Healthcare Professionals
Viva S CRT-D
Cardiac Resynchronization Therapy Defibrillators (CRT-D)
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Healthcare Professionals
Cardiac Resynchronization Therapy Defibrillators (CRT-D)
Viva™ S CRT-D devices feature the Ensure CRT™ Suite, five integrated algorithms that automatically work together to ensure CRT delivery during challenging conditions.1-7 CRT non-response is a significant unmet medical need affecting up to one-third of patients implanted with CRT devices.8-13 The new PhysioCurve™ contoured Viva S CRT-D has increased device longevity14 and enhances patient comfort.15
While CRT is a highly effective therapy, there remains a need to improve the percentage of patients who receive full benefits. Studies have shown that up to one-third of patients do not experience all of the benefits of CRT.8-13
Many factors contribute to CRT non-response, including suboptimal AV timing, suboptimal LV lead placement, presence of arrhythmias, and reduced BiV pacing.16
As part of its comprehensive approach to treating heart failure patients with CRT, Medtronic offers a variety of solutions across every stage of care, including ways to optimize CRT response.
The Ensure CRT™ Suite, available in the Medtronic Viva™ S CRT-D device, is designed to address conditions that can interrupt CRT response:
The Ensure CRT Suite incorporates five integrated algorithms that automatically work together during these challenging conditions to ensure CRT delivery.19
Five Algorithms Address Challenging Conditions
Detail - Ensure CRT Graph
Learn more about the Ensure CRT Suite.
For CRT-D devices, certain programming and device operations may not provide cardiac resynchronization. Changes in a patient's disease and/or medications may alter the efficacy of a device's programmed parameters. Please refer to the Instructions For Use for complete safety Information, potential complications, Indications, Contraindications, Warnings and Precautions.
Lemke B, Birnie D, Aonuma K. Comparison of cardiac resynchronization therapy optimization methods with respect to biventricular pacing percentage: sub-analysis of adaptive CRT trial. J Card Fail. 2012;18:S53-S54.
Aktas MK, Jeevanantham V, Sherazi S. Effect of biventricular pacing during a ventricular sensed event. Am J Cardiol. June 15, 2009;103(12):1741-1745.
Tse HF, Newman D, Ellenbogen KA, et al., for the AF SYMPTOMS study investigators. Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (AF symptoms mediated by pacing to mean rates [AF SYMPTOMS study]). Am J Cardiol. October 1, 2004;94(7):938-941.
Newman D, Lau CP, Tse HF, et al, for the AF SYMPTOMS study investigators. Clinical impact of rate regularization in patients with paroxysmal atrial fibrillation.Pacing Clin Electrophysiol. April 2003;26(4, Part II):1036.
Murgatroyd FD, Helmling E, Lemke B, et al. Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators. Europace. June 2010;12(6):811-816.
Crossley GH, Mead H, Kleckner K, et al. Automated left ventricular capture management. Pacing Clin Electrophysiol. October 2007;30(10):1190-1200.
Burri H, Gerritse B, Davenport L, et al., on behalf of the Concerto AT Clinical Study Investigators. Fluctuation of left ventricular thresholds and required safety margin for left ventricular pacing with cardiac resynchronization therapy. Europace. July 2009;11(7):931-936.
Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.
Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.
Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. November 2, 2004;110(18):2864-2868.
Chung ES, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (PROSPECT) trial. Circulation. May 20, 2008;117(20):2608-2616.
Abraham WT, Leon AR, Hannon C, et al. Results of the InSync III Marquis clinical trial. Heart Rhythm. May 2005;2(5):S65.
Abraham WT, et al. Results from the FREEDOM Trial – Assess the Safety and Efficacy of Frequent Optimization of Cardiac Resynchronization Therapy. Late-Breaking Clinical Trials,SP08. Presented at the Heart Rhythm Society 31st Annual Scientific Sessions, May 2010, Denver, Colorado.
Sawchuk R, Younker G. Projected Service Life: 10% Longevity Improvement over Protecta. Medtronic data on file. January 2013. (Projected service life estimates are based on accelerated battery discharge data and device modeling as specified. Do not interpret these values as precise numbers.)
Flo, Daniel. CRT-D IS4/DF4 Device Shape Analysis. April 2012. Medtronic data on file.
Mullens W, Grimm RA, Verga T, et al. Insights from a cardiac resynchronization optimization clinic as part of a heart failure disease management program. JACC. 2009;53(9):765-773.
Knight BP, Desai A, Coman J, et al. Long-term retention of cardiac resynchronization therapy. J Am Coll Cardiol. 2004; 44(1):72-77.
Crossley GH, Mead H, Kleckner K, et al. Automated left ventricular capture management. Pacing Clin Electrophysiol. 2007;30(10):1190-1200.
Medtronic Viva S CRT-D Technical Manual, Medtronic Inc.
The new PhysioCurve™ design for the Medtronic Viva™ S CRT-D devices features a physiologic contoured shape for enhanced patient comfort.15
The Viva S CRT-D also has 10% increased device longevity14* and maintains 35 J output for ALL shocks.16
*As compared to Protecta XT CRT-D. Assumptions for Viva S CRT-D: 600 ohm lead impedance; pre-arrhythmia EGM storage ON for 6 months; RA/RV Pacing % = 15%/100%; RA/RV Pacing Amplitudes: 2.5 V/2.5 V; LV Pacing Amplitude: 3.0 V; LV Pacing 100%. For more information, see Viva S manual.
The PhysioCurve Design
Detail – PhysioCurve Design
Using a proprietary comparative shape pressure analysis, the contoured shape of PhysioCurve (Viva S CRT-D IS1/DF4) resulted in a 30% reduction in skin pressure compared to non-contoured devices (CRT-D IS1/DF4).15 (Red areas indicate high skin pressure.)
Detail – Pressure Analysis
For CRT-D devices, certain programming and device operations may not provide cardiac resynchronization. Changes in a patient's disease and/or medications may alter the efficacy of a device's programmed parameters.
Lemke B, Birnie D, Aonuma K. Comparison of cardiac resynchronization therapy optimization methods with respect to biventricular pacing percentage: sub-analysis of adaptive CRT trial. J Card Fail. 2012;18:S53-S54.
Aktas MK, Jeevanantham V, Sherazi S. Effect of biventricular pacing during a ventricular sensed event. Am J Cardiol. June 15, 2009;103(12):1741-1745.
Tse HF, Newman D, Ellenbogen KA, et al., for the AF SYMPTOMS study investigators. Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (AF symptoms mediated by pacing to mean rates [AF SYMPTOMS study]). Am J Cardiol. October 1, 2004;94(7):938-941.
Newman D, Lau CP, Tse HF, et al, for the AF SYMPTOMS study investigators. Clinical impact of rate regularization in patients with paroxysmal atrial fibrillation.Pacing Clin Electrophysiol. April 2003;26(4, Part II):1036.
Murgatroyd FD, Helmling E, Lemke B, et al. Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators. Europace. June 2010;12(6):811-816.
Crossley GH, Mead H, Kleckner K, et al. Automated left ventricular capture management. Pacing Clin Electrophysiol. October 2007;30(10):1190-1200.
Burri H, Gerritse B, Davenport L, et al., on behalf of the Concerto AT Clinical Study Investigators. Fluctuation of left ventricular thresholds and required safety margin for left ventricular pacing with cardiac resynchronization therapy. Europace. July 2009;11(7):931-936.
Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.
Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.
Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. November 2, 2004;110(18):2864-2868.
Chung ES, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (PROSPECT) trial. Circulation. May 20, 2008;117(20):2608-2616.
Abraham WT, Leon AR, Hannon C, et al. Results of the InSync III Marquis clinical trial. Heart Rhythm. May 2005;2(5):S65.
Abraham WT, et al. Results from the FREEDOM Trial – Assess the Safety and Efficacy of Frequent Optimization of Cardiac Resynchronization Therapy. Late-Breaking Clinical Trials,SP08. Presented at the Heart Rhythm Society 31st Annual Scientific Sessions, May 2010, Denver, Colorado.
Sawchuk R, Younker G. Projected Service Life: 10% Longevity Improvement over Protecta. Medtronic data on file. January 2013. (Projected service life estimates are based on accelerated battery discharge data and device modeling as specified. Do not interpret these values as precise numbers.)
Flo, Daniel. CRT-D IS4/DF4 Device Shape Analysis. April 2012. Medtronic data on file.
Medtronic Viva S CRT-D Technical Manual.
Introduced with Medtronic’s previous generation of CRT-D devices, SmartShock® Technology includes six exclusive algorithms that discriminate true lethal arrhythmias from other arrhythmic and nonarrhythmic events. SmartShock Technology dramatically reduces the incidence of inappropriate shocks while maintaining sensitivity.16,17
Detail – Chart
SmartShock Technology has been enhanced to improve long-term shock reduction, while simplifying device programming. SmartShock 2.0 includes the following:
For CRT-Ds, certain programming and device operations may not provide cardiac resynchronization. Changes in patient’s disease and/or medications may alter the efficacy of the device’s programmed parameters.
Lemke B, Birnie D, Aonuma K. Comparison of cardiac resynchronization therapy optimization methods with respect to biventricular pacing percentage: sub-analysis of adaptive CRT trial. J Card Fail. 2012;18:S53-S54.
Aktas MK, Jeevanantham V, Sherazi S. Effect of biventricular pacing during a ventricular sensed event. Am J Cardiol. June 15, 2009;103(12):1741-1745.
Tse HF, Newman D, Ellenbogen KA, et al., for the AF SYMPTOMS study investigators. Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (AF symptoms mediated by pacing to mean rates [AF SYMPTOMS study]). Am J Cardiol. October 1, 2004;94(7):938-941.
Newman D, Lau CP, Tse HF, et al, for the AF SYMPTOMS study investigators. Clinical impact of rate regularization in patients with paroxysmal atrial fibrillation.Pacing Clin Electrophysiol. April 2003;26(4, Part II):1036.
Murgatroyd FD, Helmling E, Lemke B, et al. Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators. Europace. June 2010;12(6):811-816.
Crossley GH, Mead H, Kleckner K, et al. Automated left ventricular capture management. Pacing Clin Electrophysiol. October 2007;30(10):1190-1200.
Burri H, Gerritse B, Davenport L, et al., on behalf of the Concerto AT Clinical Study Investigators. Fluctuation of left ventricular thresholds and required safety margin for left ventricular pacing with cardiac resynchronization therapy. Europace. July 2009;11(7):931-936.
Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.
Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.
Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. November 2, 2004;110(18):2864-2868.
Chung ES, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (PROSPECT) trial. Circulation. May 20, 2008;117(20):2608-2616.
Abraham WT, Leon AR, Hannon C, et al. Results of the InSync III Marquis clinical trial. Heart Rhythm. May 2005;2(5):S65.
Abraham WT, et al. Results from the FREEDOM Trial – Assess the Safety and Efficacy of Frequent Optimization of Cardiac Resynchronization Therapy. Late-Breaking Clinical Trials,SP08. Presented at the Heart Rhythm Society 31st Annual Scientific Sessions, May 2010, Denver, Colorado.
Sawchuk R, Younker G. Projected Service Life: 10% Longevity Improvement over Protecta. Medtronic data on file. January 2013. (Projected service life estimates are based on accelerated battery discharge data and device modeling as specified. Do not interpret these values as precise numbers.)
Flo, Daniel. CRT-D IS4/DF4 Device Shape Analysis. April 2012. Medtronic data on file.
Volosin, KJ, Exner DV, Wathen MS, et al. Combining shock reduction strategies to enhance ICD therapy: A role for computer modeling. J Cardiovasc Electrophysiol. March 2011;22(3):280-289.
Protecta Clinical Study, Medtronic data on file.
OptiVol Fluid Status Monitoring objectively tracks fluid status and other physiologic trends to help clinicians monitor complications,17,18 identify patients with long-term mortality risk,19 and potentially avoid hospital readmissions for their heart failure patients.20-23 OptiVol 2.0, an enhanced version of the original OptiVol feature, is available in the Medtronic Viva XT, Viva S, and other Medtronic CRT-D devices.
OptiVol 2.0 enhancements include24:
Reduced Unexplained Detections24
Detail - Unexplained Detections
For CRT-D devices, certain programming and device operations may not provide cardiac resynchronization. Changes in a patient's disease and/or medications may alter the efficacy of a device's programmed parameters.
Lemke B, Birnie D, Aonuma K. Comparison of cardiac resynchronization therapy optimization methods with respect to biventricular pacing percentage: sub-analysis of adaptive CRT trial. J Card Fail. 2012;18:S53-S54.
Aktas MK, Jeevanantham V, Sherazi S. Effect of biventricular pacing during a ventricular sensed event. Am J Cardiol. June 15, 2009;103(12):1741-1745.
Tse HF, Newman D, Ellenbogen KA, et al., for the AF SYMPTOMS study investigators. Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (AF symptoms mediated by pacing to mean rates [AF SYMPTOMS study]). Am J Cardiol. October 1, 2004;94(7):938-941.
Newman D, Lau CP, Tse HF, et al, for the AF SYMPTOMS study investigators. Clinical impact of rate regularization in patients with paroxysmal atrial fibrillation.Pacing Clin Electrophysiol. April 2003;26(4, Part II):1036.
Murgatroyd FD, Helmling E, Lemke B, et al. Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators. Europace. June 2010;12(6):811-816.
Crossley GH, Mead H, Kleckner K, et al. Automated left ventricular capture management. Pacing Clin Electrophysiol. October 2007;30(10):1190-1200.
Burri H, Gerritse B, Davenport L, et al., on behalf of the Concerto AT Clinical Study Investigators. Fluctuation of left ventricular thresholds and required safety margin for left ventricular pacing with cardiac resynchronization therapy. Europace. July 2009;11(7):931-936.
Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.
Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.
Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. November 2, 2004;110(18):2864-2868.
Chung ES, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (PROSPECT) trial. Circulation. May 20, 2008;117(20):2608-2616.
Abraham WT, Leon AR, Hannon C, et al. Results of the InSync III Marquis clinical trial. Heart Rhythm. May 2005;2(5):S65.
Abraham WT, et al. Results from the FREEDOM Trial – Assess the Safety and Efficacy of Frequent Optimization of Cardiac Resynchronization Therapy. Late-Breaking Clinical Trials,SP08. Presented at the Heart Rhythm Society 31st Annual Scientific Sessions, May 2010, Denver, Colorado.
Sawchuk R, Younker G. Projected Service Life: 10% Longevity Improvement over Protecta. Medtronic data on file. January 2013. (Projected service life estimates are based on accelerated battery discharge data and device modeling as specified. Do not interpret these values as precise numbers.)
Flo, Daniel. CRT-D IS4/DF4 Device Shape Analysis. April 2012. Medtronic data on file.
Mullens W, Grimm RA, Verga T, et al. Insights from a cardiac resynchronization optimization clinic as part of a heart failure disease management program. JACC. 2009;53(9):765-773.
Yu CM, Wang L, Chau E, et al. Intrathoracic impedance monitoring in patients with heart failure: correlation with fluid status and feasibility of early warning preceding hospitalization. Circulation. August 9, 2005;112(6):841-848.
Abraham WT, Compton S, Haas G, et al. Superior performance of intrathoracic impedance-derived fluid index versus daily weight monitoring in heart failure patients. Results of the Fluid Accumulation Status Trial. Late Breaking Clinical Trials. J Card Fail. November 2009;15(9):813.
Tang WH, Warman EN, Johnson JW, et al. Threshold crossing of device-based intrathoracic impedance trends identifies relatively increased mortality risk. Eur Heart J. September 2012;33(17):2189-2196.
Small RS, Whellan DJ, Boyle A, et al. Implantable device diagnostics on the day of discharge from a heart failure hospitalization can predict 30 day readmission risk. J Card Fail. August 2012;18(8 Suppl):S50.
Whellan DJ, Ousdigian KT, Al-Khatib SM, et al. Combined heart failure device diagnostics identify patients at higher risk of subsequent heart failure hospitalizations: results from PARTNERS HF (Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients with Heart Failure) study. J Am Coll Cardiol. April 27, 2010;55(17):1803-1810.
Small RS, Wickemeyer W, Germany R, et al. Changes in intrathoracic impedance are associated with subsequent risk of hospitalizations for acute decompensated heart failure: clinical utility of implanted device monitoring without a patient alert. J Card Fail. August 2009;15(6):475-481.
Whellan DJ, Sarkar S, Koehler J, et al. Development of a method to risk stratify patients with heart failure for 30-day readmission using implantable device diagnostics.Am J Cardio. January 1, 2013;111(1):79-84.
Sarkar S, Hettrick DA, Koehler J, et al. Improved algorithm to detect fluid accumulation via intrathoracic impedance monitoring in heart failure patients with implantable devices. J Card Fail. 2011;17(7):569-576.
Viva™ S CRT-D Specifications
IS1/DF4 (Model DTBB2D4) and IS1/DF1 (Model DTBB2D1) | |
---|---|
Volume * | 35 cm3 |
Mass |
80 gr |
H x W x D |
73 mm x 51 mm x 13 mm (IS1/DF4) 71 mm x 51 mm x 13 mm (IS1/DF1) |
*Volume with connector holes unplugged
See the appropriate Medtronic Clinician Manual for more information.
Lemke B, Birnie D, Aonuma K. Comparison of cardiac resynchronization therapy optimization methods with respect to biventricular pacing percentage: sub-analysis of adaptive CRT trial. J Card Fail. 2012;18:S53-S54.
Aktas MK, Jeevanantham V, Sherazi S. Effect of biventricular pacing during a ventricular sensed event. Am J Cardiol. June 15, 2009;103(12):1741-1745.
Tse HF, Newman D, Ellenbogen KA, et al., for the AF SYMPTOMS study investigators. Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (AF symptoms mediated by pacing to mean rates [AF SYMPTOMS study]). Am J Cardiol. October 1, 2004;94(7):938-941.
Newman D, Lau CP, Tse HF, et al, for the AF SYMPTOMS study investigators. Clinical impact of rate regularization in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. April 2003;26(4, Part II):1036.
Murgatroyd FD, Helmling E, Lemke B, et al. Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators. Europace. June 2010;12(6):811-816.
Crossley GH, Mead H, Kleckner K, et al. Automated left ventricular capture management. Pacing Clin Electrophysiol. October 2007;30(10):1190-1200.
Burri H, Gerritse B, Davenport L, et al., on behalf of the Concerto AT Clinical Study Investigators. Fluctuation of left ventricular thresholds and required safety margin for left ventricular pacing with cardiac resynchronization therapy. Europace. July 2009;11(7):931-936.
Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.
Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.
Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. November 2, 2004;110(18):2864-2868.
Chung ES, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (PROSPECT) trial. Circulation. May 20, 2008;117(20):2608-2616.
Abraham WT, Leon AR, Hannon C, et al. Results of the InSync III Marquis clinical trial. Heart Rhythm. May 2005;2(5):S65.
Abraham WT, et al. Results from the FREEDOM Trial – Assess the Safety and Efficacy of Frequent Optimization of Cardiac Resynchronization Therapy. Late-Breaking Clinical Trials,SP08. Presented at the Heart Rhythm Society 31st Annual Scientific Sessions, May 2010, Denver, Colorado.
Sawchuk R, Younker G. Projected Service Life: 10% Longevity Improvement over Protecta. Medtronic data on file. January 2013. (Projected service life estimates are based on accelerated battery discharge data and device modeling as specified. Do not interpret these values as precise numbers.)
Flo, Daniel. CRT-D IS4/DF4 Device Shape Analysis. April 2012. Medtronic data on file.
Lemke B, Birnie D, Aonuma K. Comparison of cardiac resynchronization therapy optimization methods with respect to biventricular pacing percentage: sub-analysis of adaptive CRT trial. J Card Fail. 2012;18:S53-S54.
Aktas MK, Jeevanantham V, Sherazi S. Effect of biventricular pacing during a ventricular sensed event. Am J Cardiol. June 15, 2009;103(12):1741-1745.
Tse HF, Newman D, Ellenbogen KA, et al., for the AF SYMPTOMS study investigators. Effects of ventricular rate regularization pacing on quality of life and symptoms in patients with atrial fibrillation (AF symptoms mediated by pacing to mean rates [AF SYMPTOMS study]). Am J Cardiol. October 1, 2004;94(7):938-941.
Newman D, Lau CP, Tse HF, et al, for the AF SYMPTOMS study investigators. Clinical impact of rate regularization in patients with paroxysmal atrial fibrillation.Pacing Clin Electrophysiol. April 2003;26(4, Part II):1036.
Murgatroyd FD, Helmling E, Lemke B, et al. Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators. Europace. June 2010;12(6):811-816.
Crossley GH, Mead H, Kleckner K, et al. Automated left ventricular capture management. Pacing Clin Electrophysiol. October 2007;30(10):1190-1200.
Burri H, Gerritse B, Davenport L, et al., on behalf of the Concerto AT Clinical Study Investigators. Fluctuation of left ventricular thresholds and required safety margin for left ventricular pacing with cardiac resynchronization therapy. Europace. July 2009;11(7):931-936.
Abraham WT, Fisher WG, Smith AL, et al. Cardiac resynchronization in chronic heart failure. N Engl J Med. June 13, 2002;346(24):1845-1853.
Young JB, Abraham WT, Smith AL, et al. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA. May 28, 2003;289(20):2685-2694.
Abraham WT, Young JB, León AR, et al. Effects of cardiac resynchronization on disease progression in patients with left ventricular systolic dysfunction, an indication for an implantable cardioverter-defibrillator, and mildly symptomatic chronic heart failure. Circulation. November 2, 2004;110(18):2864-2868.
Chung ES, Leon AR, Tavazzi L, et al. Results of the predictors of response to CRT (PROSPECT) trial. Circulation. May 20, 2008;117(20):2608-2616.
Abraham WT, Leon AR, Hannon C, et al. Results of the InSync III Marquis clinical trial. Heart Rhythm. May 2005;2(5):S65.
Abraham WT, et al. Results from the FREEDOM Trial – Assess the Safety and Efficacy of Frequent Optimization of Cardiac Resynchronization Therapy. Late-Breaking Clinical Trials,SP08. Presented at the Heart Rhythm Society 31st Annual Scientific Sessions, May 2010, Denver, Colorado.
Sawchuk R, Younker G. Projected Service Life: 10% Longevity Improvement over Protecta. Medtronic data on file. January 2013. (Projected service life estimates are based on accelerated battery discharge data and device modeling as specified. Do not interpret these values as precise numbers.)
Flo, Daniel. CRT-D IS4/DF4 Device Shape Analysis. April 2012. Medtronic data on file.
Mullens W, Grimm RA, Verga T, et al. Insights from a cardiac resynchronization optimization clinic as part of a heart failure disease management program. JACC. 2009;53(9):765-773.
IMPORTANT INFORMATION ON INDICATIONS, SAFETY AND WARNINGS
For listing of Indications, Contraindications, Warnings, Precautions, and Potential Adverse Events, please refer to the Instructions For Use .