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Group2, UG, Rev2
A Pace Ahead
MODEL
THREE-MODE RATE ADAPTIVE CARDIAC PACEMAKER
User Guide
Group 2
Chatterjee, Kalyan – 0259250
Das, David – 0358484
Mahmood, Asim – 0252904
Park, Hyo-min – 0375695
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REQUIRED HARDWARE

The pacemaker board

Pacing leads – either coax as show below for the BNC connectors or just wire
connectors to use on the binding posts

9-12 Volt A/C Power Adapter that provides at least 200mA
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USB to serial Connector (shown below) or a Serial cable with a DB-9 connector.
Laptop or Desktop PC running 32-bit Windows XP or Vista
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TABLE OF CONTENTS
LIST OF FIGURES ................................................................................................. 6
LIST OF TABLES .................................................................................................. 6
1 INTRODUCTION .................................................................................................. 7
1.1 Background ........................................................................................................................... 7
1.1.1 What is a pacemaker? ........................................................................................ 7
1.1.2 Device Overview................................................................................................. 7
1.2 Assumptions ......................................................................................................................... 8
1.3 Definitions, Acronyms, and Abbreviations ................................................................... 9
1.4 Document Conventions.................................................................................................... 10
2 QUICK START GUIDE ....................................................................................... 12
2.1 Important to Note ............................................................................................................... 12
2.2 Safety .................................................................................................................................... 12
2.3 Minimum System Requirements .................................................................................... 12
2.4 Setup Time ........................................................................................................................... 12
2.5 Installing the Pacemaker Software................................................................................ 13
2.6 Connecting the Pacemaker to your Computer........................................................... 20
2.6.1 Quick Setup – Advanced Users ........................................................................ 20
2.6.2 Detailed Setup Instructions ............................................................................... 21
2.6.3 Hardware Detected/Undetected........................................................................ 23
2.7 Connecting the Pacing Leads ........................................................................................ 24
2.8 Using the Pacemaker Software ...................................................................................... 26
2.8.1 Logging In......................................................................................................... 26
2.8.2 Creating a New Client ....................................................................................... 26
2.8.3 Initial Configuration ........................................................................................... 27
2.8.4 Knowing the User Interface .............................................................................. 29
3 PACEMAKER PARAMETER CONFIGURATION .................................................. 31
3.1 Changing Parameters ....................................................................................................... 31
Error Checking on Input Values ................................................................................. 34
3.2 Event Histogram and Electro Cardiogram .................................................................. 35
3.4 Panic Button........................................................................................................................ 36
3.4 Ending a Session ............................................................................................................... 36
4 STORING YOUR PACEMAKER SYSTEM ........................................................... 37
5 CONTACT US.................................................................................................... 38
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6 TROUBLESHOOTING ........................................................................................ 39
APPENDIX ........................................................................................................... 41
Pacemaker Modes .................................................................................................................... 41
VVI mode .................................................................................................................. 42
DDD mode ................................................................................................................ 43
DDDR mode .............................................................................................................. 45
INDEX .................................................................................................................. 46
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LIST OF FIGURES
Figure 1 - Pacemaker System Overview Schematic ........................................................... 8
Figure 2 - Creating a Desktop Shortcut ............................................................................ 11
Figure 3 – Installation Welcome Screen ........................................................................... 14
Figure 4 – Select Installation Folder ................................................................................. 15
Figure 5 – Installation Progress ........................................................................................ 16
Figure 6 – Installation Confirmation................................................................................. 17
Figure 7 - Desktop Shortcut .............................................................................................. 17
Figure 8 - PC Connection ................................................................................................. 21
Figure 9 - Serial Port on the Pacemaker board ................................................................. 21
Figure 10 - Serial Cable Connection ................................................................................. 22
Figure 11 - USB Connection to your PC .......................................................................... 22
Figure 12 - Hardware Detection Notification ................................................................... 23
Figure 13 – Step 1 – Locate the pacemaker ports as shown above................................... 24
Figure 14 – Step 2 – Connect one end of each pacing lead to the Atrial and Ventricle
ports................................................................................................................................... 25
Figure 15 - Your pacemaker system should look this at this point ................................... 25
Figure 16 – Login Window ............................................................................................... 26
Figure 17 - Pacemaker User Interface I ............................................................................ 27
Figure 18 - Pacemaker ID not entered .............................................................................. 28
Figure 19 - Pacemaker ID not found on Database ............................................................ 28
Figure 20 - Serial Port Error ............................................................................................. 29
Figure 21 - Knowing your Pacemaker System User Interface ......................................... 30
Figure 22 - Mode VVI ...................................................................................................... 31
Figure 23 - Mode DDDR .................................................................................................. 32
Figure 24 - Changing a parameter value ........................................................................... 32
Figure 25 - Error check on input values............................................................................ 34
Figure 26 - Real-Time Event Histogram and ECG ........................................................... 35
Figure 27 - Panic Button ................................................................................................... 36
Figure 28 - Anti-Static Storage Box ................................................................................. 37
Figure 29 - Windows Device Manager ............................................................................. 39
Figure 30 - Install missing drivers .................................................................................... 40
LIST OF TABLES
Table 1: Bradycardia Operating Modes ......................................................................... 41
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1 Introduction
1.1 Background
If you are an expert in pacemakers you may skip this section. However, it is
recommended that the user reads section 1.1.2 to get an overview of the device.
1.1.1 What is a pacemaker?
A pacemaker is a medical device which uses electrical impulses, delivered by electrodes
contacting the heart muscles, to regulate the beating of the heart. The primary purpose
of a pacemaker is to maintain an adequate heart rate, either because the heart’s native
pacemaker is not fast enough, or there is a block in the heart’s electrical conduction
system. The pacemaker software is embedded in a pacemaker hardware device which
is implanted along with leads by physicians and hospital staffs with varying degrees of
experience. Follow-up with the patients is typically performed by nurses or technicians
under the supervision of a physician.
1.1.2 Device Overview
A Pace Ahead pacemaker system is designed to train medical practitioners about
various pacemaker parameters. Specifically, the system allows a user to change
different pacemaker parameters in order to study the effect of those changes on a
patient’s heart condition. Any real life heart condition could be emulated using a software
package like National Instrument’s ©LabVIEW, which is then sensed by the pacemaker
hardware. The software provides a dynamic graphical user interface which provides a
real-time histogram of various heart parameters and also an Electro Cardiogram (ECG).
The pacemaker needs to be connected to a computer with a RS232 port.
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ste
Sy
m
a
St
rt-
VVI
up
Fail-Safe VVI
Mode
Mode Y
Mode Z
Mode X
Configuration Change
Via USART
USART Start Mode
Figure 1 - Pacemaker System Overview Schematic
As soon as the Pacemaker System is wired to the heart and turned on, the Pacemaker
Software will operate under default mode which is fail-safe mode. A specific mode can
be programmed on-the-fly via the port connection. Once put in any mode, it will stay in
that mode until it detects a system failure or an operator sends it parameters to change
the mode. At any of these points, it will return instantly to Fail-Safe Mode. The three
pacemaker modes that could be programmed with this model are VVI, DDD and DDD-R.
For further information on the pacemaker modes please see Pacemaker Modes .
1.2 Assumptions
The document assumes the user’s familiarity with the following:
1. Basic PC operations (Don’t worry, the setup is really easy!)
2. A Pacemaker ID is known. Required in this step
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1.3 Definitions, Acronyms, and Abbreviations
Accelerometer
AP
AS
ARP
ATR
AV
BOL
BPM
cc
CCI
DCM
ECG
EGM
EOL
EP
ERN
ERT
HRL
ICD
IS-1
LRL
LRI
MSR
NSR
OR
PG
PIC
POR
PMT
ppm
PVARP
PVC
QRS
Rate smoothing
Rate response
SIR
SRD
URL
URI
VP
VS
VRP
A device that detects and measures acceleration and tilt
Atrial Pace
Atrial Sense
Atrial Refractory Period
Atrial Tachycardia Response
Atrial-to-Ventricular
Beginning Of (battery) Life
Beats Per Minute
Cardiac Cycle(s)
Cardiac Cycle Interval
Device Controller-Monitor
Electrocardiogram, external heart signals
Electrogram, internal heart signals
End Of (battery) Life
Electrophysiology, electrophysiologist
Elective Replacement Near
Elective Replacement Time
Hysteresis Rate Limit
Implantable Cardio-Defibrillator
Industry Standard lead type 1
Lower Rate Limit
Lower Rate Interval
Maximum Sensor Rate
Normal Sinus Rhythm
Operating Room
Pulse Generator
Programmable Integrated Circuit
Power-On Reset
Pacemaker-Mediated Tachycardia
Pulses Per Minute
Post-Ventricular Atrial Refractory Period
Premature Ventricular Contraction
Electrical shock instigation of the heart’s contraction cycle
Rate modulated based on the heart’s pacing rate
Rate modulated based on the accelerometer
Sensor Indicated Rate
Sustained Rate Duration
Upper Rate Limit
Upper Rate Interval
Ventricular Pace
Ventricular Sense
Ventricular Refractory Period
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1.4 Document Conventions
The following symbols are used throughout the document. They are defined here for
your convenience.
(i)
- Wherever this sign is found on the document, please keep a note of the
information you are requested. It may come handy while trouble troubleshooting various
issues or in time of emergency
(ii)
(iii)
- Safety hazard
- Caution must be exercised to avoid damage to the device
iv)
- Error Messages
(v) A procedure like Figure 2 is written as:
“CLICK on START RIGHT-CLICK “A Pace Ahead”  SELECT Send To’ 
”
‘Desktop’
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Figure 2 - Creating a Desktop Shortcut
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2 Quick Start Guide
The following sub-sections should be read carefully as they contain all the necessary
information for setting up the pacemaker board.
Please note that in this document, the pacemaker board will be referred to as the ‘unit’.
2.1 Important to Note
 If you have any particular questions, please read through the 6 Troubleshooting
section. It answers most issues you may encounter.
 If you need help at any point during the installation process please email
[email protected]
2.2 Safety
Like with any electrical device, there is a hazard of electrical shock. Please refrain from
touching pacemaker components while it is powered ON.
2.3 Minimum System Requirements

A Windows PC (2000/Me/XP/Vista) running .NET version 3 framework

Pentium II 400 MHz or equivalent

256 MB of RAM

50 MB of free HDD Space

CD-ROM Drive

USB port
2.4 Setup Time
It should take 10 to 20 minutes to set up the pacemaker system and install the
pacemaker software on an average performance ©Windows PC.
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2.5 Installing the Pacemaker Desktop Software and Board
Firmware
2.5.1 Installing the Pacemaker Desktop Software
Step 1
DOWNLOAD the zip file containing the Desktop GUI software

GUI Installation.zip
From http://www.cas.mcmaster.ca/~lawford/Pacemaker
Step 2
SELECT “Open” the zip file.
Step 3
DOUBLE-CLICK on the file named setup.exe to open the application installer
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Figure 3 – Installation Welcome Screen
Step 4
CLICK on ‘Next’ after you have read the copyright infringement warning (as in Figure
3)
Step 5

CLICK on ‘Browse’ (Figure 4) to select an installation directory (
important: make a note of this location).

SELECT ‘Just me’ if other users on the computer do not need to use the APA
software.

CLICK on ‘Next’ to proceed.
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Figure 4 – Select Installation Folder
Step 6
Make changes (if any) to the installation settings by clicking on the ‘Back’ button,
else CLICK on ‘Next’ to proceed with installation. The installation (as shown in
Figure 5) takes a minute or two.
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Figure 5 – Installation Progress
Step 7
Once the installation completes, a confirmation (Figure 6) is displayed. CLICK
‘Close’ to complete the installation.
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Figure 6 – Installation Confirmation
Step 8
Ensure that there is a desktop shortcut (as in Figure 7) for the application
Figure 7 - Desktop Shortcut
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No Desktop icon?
Browse to your installation directory (that you noted in Step 5 of this section) and
RIGHT-CLICK on the icon than says “4G06Group2.exe”, SELECT “Send To 
Desktop”. This should create a shortcut like Figure 7 on the desktop.
2.5.2 Installing the Pacemaker Board Firmware
Step 1
DOWNLOAD the zip file containing the Microcontroller software

MicrocontrollerSource.zip
From http://www.cas.mcmaster.ca/~lawford/Pacemaker
Step 2
RIGHT CLICK on the zip file and select “Extract All …”.
This will create a
Directory called MicroControllerSource.
Step 3
START Microchip’s MPLAB IDE and se on the zip file and SELECT “File  Open
Workspace …” and then navigate to the MicroControllerSource directory and open
the file “Group2SE4G06.mcw”. Ignore warnings about missing source files (only the
binary for the firmware is contained in the zip file).
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Step 4
CONNECT the programmer to the board as shown below.
Cables are supplied for the IDC2 and the PICKit2 with the Pacemaker Board.
Step 5
SELECT the correct programmer (e.g. ICD2 or PICKit2” from the “Programmer 
Select Programmer” entry.
Step 6
CONNECT to the programmer in the MPLAB IDE by SELECT “Programmer 
Connect”.
Step 7
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PROGRAM the board from the MPLAB IDE via SELECT “Programmer  Program”
Step 8
DISCONNECT programmer and from the board and exit the MPLAB IDE.
2.6 Connecting the Pacemaker to your Computer
2.6.1 Quick Setup – Advanced Users

While the pacemaker board is not connected to a power source, CONNECT the
serial port of the pacemaker board to your computer’s USB port using the USBSerial Connector provided with the pacemaker system.

ENSURE the serial cable is properly screwed to the pacemaker board.

Connect the pacemaker to the power source.
Attempting to connect the pacemaker to the computer while the pacemaker
is powered ON may result is permanent damage to the system.
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Figure 8 - PC Connection
2.6.2 Detailed Setup Instructions
Follow the steps shown below to connect the pacemaker system to your computer.
1. Locate the serial port on the pacemaker.
Figure 9 - Serial Port on the Pacemaker board
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2. Connect the serial end of the USB-serial connector to the serial port of the
pacemaker as shown below.
Figure 10 - Serial Cable Connection
3. Connect the USB cable to any free USB port on your Windows PC.
Figure 11 - USB Connection to your PC
I
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Step 2

CONNECT the pacemaker board to the power source using a 9 to 12V AC power
adapter with at least 200mA.
You can even run the board off of a 9V radio battery, but please ensure that
the connections have the correct polarity: The center is the positive voltage
and the outer connector is the ground.
2.6.3 Hardware Detected/Undetected
If your computer detects the pacemaker device you should see a notification on your
Windows taskbar (Figure 12)
Figure 12 - Hardware Detection Notification
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Please refer to Troubleshooting if your computer did not detect the pacemaker
system or failed to install it properly.
2.7 Connecting the Pacing Leads (Optional)
CONNECT the pacemaker leads as shown in the illustrative steps below if you want to
connect a signal generator and/or an oscilloscope. The black screw terminal(s) is board
ground corresponding to the outer ring of the BNC connectors. The red screw terminals
are for the ventricle and atrial inputs/outputs and correspond to the respective centre
connectors of the BNC connectors.
Figure 13 – Step 1 – Locate the pacemaker ports as shown above
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Figure 14 – Step 2 – Connect one end of each pacing lead to the Atrial and Ventricle ports
Figure 15 - Your pacemaker system should look this at this point
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2.8 Using the Pacemaker Software
2.8.1 Logging In

DOUBLE-CLICK on the “A Pace Ahead” icon on your DESKTOP which brings
up the login window (as in Figure 16).
Figure 16 – Login Window
The factory default username and password is admin and letmein respectively.

Enter Username and Password and CLICK OK. You should see the main user
interface as in Figure 17 - Pacemaker User Interface I.
2.8.2 Creating a New Client
Please see the list of possible errors in section 2.8.3
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2.8.3 Initial Configuration

SELECT the COM PORT number from the dropdown menu labeled “Port”. In
Figure 17 we have selected port COM3.

ENTER a valid pacemaker ID in the field “PacemakerID” – NOTE: The default in
the firmware is 65535. Due to a bug in the desktop software you may need to
delete some spaces in this field before entering “65535”

CLICK on “Connect”
Figure 17 - Pacemaker User Interface I
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Possible Setup Errors
 If you leave the “PacemakerID” field blank and click Connect, the following error
message is displayed.
Figure 18 - Pacemaker ID not entered
 Please enter a Pacemaker ID before clicking on Connect.
 If you enter an invalid pacemaker ID, that is, a Pacemaker ID not on the database,
the following error message is displayed.
Figure 19 - Pacemaker ID not found on Database
 If you made an error, click “No” and enter the correct Pacemaker ID and try again
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If you were trying to create New Client - The current version of this software only
allows you to access clients who are in the database. However, if you wish to enter a
new user in the database, the only way to do that with the current software version, is to
CLICK “Yes” in the prompt shown in Figure 19 and enter the new client ID in the
“PacemakerID” field (Figure 16) and enter
 If a wrong COM PORT is selected an error message is displayed as in Figure 20.
Figure 20 - Serial Port Error
 Select the correct COM PORT from the “Port” drop down menu (Figure 17)
2.8.4 Knowing the User Interface
Upon successful setup you should see the following screen (Figure 21). User and Client
information has been labeled for quick reference.
PANIC Button – Please see section 3.4 Panic Button for the functionality of the PANIC
button
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Figure 21 - Knowing your Pacemaker System User Interface
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3 Pacemaker Parameter Configuration
3.1 Changing Parameters
The pacemaker system currently supports three pacemaker modes – VVI, DDD and
DDD-R. Figure 22 and Figure 23 show modes VVI and DDDR with different parameter
values.
Figure 22 - Mode VVI
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Figure 23 - Mode DDDR
The user interface is designed to minimize the risk of wrong input. Therefore, keyboard
input is not allowed. To enter a value you need to use the UP/DOWN buttons or the pink
slide bar (Figure 24).
Figure 24 - Changing a parameter value
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SELECT the ‘Configuration’ tab and you will see a screen like Figure 23 above
with a certain mode (DDDR in this figure)

USE the drop down menu labeled ‘Pacemaker Mode’ to select other configurable
modes

CLICK the UP or DOWN arrow button (Figure 24) to increase or decrease a
particular parameter value. Lower Rate Limit is shown here.

Alternatively, PRESS and HOLD the LEFT-MOUSE button at point A (Figure 24)
and traverse along the pink slide bar region towards B to increase a value. To
decrease a parameter value perform the same action, but this time start at B and
move towards A
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Error Checking on Input Values
The user interface also provides simple error checking on the parameter values to
ensure consistency. The figure below shows a warning message that displayed when
the user selected a higher value for Lower Rate Interval than the Upper Rate Interval.
Figure 25 - Error check on input values
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3.2 Event Histogram and Electro Cardiogram
The user interface provides Real-Time Event Histogram of four heart events – Atrial
Sense (AS), Atrial Pace (AP), Ventricle Sense (VS) and Ventricle Pace (VP). Please
see the “Real Time ECG” Figure 26.
Figure 26 - Real-Time Event Histogram and ECG
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3.4 Panic Button
The Panic button is provided for use in case of emergency only.
In a situation where a patient does not feel comfortable with the updated pacemaker
settings, CLICK on the panic button (see Figure 27) to revert to FAIL SAFE Mode
(schematic shown in Figure 1) which restores default parameter values that would help
stabilize the patient’s heart condition.
Figure 27 - Panic Button
3.4 Ending a Session
CLICK on the ‘Disconnect’ button (Figure 21) before powering OFF the pacemaker unit.
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4 Storing Your Pacemaker System
The pacemaker board consists of numerous delicate electronic components. To make
sure that your pacemaker system functions properly for many years, always store it at
room temperature in a dry place and inside an anti-static package such as the one that
originally came with the system.
Figure 28 - Anti-Static Storage Box
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5 Contact Us
If you are having trouble getting the pacemaker board working, e-mail Mark Lawford at
[email protected]. You can also check out the Pacemaker Wiki at:
http://www.cas.mcmaster.ca/wiki/index.php/Pacemaker
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6 Troubleshooting
“My Pacemaker System was not detected by the computer.”
This most likely means that you do not have the proper driver for Serial-USB connector
installed on your system. There are two actions you could take to resolve this issue.
Action 1
Use Windows Automatic hardware driver update utility (Windows XP/Vista)

RIGHT-CLICK on ‘My Computer’, SELECT ‘Properties’ and from the ‘System
Properties’ window, SELECT the ‘Hardware’ tab. This will take you to the device
manager as shows in Figure 29.
Figure 29 - Windows Device Manager
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CHECK for entries that say “Other Device”. EXPAND and SELECT ‘Update
driver’ to download and necessary drivers required for Serial-USB connector
(Figure 30).
Figure 30 - Install missing drivers

RESTART YOUR COMPUTER
Note: This requires that you are connected to the internet.
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APPENDIX
Pacemaker Modes
This chapter briefly explains various pacemaker modes. It’s a good idea to familiarize
yourself with pacemaker modes if you are not sure what they mean. If you look at Table
1 below, it shows the various pacemaker modes. The pacemaker mode letters
correspond to columns of Table 1.
Table 1: Bradycardia Operating Modes
Category
Letters
I
II
III
IV (optional)
Chambers
Paced
Chambers
Sensed
Response To
Sensing
Rate
Modulation
O-None
O-None
O-None
A-Atrium
A-Atrium
T-Triggered
V-Ventricle
V-Ventricle
I-Inhibited
D-Dual
D-Dual
D-Tracked:
Dual (T & I)
For example,
VVI would mean:
Column I = V – Ventricle
Column II = V – Ventricle
Column III – I – Inhibited
DDD would mean:
Column I = D – Dual (both Ventricle and Atrium)
Column II = D – Dual
Column III – D – Dual
Note: D is column II and III have different meaning.
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DDD-R would mean:
Column I = D – Dual
Column II = D – Dual
Column III – D – Dual
Column IV – R-Sensor Driven Rate Modulation
VVI mode
Ventricle Ventricle Inhibited, henceforth VVI, mode operates as it paces, and senses
ventricle with inhibited response. Most of the time, the pacemaker will operate under
standby mode, and paces heart only when spontaneous QRS complex is not sensed.
Use Case: determine spontaneous QRS complex
Brief Description
There are mainly two valid types of QRS complex: paced QRS and spontaneous
QRS. While hardware may not distinguish differences between spontaneous QRS
outside blanking/refractory period and those occurring inside the period, software must
be able to determine validity of the spontaneous QRS complex; spontaneous QRS
sensed during the blanking/refractory period must be discarded.
Use Case: determine wait time interval
Brief Description
During VVI mode, spontaneous QRS complex sensed from ventricle will put the
pacemaker into standby mode to conserve battery life. Otherwise, the pacemaker must
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wait for the determined interval (escape interval + hysteresis value) before pacing heart
manually.
Additionally, if the heart rate increases or decreases then the pacemaker must
accommodate this change by applying rate smoothing with programming rate value.
Rate smoothing will be bounded by upper rate limit and lower rate limit to prevent too
low or high heart rate. (Please refer to 1.3 Definitions, Acronyms, and Abbreviations for
the difference between Rate smoothing and Rate response)
DDD mode
Dual Dual Dual (sometimes denoted as double), henceforth DDD, mode operates as it
paces, and senses both atrial and ventricle with dual (triggered and inhibited) response.
Most of the time, the pacemaker will operate under standby mode, and paces hearts
only when spontaneous QRS complex from atrial and/or ventricular is not sensed.
General rule of thumb, atrial QRS complex must be followed by ventricular QRS
complex, whether paced or sensed.
Use Case: determine spontaneous atrial QRS complex
Brief Description
There are mainly two types of QRS complex: paced QRS and spontaneous QRS. While
hardware may not recognize the differences between two, software must be able to
determine spontaneous QRS complex.
Use Case: determine spontaneous ventricular QRS complex
Brief Description
There are mainly two types of QRS complex: paced QRS and spontaneous QRS. While
hardware may not recognize the differences between two, software must be able to
determine spontaneous QRS complex.
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Use Case: determine wait time interval (applies to both atrial and ventricular QRS
complex)
Brief Description
Under DDD mode, whenever spontaneous QRS complex is sensed, the pacemaker
must hold for the specific interval before determining the needs of manual pacing. Each
successive spontaneous QRS complex will put the pacemaker into standby mode to
conserve battery life. There are seven parameters to be considered upon adjusting wait
time interval. These are: AVI (AV interval), PVARP (postventricular atrial refractory
period), TARP (total atrial refractory period), AEI (atrial escape interval), PAVB
(postatrial ventricular blanking), VSP (ventricular safety pacing window), VRP
(ventricular refractory period), LRI (lower rate interval), and URI (upper rate interval).
Use Case: Standby or Pace
Brief Description
Under DDD mode, manual pacing of atrial must be performed when AEI has passed
since followed by ventricular QRS complex; otherwise pacing of atrial is withheld.
Additionally, manual pacing or sensing of atrial QRS complex must be followed by a
ventricular QRS complex after AVI has passed; this is valid only if URI has not passed
yet, and otherwise AVI will be extended to restrict the pacing interval within URI.
On the other hand, successive ventricular QRS complex must be sensed within LRI, and
otherwise manual pacing must be performed.
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DDDR mode
Dual Dual Dual Rate modulation (sensor driven) henceforth DDD-R, mode operates as
an extension of DDD mode described above. DDDR inherits all functionalities (use
cases) from DDD and extends it by using accelerometer to detect body movement. The
pacemaker then uses this measurement of body acceleration to modulate rate
smoothing.
Accelerometer is used to mediate the rate response in the pacemaker. The pacemaker,
thus, can increase or decrease the rate of pacing depending on the degree of body
movement.
Additional Use Case (in addition to DDD mode): detect and measure vibration in
the body
Brief Description
When the pacemaker detects increased or decreased vibration in the body, it adjusts the
pacing interval accordingly in order to cope with body movements. The pacing rate may
accelerate or decelerate based on the measurement of vibration.
45
APA-SE4G06-2
User Guide
Notes
Index
—A—
—L—
Abbreviations, 12
Accelerometer, 12
Acronyms, 12
anti-static package, 38
LabVIEW, 10
—C—
New Client, 27, 30
—M—
Minimum System Requirements, 15
—N—
—P—
COM PORT, 28
customer help line, 15
Pacemaker, 10
pacemaker board, 5
pacemaker ID, 28
Pacing leads, 5
PANIC, 30
Permanent Configuration, 34
product upgrade information, 15
—D—
DDD, 11, 43, 45
DDD-R, 11, 32, 44, 47
default
password, 27
username, 27
—R—
Definitions, 12
Desktop icon, 21
desktop shortcut, 20
driver, 40, 41
registration, 6, 15
—S—
Setup Errors, 29
slide bar, 33
—E—
—U—
ECG. See Electro Cardiogram
Electro Cardiogram, 10
USB Connector, 6
USB-serial connector, 23
Use Case, 44, 45, 46, 47
—F—
Fail-Safe Mode, 11
FDA, 2
Feedback, 39
—V—
VVI, 11, 32, 43, 44
—K—
keyboard input, 33
46