Use Instructions

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10.9 Parameter Restrictions and Warnings
Whenever a parameter value is modified, the OPTIMIZER Smart Mini Programmer application
performs a check of the modified value against all the other parameter values currently
programmed into the OPTIMIZER Smart Mini IPG. If the modified parameter value violates the
one of the following restrictions, then an error message is generated and displayed in the error
message window.
1. AV Limit Long shall be greater than AV Limit Short
Rationale: By definition, the AV Long Delay should always be greater than the AV Short
Delay
2. Total CCM event period (Alert Start + Alert Width +CCM Train Delay + CCM Train
Duration + Balancing Phase Duration) must be shorter than the A/V refractory period
minus 86 ms (noise window)
Rationale: In order to avoid false event detections, the CCM therapy has to be delivered
entirely within the atrial and ventricular refractory period. Prior to the end of these
refractory periods, an 86 ms long noise window is activated to detect external
interference. Therefore, CCM therapy delivery has to be completed before the noise
window is opened.
3. Alert Start + CCM Train Delay must be equal to or greater than 3 ms
Rationale: The Alert Start time relates to the right ventricular event. Thus, if the Alert Start
value is negative and if a local sense event is detected during the AV interval, a right
ventricular event will have to occur and be detected before the device can determine if
the event fell inside the alert window. This implies that CCM therapy deliver will not occur
prior to the detection of a right ventricular event. Thus, this constraint allows for the
detection of a right ventricular event prior to the delivery of CCM therapy.
4. Post LS Refractory Period cannot be greater than the CCM Train Delay
Rationale: Since the Post LS Refractory Period masks any event (e.g., CCM event) that
may occur after the detection of the LS event, the delivery of CCM therapy cannot begin
during the Post LS Refractory Period.
5. The period (in milliseconds) corresponding to the Atrial Tachycardia Rate shall be greater
than the Post-V atrial refractory plus Short AV delay plus 50 ms (RA/RV)
Rationale: After an atrial event has been detected, a new atrial event can not be sensed
until the Post-V Atrial Refractory period ends. In addition, the minimum required alert
period to detect tachycardia is 50 ms.
6. The period (in milliseconds) corresponding to the Ventricular Tachycardia Rate shall be
greater than the Post-V ventricular refractory plus 50 ms (RA/RV)
Rationale: After a ventricular (RV) event has been detected, a new ventricular (RV) event
can not be sensed until the Post-V RV Refractory period ends. In addition, the minimum
required alert period to detect tachycardia is 50 ms.
7. LS Alert Window Start cannot be in the Pre and/or Post RV Refractory period
Rationale: If the LS Alert Window starts inside the Pre or Post RV Refractory period, only
LS events falling inside the Alert Window and outside the RV Refractory Periods will be
detected and trigger CCM therapy delivery. This effectively shortens the LS Alert window
and may prevent the detection of an LS event.
8. LS Alert Window End cannot be in the Pre and/or Post RV Refractory period
Rationale: If the LS Alert Window ends inside the Pre or Post RV Refractory period, only
LS events falling inside the Alert Window and outside the RV Refractory Periods will be
detected and trigger CCM therapy delivery. This effectively shortens the LS Alert window
and may prevent the detection of an LS event.