Boston Manuals

Question 1

Device alerts - Shock/ATP

Question 2

Device alerts - HM disconnected

Question 3

Device alerts - Lead integrity

Question 4

ICD

Define detection window

Answer 4

Uses a moving window of 10 intervals to make decisions

Detection is satisfied when 8/10 intervals are fast

Rate is the criterion

Question 5

ICD

Define duration

Answer 5

Durations ensures that the arrhythmia is sustained before initiating treatment

6/10 must remain fast

Rate and duration are criterion

Question 6

What determines which therapy is delivered?

Answer 6

Last interval in the zone

*last interval must be fast and in the zone for therapies to occur

Question 7

Identify BS detection enhancements

Answer 7

Onset
Stability
V rate > A rate
A fib rate threshold
Sustained Rate duration
Morphology (Rhythm ID)

*only enhancements programmed ON at GOSH are Rhythm ID in VT and VT mom zone.

Question 8

How many stages does BS reconfirmation have?

Answer 8

2 stages:
- during charge: 6/10
- After charge: 2/3

Question 9

Programming for history of VF/SCD

Answer 9

VF - 180/230bpm - ATP, then shocks
VT - 160bpm - monitor only

Question 10

Programming for history of VT/VF

Answer 10

VF - 200bpm - ATP, then shocks
VT - 160bpm - ATP, the shocks

Question 11

Programming prophylaxis for VT/VF

Answer 11

VF - 180bpm - ATP, the shocks
VT - 160bpm - Monitor only

Question 12

Programming for VF only (Long QT etc.)

Answer 12

VF - 220bpm - shocks

Question 13

What Detection enhancements are only found in single chamber BS devices?

Answer 13

Onset
Stability
Shock if unstable
Sustained rate discrimination (SRD)

Question 14

What is the magnet rate for Boston devices at each stage of life?

Answer 14

1. BOL = 100
2. ERI = 90
3. EOL = 85

Question 15

For Emblem SICD and Embelm SICD MRI, what models are MRI compatible?

Answer 15

A209
A219

Question 16

Which Boston SCID leads are considered MRI compatible?

Answer 16

Boston Scientific Emblem SICD electrode (3401 & 3501)

Cameron health Q-TRACK SICD electrode (3010)

Question 17

What is the recommended magnet strength for MRI scans?

Answer 17

1.5 T

Question 18

Identify 3 contraindications for MRI scan in cardiac devices

Answer 18

1. Non MRI compatible system
2. Abandoned devices, components or accessories
3. <6 weeks post implant/intervention

Question 19

What features and functions are suspended during MRI mode?

Answer 19

1. Tachy detection & therapy
2. System diagnostics
3. Magnet detection

Question 20

Purpose of ventricular tachy-arrhythmia therapy

Answer 20

Treat arrhythmias associated with sudden cardiac death - VT/VF

Question 21

Purpose of bradycardia pacing

Answer 21

To detect and treat bradyarrythmias and provide cardiac rate support after defibrillation therapy

Question 22

Identify the shock vectors in Boston devices

Answer 22

1. Distal shock electrode to proximal shock electrode & can
2. RV to RA coil
3. RV coil to can

Question 23

Boston scientific pulse generators are contraindicated in which patients?

Answer 23

1. Digitalis
2. Electrolyte imbalance
3. Hypoxia
4. Sepsis

All reversible causes of VF