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Low Voltage Technology. Pulse Generator Technology Lead Technology. Pulse Generator. 1958, 8 October. Identity ADx XL DR. Feed Through. Defib. protection. Capacitors. Sensor. Crystal. Telemetry Coil. X-ray marker. Golden Thread Welded Bonds. All bonding is doubled for safety reasons.

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Presentation Transcript
low voltage technology

Low VoltageTechnology

Pulse Generator Technology

Lead Technology

slide6

Feed Through

Defib. protection

Capacitors

Sensor

Crystal

Telemetry Coil

X-ray marker

golden thread welded bonds
Golden Thread Welded Bonds

All bonding is doubled for safety reasons

e lective r eplacement i ndicator

Magnet Rate <99/min:

(and normal energy consumption)

6 months F-U interval

98.6

BOL

Magnet Rate ~93/min:

(and normal energy consumption)

Replacement within 3 months

ERI

86.3

Magnet Rate <85/min:

Immediate replacement

Elective Replacement Indicator

Magnet

test rate

100

85

EOL

EOJ

e lective r eplacement i ndicator1

Stimulationrate

63.2

64.5

65.9

67.4

69.0

70.6

Battery impedance kOhms

10

20

30

40

BOL

EOL

Elective Replacement Indicator
exemple of current drain

25

20

15

Stimulation current

consumption

10

5

Exemple of current drain

Single-chamber unit, rate 60min-1 and 500Ω lead imp.

Current drain µA

Intrinsic current

consumption

0,5ms

1,0ms

0,5ms

1,0ms

0,5ms

1,0ms

1,0 Volt

2,5 Volt

7,5 Volt

how to find the set screw
How to ”find” the set screw

Silicone rubber sealing membrane

different 3 2 mm short bore connectors

VS 1

IS-1

IS-1

VS 1B

Cordis 3.2 mm

IS-1

Different 3.2 mm ”Short Bore” Connectors
different 3 2 mm long bore connectors

VS 1A / IS-1

VS 1B / IS-1

IS-1

IS-1

VS 1B

Cordis 3.2 mm

Different 3.2 mm ”Long Bore” Connectors
connectors in our products

VS 1B / IS -1

IS-1

IS-1

† Not µ-size cans

* Not M/S version

Connectors in our Products

Sensolog*

Dialog*

Sensorithm*

Regency*

Paragon*

Synchrony*

Trilogy*

Affinity*

Entity

Integrity†

Identity†

ADx Family†*

Microny

Integrity µ-size

Identity µ-size

ADx Family µ-size

connectors

M, 5 mm

S, 6 mm

K, 3.2 mm (IS-1)

T, 3.2 mm (IS-1)

C, 3.2 mm inline (VDD)

(for old version AddVent, obsolete now)

Bifurcated 3.2 mm (VDD)

Connectors
lead position
Lead position

Endocardial

Myocardial

Epicardial

polarity configuration
Polarity configuration

Bi-polar

Uni-polar

uni polar or bi polar leads
Advantages - Bi-polar

Less risk of myopotential oversensing

Less risk of musclestim.

Less risk of Crosstalk and Far Field Sensing

Uni-polar or bi-polar leads?
  • Advantages - Uni-polar
  • Smaller diameter
  • Larger “spikes” on ECG

( )

With a bipolar lead, you can program the device to e.g. stimulate unipolar but sense bipolar

slide23

Far-field sensing

Sensing intrinsic

activity in the

other chamber

Crosstalk

Sensing pacemaker-

activity in the other chamber

is 1 connector
IS-1 connector

Bi-polar

Uni-polar

fixation methods
Fixation methods

Passive

Active

titanium nitride tin coating

This fractal coating creates a microscopic area ~4-600 times larger than the macro-scopic area (~15 cm2 vs 3,2 mm2 (Isoflex))

Titanium nitride (TiN) coating
factors affecting threshold
Factors affecting threshold

Insulation defects/Conductor failure

Lead position

Inflammatory reaction

Scar tissue

Polarisation losses

naspe bpeg generic pacemaker code

I

II

III

V

IV

What is

stimulated?

What is

sensed?

Reaction to

sensing

MultisitePacing

Rate Modulation

0=NoneR=Rate Modulation

0=None

A=AtriumV=VentricleD=Dual (A+V)

0=None

A=AtriumV=VentricleD=Dual (A+V)

0=NoneT=TriggeredI=InhibitedD=Dual (T+I)

0=None

A=AtriumV=VentricleD=Dual (A+V)

S=Single

(A or V)

S=Single

(A or V)

NASPE/BPEG Generic Pacemaker Code

The Revised NASPE/BPEG Generic Code for

Antibradycardia, Adaptive-Rate, and Multisite

Pacing,

PACE , Volume 25, No. 2, February 2002

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