RV Sense Polarity

RV Sense Polarity
Overview
RV Sense Polarity is a feature available to program the RV sensing vector between true bipolar and
integrated bipolar. It offers a noninvasive option to troubleshoot T wave oversensing and/or a reduction in R
wave amplitudes. It is only available in ICDs and requires that a true bipolar lead be implanted.
Programming
The RV sensing vector is programmable via the RV Sense Polarity parameter. RV Sense Polarity can be
programmed to either Bipolar (tip-to-ring) or Tip to Coil (integrated bipolar).
To program this feature go to Params -> Pacing…
Feature Operation
The RV Sense Polarity feature determines which electrodes the RV lead uses to sense. It can be
programmed to either true bipolar, sensing between the tip and ring electrodes, or integrated bipolar, sensing
between the tip and RV coil electrodes. Changing the RV Sense Polarity between these two configurations
may change the amplitude of the RV sensed EGM. This change may result in an increase or decrease in the
R wave and T wave amplitude depending on lead position. This feature can offer a noninvasive option for
troubleshooting T wave oversensing.
© 2013 Medtronic, Inc.
www.medtronicfeatures.com
Page 1 of 3
C
Caution should be taken in
n changing th
he RV Sense
e Polarity beccause the ab
bility of the de
evice to detecct and
se
ense fine VF is changed. Reevaluatio
on of the ability of the devvice to sense VF should b
be considered
d through
de
efibrillation te
esting.
C
Considerations:
eature does not
n work for dedicated
d
inttegrated bipo
olar defibrillattion leads, siince there is no RV
 This fe
ring electrode.
 Note that changing
g the RV sense vector willl not affect th
he RV pace p
polarity, whicch is nonprogra
ammable.
 The ve
entricular sen
nsing electro
odes included
d in Sensing Test measurrements depe
end on the
progra
ammed RV Sense
S
Polarity value.
D
Devices
IC
CDs EveraTM XT VR, Evera XT DR, Evera S VR, Evera S DR, Proteccta® XT VR, Protecta XT DR, Protecta
a VR,
®
S
VR, Secura DR, Virtuoso® II VR, Virtuoso
o II DR, Maximo® II VR, M
Maximo II DR
R
Protecta DR, Secura
C
CRT-D
V
VivaTM XT CR
RT-D, Viva S CRT-D, Prottecta XT CRT
T-D, Protecta
a CRT-D, Co
onsulta® CRT
T-D, Concerto
o® II CRTD
D, Maximo II CRT-D
C
So
ources: Medtro
onic Protecta® XT
X DR Clinicia
an Manual; Med
dtronic Protecta
a® XT CRT-D C
Clinician Manu
ual.
his document is
s provided for general
g
educattional purposes
s only and shou
uld not be conssidered the excclusive source for this
Th
tyype of information. At all times
s, it is the profe
essional respon
nsibility of the p
practitioner to e
exercise indepe
endent clinical jjudgment in
a particular situa
ation. Changes in a patient’s disease
d
and/orr medications m
may alter the effficacy of a devvice’s programm
med
arameters or re
elated features and results ma
ay vary. The de
evice functiona
ality and progra
amming describ
bed in this docu
ument are
pa
ba
ased on Medtro
onic products and
a can be refe
erenced in the published devi ce manuals.
© 2013 Medtron
nic, Inc.
ww w.medtronic
cfeatures.co
om
Page 2 of 3
Indications, Safety, and Warnings
Brief Statement: ICDs and CRT ICDs
Indications
Implantable cardioverter defibrillators (ICDs) are indicated for ventricular antitachycardia pacing and ventricular defibrillation for automated
treatment of life-threatening ventricular arrhythmias.
Cardiac resynchronization therapy (CRT) ICDs are indicated for ventricular antitachycardia pacing and ventricular defibrillation for automated
treatment of life-threatening ventricular arrhythmias and for providing cardiac resynchronization therapy in heart failure patients who remain
symptomatic despite optimal medical therapy, and meet any of the following classifications:

New York Heart Association (NYHA) Functional Class III or IV and who have a left ventricular ejection fraction ≤ 35% and a prolonged
QRS duration.

Left bundle branch block (LBBB) with a QRS duration ≥ 130 ms, left ventricular ejection fraction ≤ 30%, and NYHA Functional Class II.
Contraindications
ICDs and CRT ICDs are contraindicated in patients whose ventricular tachyarrhythmias may have transient or reversible causes, patients with
incessant VT or VF, and for patients who have a unipolar pacemaker.
In CRT ICD systems, the leads are contraindicated for patients with coronary venous vasculature that is inadequate for lead placement, as
indicated by venogram. The lead is also contraindicated in patients for whom a single dose of 1.0 mg of dexamethasone acetate and/or
dexamethasone sodium phosphate may be contraindicated.
Warnings/Precautions
Changes in a patient’s disease and/or medications may alter the efficacy of the device’s programmed parameters. Patients should avoid sources
of magnetic and electromagnetic radiation to avoid possible underdetection, inappropriate sensing and/or therapy delivery, tissue damage,
induction of an arrhythmia, device electrical reset or device damage. Do not place transthoracic defibrillation paddles directly over the device.
Additionally, for CRT ICDs, certain programming and device operations may not provide cardiac resynchronization.
Potential Complications
Potential complications include, but are not limited to, rejection phenomena, erosion through the skin, muscle or nerve stimulation, oversensing,
failure to detect and/or terminate arrhythmia episodes, and surgical complications such as hematoma, infection, inflammation, and thrombosis.
An additional complication for ICDs and CRT ICDs is the acceleration of ventricular tachycardia.
See the device manual for detailed information regarding the implant procedure, indications, contraindications, warnings, precautions, and
potential complications/adverse events. For further information, please call Medtronic at 1-800-328-2518 and/or consult Medtronic’s website at
www.medtronic.com.
Caution: Federal law (USA) restricts these devices to sale by or on the order of a physician.
World Headquarters
Medtronic, Inc.
710 Medtronic Parkway
Minneapolis, MN 55432-5604
USA
© 2013 Medtronic, Inc.
Tel: (763) 514-4000
Fax: (763) 514-4879
Toll-free: 1 (800) 328-2518
(24-hour technical support for physicians and medical professionals)
www.medtronicfeatures.com
Page 3 of 3

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