User's Manual

As a matter of fact, when the lead port is filled with a liquid, the physics piston effect can
give the feeling the lead is properly tightened.
4. One single set screw is located on the side of the connection header.
5. Use only the screwdriver provided with the defibrillator. Keep the screwdriver's shaft
perpendicular to the plane of the defibrillator (see figure below).
6. Removing the screwdriver: to avoid all risk of loosening screws during removal, hold the
screwdriver by its metal part and not by the handle.
WARNING: Ensure that the screwdriver's tip is fully inserted in the setscrew; otherwise the
screwdriver can damage the setscrew and prevent connection with or disconnection from the
lead.
To ensure full insertion, push the screwdriver's hex tip smoothly into the setscrew until it
reaches the bottom of the hex chamber in the screw, which can be felt as a solid metallic
contact. Do not implant the defibrillator if there is no feeling of solid metallic contact. Do not
implant the defibrillator if the wrench does not click when attempting to tighten the setscrew
on the lead pin.
NOTE: To optimize cardioversion/defibrillation shocks, electrodes must be positioned so that
the electric field between anode(s) and cathode covers the largest myocardial mass. In
normal conditions, the anode and cathode are adequately separated. In case of a short-
circuit, the shock may be aborted.
In the case of an external defibrillation shock delivered to the patient, always check the
programming and functioning of the device, in particular its capacity to deliver shocks.
DEVICE IMPLANTATION
PLATINIUM 4LV CRT-D 1744 should be implanted with the device identification engraved
side facing outwards for optimal communication with the programming head and radiographic
identification.
In order to prevent lead damage or dislodgement, it is important to loosely coil the leads and
place them in a manner that minimizes lead tension, twisting, sharp angles, and pressure.
The following factors should be considered in placing any excess of lead length:
1. recommendations/warnings of the (other) associated leads,
2. patient anatomy, and
3. pulse generator size and motion.
Suture the casing connector to the muscle using the hole provided for this purpose, in order
to avoid potential migration of the device into the pectoral muscle.
14.11.
14. IMPLANT PROCEDURE
SORIN – PLATINIUM 4LV CRT-D 1744 – U904A 37