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124 Stratos LV/LV-T Technical Manual
To determine the threshold, the ECG must be observed
continuously. Based on the measured threshold, the pulse
amplitude for the permanent program should be adjusted.
Please consult the pertinent medical literature for specific
recommendations regarding necessary safety margins.
NOTE:
With successful biventricular pacing of patients with
congestive heart failure, the QRS complex should be visibly
shortened.
5.2 P/R Measurement - Testing the
Sensing Function
Stratos CRT-Ps provide a P-/R-wave test for measuring the
amplitude of intrinsic events during follow-up examination. The
test determines the minimum, mean and maximum amplitude
values over a programmable period of time. In addition, these
values may be printed out.
To permit evaluation of the sensing function, the pacing rate
must be lower than the patient's intrinsic rate. In demand
pacing, the proper sensing function can be recognized if the
interval between intrinsic events and the following pacing pulse
equals the basic interval (if no Hysteresis is programmed).
For evaluation of the sensing function, the CRT-P features an
intracardiac electrogram (IEGM) with marker signals to indicate
sensed and paced events. In addition, triggered pacing modes
can be selected which, synchronously to the detection of an
intrinsic event, emit a pacing pulse and mark the sensed event
and its timing on the ECG.
Especially with unipolar sensing functions, the selected
sensitivity level should be checked for possible interference from
skeletal myopotentials. If oversensing is observed, the
programming of a lower sensitivity (higher value), or bipolar
sensing function, if the implanted lead is bipolar, should be
evaluated.