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LV, LV-T
12. Order Information, Order Number, Pulse Generator Type
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Stratos
LV/LV-T
Technical Manual 161
12. Order Information
Pulse Generator Type
Order Number
Stratos LV
338 200
Stratos
LV-T
338 202
Contents
Family of Cardiac Resynchronization
Therapy Pacemakers
CAUTION
Contents
Page
Page
9. Elective Replacement Indication (ERI)
Page
Page
1. General
1.1Device Description
1.2Indications
1.3Contraindications
1.4Note to Physician
1.5Warnings and Precautions
1.5.1 Interactions with Other Medical Therapy
Page
1.5.2 Storage and Sterilization
1.5.3 Lead Connection and Evaluation
1.5.4 Programming and Operation
AV Hysteresis
Sensing –
AV Conduction
Unipolar/Bipolar
bipolar
Page
1.5.5 Home Monitoring
Page
1.5.6 Electromagnetic Interference (EMI)
1.5.7 Home and Occupational Environments
1.5.8 Cellular Phones
1.5.9 Hospital and Medical Environments
1.5.10 Device Explant and Disposal
1.6Potential Effects of the Device on
Health
1.7Clinical Studies
1.7.1 Stratos LV Clinical Study – AVAIL CLS/CRT
Page
Clinical Inclusion Criteria
Clinical Exclusion Criteria
Follow-UpSchedule
Clinical Endpoints
Accountability of PMA Cohorts
Figure
Figure 1: Patient Accountability
Demographics and Baseline Parameters
Table
Table 1: Patient Demographics at Enrollment
Page
Table 2: Atrial Fibrillation Demographics at Enrollment
Page
Table 3: Current Cardiac Medications at Enrollment
Safety and Effectiveness Results
Page
Primary Endpoint—Complication-freeRate (Safety)
Page
Other Medical
13.3%
Total—All
25.3%
Patients and
Page
Page
Page
46.7%
60.0%
Table 7: Summary of Patient Deaths
All Causes
Primary Endpoint: Six Minute Walk Test & QOL (Effectiveness)
Table 8: Composite of Six Minute Walk Test and QOL
(Effectiveness)
(N = 53)
Distance Walked
at Baseline
Primary Effectiveness Endpoint Analysis and Conclusions
Multi-sitePoolability and Gender Analysis
1.7.2 Stratos LV Clinical Study – OVID study
Page
Page
Page
Page
Table 10: Summary of Complications at 6 months
3.3%
Atrial Lead Related
1.1%
5.6%
Page
13.5%
19.1%
Observation
1.7.3AVAIL and OVID Combined Primary Endpoint-Complication-freeRate (Safety)
1.2%
1.8%
12.8%
17.7%
Categtories
1.7.4Tupos LV/ATx Clinical IDE Study - OPTION CRT/ATx
Page
Page
Page
Figure 2: Patient Accountability
Table 13: Patient Demographics at Pre-Enrollment
N=133
N=67
value
Table 14: Cardiac Medications at Pre-Enrollment
Drug
(N=133)
(N=67)
Specific CHF Medications
Primary Endpoint 1: Six Minute Walk Test & QOL (Effectiveness)
Table 15: Composite of Six Minute Walk Test and QOL
P-value
Distance
∆ in QOL
Score†
Secondary Endpoint Results
Table 16: Six Minute Walk Distance
Six-Month
Table 17: Improvement in NYHA Classification at
Six-Monthsfrom Baseline
Page
1.7.5 Conclusions Drawn from Studies
Page
2. Programmable Parameters
2.1Pacing Modes
2.1.1 Rate-adaptiveModes
2.1.2 DDD
Table 18: Timing Intervals
Timing
Event
Interval
Vsp
Trigger Pacing
Demand
Pacing
Triggered
pacing
Page
2.1.3 DDI
NOTE:
2.1.4 DVI
2.1.5 VDD
2.1.6 AAI and
2.1.7 AAI
2.1.8 AOO, VOO
2.1.9 DOO
2.1.10 VDI
2.2Biventricular Synchronization of the
Stratos CRT-Ps
2.3Timing Functions
2.3.1 Basic Rate
2.3.2 Rate Hysteresis
2.3.3 Scan Hysteresis
Figure 3. Scan Hysteresis
NOTES:
2.3.4 Repetitive Hysteresis
2.3.5 Night Mode
2.3.6 Refractory Periods
2.3.7 Atrial PMT Protection
2.3.8 Ventricular Refractory Period
2.3.9 AV Delay
2.3.9.2AV Hysteresis
2.3.9.3AV Repetitive Hysteresis
2.3.10VES Discrimination after Atrial Sensed Events
2.3.11 Sense Compensation
2.3.12 Ventricular Blanking Period
2.3.13 Safety AV Delay
2.4Pacing and Sensing Functions
2.4.1 Pulse Amplitude and Pulse Width
2.4.2 Sensitivity
2.4.3 Lead Polarity
2.5Automatic Lead Check
Lead Check
2.6Antitachycardia Functions:
2.6.1 Upper Rate and UTR Response
2.7Wenckebach 2:1
Wenckebach Behavior
2:1 Behavior
2.8Mode Switching
2.9PMT Management
2.9.1 Protection
2.9.2 PMT Detection
2.10 Adjustment of the PMT Protection Window
2.11 Atrial Upper Rate
2.12 Preventive Overdrive Pacing (Overdrive Mode)
Page
2.13 AES Detection and Pacing
2.13.1 AES Detection
2.13.2 Post AES Stimulation
2.14 Parameters for Rate-AdaptivePacing
2.14.1 Rate-Adaptation
2.14.2 Sensor Gain
2.14.3 Automatic Sensor Gain
2.14.4 Sensor Threshold
2.14.5 Rate Increase
2.14.6 Maximum Activity Rate
2.14.7 Rate Decay
2.15 Sensor Stimulation
2.16 Rate Fading
2.17 Home Monitoring (Stratos LV-T)
Page
2.17.1 Transmission of Information
2.17.2 Patient Device
2.17.3 Transmitting Data
Table 24: System Requirements / Recommendations
System
Requirements
Recommendations
(for Optimal Usage)
2.17.4 Types of Report Transmissions
2.17.4.2 Event Report
2.17.5 Description of Transmitted Data
Heart Failure Diagnostics
Ventricular Rhythm
Leads
System Status
2.18 Statistics
2.18.1 Timing
2.18.2 Arrhythmia
2.18.3 Sensor
2.18.4 Sensing
2.19 Interrogating and/or Starting Statistics
2.20 Timing Statistics
2.20.1 Event Counter
2.20.2 Event Episodes
2.20.3 Rate Trend
2.20.4 Atrial and Ventricular Rate Histogram
2.21 Arrhythmia Statistics
2.21.1 Tachy Episode Trend
2.21.2 AF Classification
2.21.3 AES Statistics
2.21.4 VES Statistics
2.22 Sensor Statistics
2.22.1 Sensor Rate Histogram
2.22.2 Activity Report
2.22.3 Sensor Optimization
2.23 Sensing Statistics
2.24 Pacing Statistics
3. Follow-upProcedures
3.1General Considerations
Page
4. Real-TimeIEGM
4.1IEGM Recordings
Page
5. Battery, Pulse and Lead Data
5.1Threshold Test - Testing the Pacing
Function
5.2P/R Measurement - Testing the
Sensing Function
5.3Testing for Retrograde Conduction
5.4.1 Description
5.4.2 Burst Stimulation
5.4.3 Programmed Stimulation
5.4.4 Back up Pacing
5.4.5 NIPS Safety Features
Page
6. Other Functions/Features
6.1Temporary Programming
6.2Patient Data Memory
6.3Safe Program Settings
6.4Magnet Effect
6.5Position Indicator
6.6Pacing When Exposed to Interference
Table 27: Response to EMI
MODE
EMI* (A)
EMI* (V)
EMI* (A+V)
Page
7. Product Storage and Handling
7.1Sterilization and Storage
7.2Opening the Sterile Container
Page
7.3Pulse Generator Orientation
8. Lead Connection
8.1Lead Configuration
8.2Lead Connection
Page
Page
Page
Page
9. Elective Replacement Indication (ERI)
Table 29: Service Cycle Definitions
Abbreviation
Service
Definition
in Table
Table 30: Stratos CRT-Psbehavior after reaching ERI
Magnet Mode
Cycles 1-10after
After Cycle
Page
Table 32: Remaining Expected Service time (ERI to EOS)
Pacing Program
Stratos LV, (months)
10. Explantation
Page
11. Technical Data
11.1 Available Pacing Modes
11.2 Pulse- and Control Parameters
Page
Page
Page
Page
11.3 Diagnostic Memory Functions
11.4 Home Monitoring (Stratos LV-T)
11.5 Additional Functions
11.6 Programmers
11.7 Default Programs
11.8 Materials in Contact with Human Tissue
11.9 Electrical Data/Battery
11.10 Mechanical Data
12. Order Information
Page
Appendix A
Known Software Anomalies