ICD Follow-up

Pacemaker Follow-up

   

1.    Patient interview/review patient history

2.    Evaluate ECG, Electrogram (EGM), and Annotated Event Markers

3.    Interrogate the device and review the Automatic System Summary

·        Clinical Events

·        Pacing Threshold Test

·        Brady Counters

·        Battery Status

·        Daily Measurements

·        Intrinsic Amplitude

·        Pacing Lead Impedance

·        Shocking Lead Impedance

4.    Evaluate Therapy History

·        Conversion Summary

·        Arrhythmia Recordings

                                                              i.      Episode Detail

·        Counters

·        Histograms

5.    Perform Device Analysis

·        Intrinsic Amplitude Test

·        Pacing Impedance Test

·        Shock Lead Impedance Test

·        Atrial Threshold Test

·        Ventricular Threshold Test

·        Retrograde Conduction Test

·        Follow-up

·        Parameters

·        Daily measurements

·        Trends

·        Therapy history

·        Episode details

7.    Save to USB, if desired

8.  Troubleshoot, as needed

9.    Reprogram, as needed

     10.  Reset Counters

1.    Patient interview/review patient history

2.    Interrogate and print pacemaker parameters - initial

·        If patient is being paced, use Temporary Parameters – VVI, rate of 30 ppm – run paper to assess patient’s underlying rhythm

3.     Evaluate Therapy History

·        Arrhythmia Recordings – review stored electrograms (EGMs)

·        Counters

·        Histograms

4.    Perform Device Analysis

·        Intrinsic Amplitude Measurements

·        Lead Impedance Measurements

·        Atrial Amplitude Threshold Test

·        Ventricular Amplitude Threshold Test

·        Retrograde Conduction Test

5.    Diagnostic Evaluation (if applicable)

·        Battery Status

·        Arrhythmia Recordings

·        Daily Measurements

·        Trends

6.    Paced ECG Analysis

·        Identify pacemaker settings

·        Measure intervals

·        Convert rate to milliseconds

·        Find pacer spikes/assess capture

·        Check P/R wave morphology

·        Assess sensing

·        Note underlying rhythm

·        Document findings

7.    A/V Electrograms and Markers

8.    Troubleshoot, as needed

9.      Reprogram, as needed

     10.  Print Final Report for chart

     11.  Reset Counters