TherapyGuide Feature

TherapyGuide offers a simple, clinically focused method for a clinician to obtain suggested parameter values. At implant or an early follow-up appointment, the clinician enters information about the patient's clinical conditions. Based on those inputs the programmer suggests parameter values. The suggestions are based on clinical studies, literature, current practice, and the consensus of physicians.

This feature can be found in some Medtronic Pacemaker, ICD, CRT-P, and CRT-D devices. Please go to manuals.medtronic.com or consult with your local Medtronic representative regarding device models available in your geography.

From the TherapyGuide window, the clinician can perform the following functions:

  • Select the clinical conditions that describe the patient.
  • Get suggestions that TherapyGuide makes pending in the device memory. The program button must be selected to store the parameters into the device.
  • View a Rationale window, and learn what parameter settings are suggested by specific clinical conditions.

The categories for the clinical conditions selected are:

  • Atrial Status
  • AV Conduction
  • Heart Failure
  • Age
  • Activity Level
  • Reflex Syncope (pacemakers only)
  • VT/VF (ICDs only)
  • Slowest VT (ICDs only)

To use TherapyGuide, go to Params -> TherapyGuide.

Pacemaker programming

ICD programming

TherapyGuide provides tailored, clinically oriented programming suggestions using physician-selected parameters. TherapyGuide does not replace the physician’s expert judgment. The physician’s knowledge of the patient’s medical condition goes beyond the set of inputs presented to TherapyGuide. The physician is free to accept, reject, or modify any of the suggested parameter values.

The following table shows an example of how programming suggestions are determined by combinations of clinical conditions. The programmable features (and certain clinical conditions) shown in the table do not apply to all device models. To learn which of the following features apply, refer to the Implant Manual for that device.

Programming suggestions Clinical conditions
Mode/Mode Switch Atrial Status
AV Conduction
Reflex Syncope
Lead Chamber
Rate Response Heart Failure
Age
Activity Level
Reflex Syncope
Lower Rate Atrial Status 
Age
Reflex Syncope
Upper Tracking Rate Age
AV intervals (including RAAV
and Search AV+)
Atrial Status
AV Conduction

Atrial Preference Pacing and 
Post Mode Switch Overdrive Pacing

Atrial Status
Reflex Syncope
Rate Drop Response Atrial Status
Reflex Syncope

 

The clinical conditions can be printed from the Patient Information screen. They are also included in the Initial Interrogation report and in the Save to Disk file.

Selecting the clinical conditions in the TherapyGuide screen below, TherapyGuide suggests programming the parameters shown as “pending” in the screens below.

View larger image

References

Sources: Medtronic Adapta/Versa/SensiaReference Guide; Medtronic Consulta CRT-P Clinician Manual;Medtronic Protecta XT DR Clinician Manual; Medtronic Protecta XT CRT-D Clinician Manual.

Last updated: 
03 Apr 2013