CONFIENT™ Implantable Cardioverter Defibrillator (ICD)

ICD Systems from Boston Scientific CRM

ICD Indications and Usage
ICDs are intended to provide ventricular antitachycardia pacing and ventricular defibrillation for automated treatment of life-threatening ventricular arrhythmias. ICDs with atrial therapies are also intended to provide atrial antitachycardia pacing and atrial defibrillation treatment in patients who have or are at risk of developing atrial tachyarrhythmias.

Contraindications
Use of ICD systems are contraindicated in: Patients whose ventricular tachyarrhythmias may have reversible cause, such as 1) digitalis intoxication, 2) electrolyte imbalance, 3) hypoxia, or 4) sepsis, or whose ventricular tachyarrhythmias have a transient cause, such as 1) acute myocardial infarction, 2) electrocution, or 3) drowning. Patients who have a unipolar pacemaker.

Warnings
Read the product labeling thoroughly before implanting the pulse generator to avoid damage to the ICD system. Such damage can result in patient injury or death. Program the pulse generator ventricular Tachy Mode to Off during implant, explant or post-mortem procedures to avoid inadvertent high voltage shocks. Always have sterile external and internal defibrillator protection available during implant. If not terminated in a timely fashion, an induced tachyarrhythmia can result in the patient’s death. Ensure that an external defibrillator and medical personnel skilled in cardiopulmonary resuscitation (CPR) are present during post-implant device testing should the patient require external rescue. Patients should seek medical guidance before entering environments that could adversely affect the operation of the active implantable medical device, including areas protected by a warning notice that prevents entry by patients who have a pulse generator. Do not expose a patient to MRI device scanning. Strong magnetic fields may damage the device and cause injury to the patient. Do not subject a patient with an implanted pulse generator to diathermy since diathermy may cause fibrillation, burning of the myocardium, and irreversible damage to the pulse generator because of induced currents. Do not use atrial tracking modes (or an AVT device) in patients with chronic refractory atrial tachyarrhythmias. Tracking of atrial arrhythmias could result in VT or VF. (Applies to dual-chamber devices only.) Do not use this pulse generator with another pulse generator. This combination could cause pulse generator interaction resulting in patient injury or lack of therapy delivery. Do not kink leads. Kinking leads may cause additional stress on the leads, possibly resulting in lead fracture. For specific models, when using a subpectoral implantation, place the pulse generator with the serial number facing away from the ribs. Implanting the pulse generator subpectorally with the serial number facing the ribs may cause repetitive mechanical stress to a specific area of the titanium case, potentially leading to a component failure and device malfunction.

Precautions
For information on precautions, refer to the following sections of the product labeling: clinical considerations; sterilization, storage and handling; implantation and device programming; follow-up testing; explant and disposal; environmental and medical therapy hazards; home and occupational environments. Advise patients to avoid sources of electromagnetic interference (EMI) because EMI may cause the pulse generator to deliver inappropriate therapy or inhibit appropriate therapy.

Potential Adverse Events

Potential adverse events from implantation of the ICD system include, but are not limited to, the following: allergic/physical/physiologic reaction, death, erosion/migration, fibrillation or other arrhythmias, lead or accessory breakage (fracture/insulation/lead tip), hematoma/seroma, inappropriate or inability to provide therapy (shocks/pacing/sensing), infection, procedure related, psychologic intolerance to an ICD system - patients susceptible to frequent shocks despite antiarrhythmic medical management/imagined shocking, and component failure. In rare cases severe complications or device failures can occur.

Refer to the product labeling for specific indications, contraindications, warnings/ precautions and adverse events. Rx only.
(Rev. M)

 

LATITUDE® Patient Management System from Boston Scientific CRM

Intended Use
The LATITUDE Patient Management system is used to remotely communicate with a compatible pulse generator device from Boston Scientific CRM and send data to a central database. The LATITUDE system is contraindicated for use with any pulse generator other than a device from Boston Scientific CRM..

The LATITUDE system is designed to tell your doctor within 24 hours if alert conditions are detected by the Communicator. Alert notifications are based on clinician configured alert settings. However, alert notification cannot occur if:

• The Communicator is unplugged or is not able to connect to the LATITUDE system through an active phone line.
• Your device and the Communicator cannot establish and complete a communication session. This session must be initiated by you if you have a device that uses inductive telemetry (Communicator that has a wand).
• The Communicator becomes damaged or it malfunctions.
• The patient is not compliant with prescribed use or is not using the LATITUDE system as described in the patient manual.

Contraindications
The LATITUDE system is contraindicated for use with any pulse generator other than a compatible pulse generator from Boston Scientific CRM. Not all Guidant or Boston Scientific pulse generators are compatible with the LATITUDE system. For contraindications for use related to the pulse generator, refer to the System Guide for the pulse generator being interrogated.

Precautions
The LATITUDE system is designed to notify clinicians within 24 hours if new pulse generator alert conditions are detected by the Communicator. Alert notifications are based on clinician configured alert settings. Pulse generator data will typically be available for review on the LATITUDE system within 15 minutes of a successful interrogation. However, data availability and alert notification can take up to 24 hours or the next business day. Note that data will not be available and alert notification cannot occur if:

• The Communicator is unplugged or is not able to connect to the LATITUDE system through an active phone line.
  
• The pulse generator and the Communicator cannot establish and complete a telemetry session. This session must be initiated by the patient if he or she has a pulse generator that uses inductive telemetry.
  
• The Communicator becomes damaged or it malfunctions.
  
• The patient is not compliant with prescribed use or is not using the LATITUDE system as described in the patient manual.

Up to two weeks may elapse before LATITUDE first detects the conditions mentioned above and additional time may be required for clinic notification and resolution of the condition. During this time, no new patient data, device data, or alert notifications since the last successful data transmission will be available.

Alert notifications are not intended to be used as the sole basis for making decisions about patient medical care. Alerts can be verified by reviewing supporting diagnostic information stored in the implanted device and viewing information on the LATITUDE clinician website.

Adverse Effects
None known.

Refer to the product labeling for specific instructions for use. Rx only.
(Rev. J)