ICM Insertion

Question 1

what is an ICM

Answer 1

implantable, patient and auto activated monitoring system

Question 2

what kind of ECG does ICM record

Answer 2

subcutaneous

Question 3

ICM indications

Answer 3

Patients with clinical an increased risk of arrhythmias.
Patients who experience transient symptoms that may suggest a cardiac arrhythmia such as
- dizziness
- palpitations
- syncope
- chest pain

Question 4

ICM size

Answer 4

1/3 the size of an AAA battery

Question 5

3 ICM components

Answer 5

ICM
Pt monitor
Pt assistant

Question 6

ICM battery life

Answer 6

3-years

Question 7

ICM dx & detection

Answer 7

Episode Detection – Pauses, brady, tachy, AT/AF
Diagnostics – ECG, Episode log, Episode counters, AT/AF Summaries, Trends, Rate Histograms

Question 8

Optimal insertion site

Answer 8

4th intercostal space, left of the sternum

Question 9

how deep & far is the ICM inserted

Answer 9

8 mm & 10 mm

Question 10

what must you do before pushing the ICM in

Answer 10

rotate the insertion tool 180 degrees

Question 11

what should be assessed/sensed

Answer 11

R-wave amplitude at the top left-hand corner of the screen

Question 12

what should the minimum R wave sensing be set to, to ensure adequate sensing

Answer 12

0.2 mV

Question 13

what do you do after ensuring the device is sensing properly

Answer 13

confirm the final device programming parameters and print a final report

Question 14

what should you do at the time of insertion

Answer 14

Distribute the Patient Monitor

Question 15

what needs to be done before the patient is discharged.

Answer 15

Perform the one-time initial set up manual transmission

Question 16

what does the pt need to do with the monitor daily, usually while asleep

Answer 16

stay within 2 meters of the monitor for 5 hours

Question 17

T/F - Verify that only P-waves are sensed by the device.

Answer 17

false

Question 18

If signals smaller than _____ are observed, it is recommended that the device be repositioned

Answer 18

0.2 mV

Question 19

According to the ICM lecture, what is the correct order of an ICM implantation?

Answer 19

a. Prepare for insertion

b. Insert ICM

c. Enable ICM

d. Check for proper sensing

e. Reposition the device, if necessary.

f. Confirm Final Programming

g. Complete Device Resigstration

h. Educate patient and connect ICM to Remote Monitor

i. Perform initial set-up manual transmission.