ICD Inductions and Programming

Question 1

Do Medtronic ICD’s have programmable tilt for ventricular therapies?

Answer 1

• No

- have fixed tilt 50/50

Question 2

What acronym is used when performing an ICD device functional integrity test prior to implantation?

Answer 2

VTOP:

• Voltage
• date and Time
• verify detections of Off
• Print

Question 3

What is the minimum battery voltage allowed when implanting an ICD?

Answer 3

voltage must be > 2.97V

Question 4

What are the 2 methods for inducing VF during a DFT?

Answer 4

T-shock and 50Hz burst

Question 5

What do the following T-Shock Parameters represent?

1) #S1
2) S1S1
3) delay

Answer 5

1) number of pacing pulses delivered in the pacing train
2) cycle length (rate) pacing train is delivered
3) time between the last pacing pulse and the shock

Question 6

What are the sequence of events seen on an EGM when performing a DFT?

Answer 6

1) pacing train
2) shock on T-wave following delay interval
3) FS sensing
4) FD detected
5) charging of capacitor
6) shock delivered
7) NS or RNID

Question 7

What are the programmable T-Shock values used for induction during a DFT?

Answer 7

• number of pulses in the pacing train (#S1)
• cycle length or rate of the pacing train
• length of delay between the last pulse and shock
• energy level

Question 8

What are the programmable 50Hz Burst values used for induction during a DFT?

Answer 8

• chamber
• amplitude
• pulse width

Question 9

What is the maximum amount of time the device will allow delivery of a 50Hz Burst used for induction during a DFT?

Answer 9

burst times out after 10 seconds regardless of how long the button is pressed

Question 10

What does the pneumonic “STD” stand for in relation to a DFT?

Answer 10

• Sensitivity (set RV to least sensitive - 1.20mV)
• Therapies (start low, 15-25J)
• Detections (set to lowest NID and RNID)

Question 11

What does the pneumonic REPD stand for in relation to a DFT?

Answer 11

• Resume at delivery (want checked)
• Enable (want checked)
• Print
• Deliver shock

Question 12

What should the RV sensitivity be set to prior to performing a DFT?

Answer 12

1.2mV or the least sensitive setting

Question 13

What should the VF therapy energy be set to after performing a DFT?

Answer 13

• add 10 Joules to the DFT rescue energy