (d) pacing rate below the intrinsic rate of patient) • Sense measurement values are now displayed on the (e) EGM with each corresponding sensed beat • Repeat procedure for other channels

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d

e

b

Sensing

Slew Rate and RV-LV Timing

(a) Slew displayed with each sensed intrinsic activity (b) RV–LV interval displayed when RV and LV cables are connected; a negative value will be displayed if LV is sensed before RV

a

b

Sensed measurement values displayed beat-by-beat

Slew Rate displayed during sensed intrinsic activity on beat-by-beat basis RV–LV Interval displayed

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Boston Scientific

LATITUDE Programming System Model 3300 Application In-Service 2020