User Manual

Lumax Technical Manual 67
1.7 Patient Selection and Treatment
1.7.1 Individualization of Treatment
 Determine whether the expected device benefits
outweigh the possibility of early device replacement for
patients whose ventricular tachyarrhythmias require
frequent shocks.
 Determine if the device and programmable options are
appropriate for patients with drug-resistant
supraventricular tachyarrhythmias (SVTs), because drug-
resistant SVTs can initiate unwanted device therapy.
 Direct any questions regarding individualization of patient
therapy to your BIOTRONIK representative or
BIOTRONIK technical services at 1-800-547-0394.
The prospective patient’s size and activity level should be
evaluated to determine whether a pectoral or abdominal implant
is suitable. It is strongly recommended that candidates for an
ICD/CRT-D have a complete cardiac evaluation including EP
testing prior to device implant to gather electrophysiologic
information, including the rates and classifications of all the
patient’s cardiac rhythms. When gathering this information,
delineate all clinically significant ventricular and atrial arrhythmias,
whether they occur spontaneously or during EP testing.
If the patient’s condition permits, use exercise stress testing to do
the following:
 Determine the maximum rate of the patient’s normal
rhythm.
 Identify any supraventricular tachyarrhythmias.
 Identify exercise-induced tachyarrhythmias.
The maximum exercise rate or the presence of supraventricular
tachyarrhythmias may influence selection of programmable
parameters. Holter monitoring or other extended ECG monitoring
also may be helpful.