User's Manual

US-ENGLISH – 23
7. PATIENT SELECTION AND TREATMENT
7.1. INDIVIDUALIZATION OF TREATMENT
Exercise stress testing: If the patient’s condition permits, use
exercise stress testing to:
 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.
CAUTION: To avoid inappropriate therapy during an exercise stress
test, do not reprogram any parameter during the test. When a
parameter is reprogrammed, "Discrimination" algorithm forces
acceleration to "ventricular". During conducted sinus tachycardia
within the programmed Tachy zone, the device detects a 1:1 fast
rhythm. Assuming that acceleration was set to ventricular by
reprogramming, the device may identify this as a VT, and may
immediately apply the corresponding therapy.
Electrophysiologic (EP) testing: EP testing may be useful for ICD
candidates. EP testing may identify the classifications and rates of all the
ventricular and atrial arrhythmias, whether spontaneous or during EP
testing.
Drug resistant supraventricular tachyarrhythmias (SVTs): Drug
resistant supraventricular tachyarrhythmias (SVTs) may initiate
frequent unwanted device therapy. A careful choice of programming
options is necessary for such patients.