4 Stratos LV/LV-T Technical Manual

Magnetic Resonance Imaging (MRI) – Avoid use of magnetic resonance imaging as it has been shown to cause movement of the CRT-Ps within the subcutaneous pocket and may cause pain and injury to the patient and damage to the CRT-P. If the procedure must be used, constant monitoring is recommended, including monitoring the peripheral pulse.

Rate Adaptive Pacing – Use rate adaptive pacing with care in patients unable to tolerate increased pacing rates.

NIPS – Life threatening ventricular arrhythmias can be induced by stimulation in the ventricle. Ensure that an external cardiac defibrillator is accessible during tachycardia testing. Only physicians trained and experienced in tachycardia induction and reversion protocols should use non-invasive programmed stimulation (NIPS).

High Output Settings – High output settings combined with extremely low lead impedance may reduce the life expectancy of the Stratos CRT-Ps. Programming of pulse amplitudes, higher than 4.8 V, in combination with long pulse widths and/or high pacing rates may lead to premature activation of the replacement indicator.

1.5.1 Interactions with Other Medical Therapy

Before applying one of the following procedures, a detailed analysis of the advantages and risks should be made. Cardiac activity during one of these procedures should be confirmed by continuous monitoring of peripheral pulse or blood pressure. Following the procedures, CRT-P function and stimulation threshold must be checked.

Therapeutic Diathermy Equipment – Use of therapeutic diathermy equipment is to be avoided for pacemaker patients due to possible heating effects of the CRT-P and at the implant site. If diathermy therapy must be used, it should not be applied in the immediate vicinity of the CRT-P or leads. The patient's peripheral pulse should be monitored continuously during the treatment.