Estella Pulse Generators - BIOTRONIK USA - News

12. Follow-up Procedures12.1 General ConsiderationsEstella Pulse Generators Technical Manual 111The pacemaker follow‐up serves to verify appropriate function of thepacing system, and to optimize the parameter settings.In most instances, pacing system malfunction attributed to causes suchas chronic threshold can be corrected by reprogramming the pulsegenerator. The follow‐up intervals are, therefore, primarily determinedby medical judgment, taking possible pacemaker dependency intoconsideration.The following notes are meant to stress certain product features,which are of importance for follow-up visit. For detailed information onfollow-up procedures and medical aspects, please refer to the pertinentmedical literature.NOTE:In order to enable full device functionality, including statisticsfunctions and ERI detection, transmit a permanent program afterimplantation by pressing the [Transmit/Program] button.CautionProgramming Modifications—Extreme programming changesshould only be made after careful clinical assessment. Clinicaljudgment should be used when programming permanent pacingrates below 40 ppm or above 100 ppm.12.2 Real-time IEGM TransmissionThe pulse generators provide real time transmission of the intracardiacelectrogram (IEGM) to the programmer. During dual chamber operation,IEGMs from the atrium and ventricle can be simultaneously recorded.The IEGMs may be transmitted to the programmer via the programminghead positioned over the implanted pulse generator. They are thendisplayed together with surface ECG and markers on the programmerscreen and printed on the ECG recorder. Likewise, intracardiac signalsand markers identifying atrial/ventricular paced and sensed eventsare received via the programming head, and may be displayed on theprogrammer screen and printed on the ECG recorder.To determine the amplitudes of intracardiac signals (P-/R-waves) theautomatic P/R-wave measurement function may be used.