User's Manual

116
Follow-up Options
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Through its external pulse control function, the pacemaker can be used
as an "implanted electrophysiologic laboratory" for non-invasive
programmed stimulation (NIPS) and for terminating tachycardia. The
maximum pacing rate is 800 ppm for single-chamber operation
(corresponding to a minimum coupling interval of 75 ms).
Two operating modes are available:
• Burst stimulation with realtime control of the burst rate
• Programmed stimulation adjustable over a broad range with up to
four extrastimuli.
Caution! External pulse control must be carried out bearing
the usual safety precautions in mind, because,
depending on the stimulation protocol and the
patient's condition, dangerous arrhythmia
including ventricular fibrillation and flutter may be
induced during any electrophysiological study. If
defibrillation becomes necessary, care should be
taken to place the leads so as to minimize the risk
of damage to the implanted pacemaker. Anterior
and posterior placement as far as possible from
the pacemaker is best.
Caution! With high triggered rates, high pulse amplitude,
and large pulse width, a temporary decrease of the
pulse amplitude may occur. Therefore, the
effectiveness of the pacing pulses must be secured
by continuous ECG monitoring. After the
replacement indication has been reached, external
pulse control is blocked.
Temporary Program Activation
The pacemakers feature two program memories, one for the
permanent program and the other for a temporary program. This
makes it possible to temporarily activate complete programs during
follow-up. Temporary programs remain active only as long as the
programming head is positioned over the pacemaker and no other
program is being transmitted. As soon as the programming head is
removed, the temporary program is replaced by the permanent
program within one cycle. Programs containing a parameter conflict
cannot be transmitted as permanent programs, but can (with some
exceptions) be transmitted as temporary programs.