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10 Stratos LV/LV-T Technical Manual
Pacing thresholds – When decreasing programmed output
(pulse amplitude and/or pulse width), the pacing threshold must
first be accurately assessed to provide a 2:1 safety margin.
EMI – Computerized systems are subject to (Electromagnetic
Interference (EMI) or “noise”. In the presence of such
interference, telemetry communication may be interrupted and
prevent programming of the Stratos CRT-P.
Programming Modifications – Extreme programming changes
should only be made after careful clinical assessment. Clinical
judgment should be used when programming permanent pacing
rates below 40 ppm or above 100 ppm.
Short Pacing Intervals – Use of short pacing intervals (high
pacing rates) with long atrial and/or ventricular refractory periods
may result in intermittent asynchronous pacing and, therefore,
may be contraindicated in some patients.
OFF Mode – The OFF mode can be transmitted as a temporary
program only to permit evaluation of the patient’s spontaneous
rhythm. (see Section 2.1.11)
Myopotential Sensing – The filter characteristics of
BIOTRONIK implantable devices have been optimized to sense
electrical potentials generated by cardiac activity and to reduce
the possibility of sensing skeletal myopotentials. However, the
risk of CRT-P’s operation being affected by myopotentials
cannot be eliminated, particularly in unipolar systems.
Myopotentials may resemble cardiac activity, resulting in
inhibition of pacing, triggering and/or emission of asynchronous
pacing pulses, depending on the pacing mode and the
interference pattern. Certain follow-up procedures, such as
monitoring CRT-P performance while the patient is doing
exercises involving the use of pectoral muscles, as well as Holter
monitoring, have been recommended to check for interference
caused by myopotentials. If sensing of myopotentials is
encountered, corrective actions may include selection of a
different pacing mode or sensitivity setting.
Muscle or Nerve Stimulation – Inappropriate muscle or nerve
stimulation may occur with unipolar pacing when using a non-
coated Stratos CRT-P.