User's Manual

81
Rate Adaptation

Individually Adjusting CLS Parameters
The following parameters can be individually adjusted with the
“extended CLS settings”:
• The required V
P
• The CLS dynamics
• Dynamic runaway protection
The Required V
P
In the DDD CLS mode, the default setting includes AV hysteresis to
support existing adequate intrinsic conduction. For patients with
inadequate or non-existing intrinsic conduction, it may be necessary to
turn off AV hysteresis. To do this, turn on the parameter [required V
P
].
CLS Dynamics
The factory settings for Closed Loop Stimulation provide most patients
with optimum rate dynamics. Typically, there is no need to make
adjustments.
The rate profile resulting from Closed Loop Stimulation can vary
greatly from patient to patient. In individual cases, the rate dynamics
can be optimized if the rate distribution is inadequate.
The [CLS Dynamics] parameter influences the pacemaker-internal
target rate, which is dependent on two other pre-set parameters: the
basic rate and the maximum closed loop rate. The pacemaker
internally controls rate adaptation so that 20% of the pace events are
always above the internal target rate. If CLS dynamics are
reprogrammed to a higher value, then the rate distribution includes
higher rates, and vice versa: lower programmed values yield rate
distribution with lower rates.