emr integration technical application overview – 357729 ... · emr integration technical...

EMR Integration Technical Application Overview – 357729-003

LATITUDE® Patient Management

Contents

Purpose.................................................1 Objectives .............................................1 Application Overview ............................2

Component Definitions.................3 Follow-up Information Retrieval ...4 Patient Record Dismissal.............6 Follow-up Information Transfer ..10 Patient Record Sign-off..............12

Appendix A – HL7 Message Structures............................................................16

LATITUDE HL7 Message Specification...............................16 GE CPO HL7 Message Specification...............................25

Appendix B – LATITUDE Terms.........26 Appendix C – Patient Matching ..........40

Purpose This document provides a high-level description of the technical architecture and data flows of the Boston Scientific LATITUDE Patient Management System to GE Healthcare Centricity® Physician Office (CPO) (formerly Logician) integration solution.

CPO is GE Healthcare’s outpatient electronic medical record (EMR) system. LATITUDE is Boston Scientific’s remote patient monitoring system. Personnel that are responsible for administering CPO at a clinic can use this document to understand the technical components of the integration solution. A base understanding of the system components, processes, and associated terminology can help administrators support the system and troubleshoot problems.

Objectives The objective of the LATITUDE EMR Integration software is to provide a quick and easy mechanism for downloading implanted cardiac device follow-up summary data from LATITUDE into the EMR and also to provide quick access from the EMR back into LATITUDE to review detailed cardiac device data for a patient.

Your existing Logician / CPO technical and user documentation should be used to understand the proper use of the Logician / CPO product.



Application Overview The following diagram is a model that depicts the major technology components and data flows of the integration solution.

Technology components are defined in “Table 1 - Component Definitions” below.

There are four major data flow processes that are described in subsequent sections of this document.

− Follow-up information retrieval

− Patient record dismissal

− Follow-up information transfer

− Patient record sign-off



Component Definitions

Table 1 - Component Definitions

Component or Actor Name Definition Clinic Environment The clinic where the CPO applications are installed and used.

Clinician This person has the role of following the patient with the implanted device. This could be a physician or an allied health professional.

DTS CPO Data Transfer Station (DTS). DTS is the CPO software component responsible for transferring data from external systems into the CPO database.

Home Environment The patient’s home (or other location) where remote follow-ups of the implanted cardiac device takes place.

Implanted Cardiac Device Implanted Cardiac Devices operate within the human body in both monitoring and therapy delivery capacities. These devices are categorized as Pacemakers, Implantable Cardioverter Defibrillators (ICDs), and Cardiac Resynchronization Therapy (CRT) devices. Each of these electronic devices delivers a controlled electric shock to the heart to return the heart back to a normal rhythm.

Internet The public network that is used to securely transfer data. NOTE: All data flows in this system are secured and encrypted using standard encryption and data transfer techniques.

LATITUDE Communicator A communications device that interrogates the implanted cardiac device, collects information from the device, and transfers collected data to the LATITUDE server.

LATITUDE Secure Server The LATITUDE secure server is a centralized computer database that stores patient data, implanted device data sent from patients’ LATITUDE Communicators, and physician and clinician configuration information. The LATITUDE secure server provides the data for presentation on the LATITUDE website, which is readily available over the Internet to authorized users.

LinkLogic Inbox Folder The local file system on the LTS / DTS server that stages the transformed LATITUDE download files prior to DTS processing.

Logician / CPO Client The CPO software component that provides a user interface for physicians to access EMR information.

Logician / CPO Database The relational database that contains and manages the CPO system data.

Logician / CPO Server The CPO server component that hosts the LTS and DTS software processes.

LTS LATITUDE Transfer Station (LTS). LTS is responsible for periodically polling the LATITUDE WebDAV Service and securely transferring and transforming new information for input into CPO.

Patient The person that has the implanted cardiac device that is being followed.

Web Browser The Internet browser used by the clinician to access the LATITUDE system.



Follow-up Information Retrieval LATITUDE retrieves information from the Home Environment

LATITUDE - GE Logician / CPO IntegrationInterrogation Clinic Environment

Boston Scientific

Home Environment

LATITUDECommunicator

Logician / CPO Database

LATITUDE Secure Server

Internet

Patientwith ImplantedCardiac Device

Logician / CPO Server

DTSLTS

LinkLogic InboxFolder

Logician / CPO Client

Web Browser

Clinician



Assumptions: − Patient has implanted cardiac device. − LATITUDE Communicator has been installed and configured.

1 At defined periods the LATITUDE Communicator interrogates the implanted

device.

2 The implanted device sends data, concerning device and patient status, to the LATITUDE Communicator.

3 The LATITUDE Communicator processes the device data and utilizes a phone line to establish a secured Internet network connection to the LATITUDE server.

4 The LATITUDE Communicator securely transfers the device data to the LATITUDE server.

5 The LATITUDE secure server processes the device data and stores it into the patient’s record in the LATITUDE database.



Patient Record Dismissal Patient records on the Patient for Review screen are reviewed by a clinician or clinicians and subsequently dismissed.

Clinic Environment

Boston Scientific

Home Environment

LATITUDECommunicator

Logician / CPO Database

LATITUDE Secure Server

Internet

Patientwith ImplantedCardiac Device

Logician / CPO Server

DTSLTS

LinkLogic InboxFolder

Logician / CPO Client

Web Browser

Clinician

LATITUDE - GE Logician / CPO IntegrationDismissal



1 The clinician logs into the LATITUDE web application…

2 And navigates to the Patients For Review screen.



3 The clinician selects a patient follow-up record and reviews patient data on the clinically appropriate LATITUDE screens.

4 The clinician dismisses the patient, triggering the creation of a LATITUDE HL7 device summary message, which is stored in the LATITUDE secure server.

Patient is selected using check box.

Patients are dismissed by clicking on the Dismiss patient icon. This function can also be performed from the Patient Detail screens.



There may be circumstances where a download of a patient follow-up record needs to be rerun. LATITUDE has a mechanism for rerunning a patient follow-up record download. By clicking on the menu options Patient Utilities / EMR Log a page will be displayed that contains a function to place already downloaded Patient follow-up records into the EMR outbox. This will cause LTS to see and transfer the HL7 file again. The data will be identical to the initial download.

Select patient record using the check box.

Move previously downloaded records into the EMR Outbox by clicking on icon



Follow-up Information Transfer Follow-up information is transferred from LATITUDE to CPO.



Assumptions: − The LATITUDE HL7 Device Summary message files have been written to

storage on the LATITUDE secure server that is accessible from the clinic. Each file includes summary follow-up information and a direct URL link to the corresponding patient detail summary screen in LATITUDE.

1 LTS running on the CPO server in the clinic monitors the clinic’s LATITUDE-hosted web folder for new HL7 files by polling the LATITUDE secure server on a periodic basis using a secure WebDAV protocol. The frequency of polling is specified in the LTS configuration file LTS.INI which should be set to 60 seconds.

2 When LTS polling finds a new HL7 file on the LATITUDE secure server, it transfers the file using a secure WebDAV protocol.

3 LTS performs the processing needed to generate appropriate files for importing into the EMR. LTS creates two CPO HL7 files for every LATITUDE HL7 file. One file is a lab report (HL7 ORU message) and has an extension HR. The other file is an image file (HL7 MDM message) and has an extension HT. Once the HL7 file is transferred, the LATITUDE secure server automatically removes access, but retains the data for retransmission purposes. If specified in LTS.INI, a copy of the HL7 file will be saved on the Logician CPO server. NOTE: Details concerning the content of the HL7 files are contained in Appendix A – HL7 Message Structures of this document.

4 LTS writes the CPO HL7 files to the LinkLogic Inbox Folder.

5 DTS imports the data from the LinkLogic inbox folder into the CPO Database. The HL7 ORU message file is first imported into a CPO lab report document. Next, the HL7 MDM message file, which contains the specified URL, is imported and attached to the lab report.

6 During the import process lab codes, document types, physician information, and

patient information are cross-referenced and mapped from LATITUDE to CPO. See Appendix C for more information on Patient Matching.

7 DTS writes the device follow-up information to the CPO Database.

8 DTS changes the extensions of processed files in the LinkLogic Inbox Folder

from HR to HRQ and from HT to HTQ.



Patient Record Sign-off Clinician reviews and signs the EMR record in CPO.



1 The clinician logs into the CPO client and observes new patient documents.

2 The clinician opens up the patient’s device follow-up document and reviews the information.

The clinician performs other clinical processes that may include linking to the LATITUDE web application for further follow-up data review. The clinician will

Clicking on paperclip icon automatically links to LATITUDE Patient Detail pages



not need to re-enter username and password if already logged into LATITUDE, and the IE browser is configured to open a new session in an existing window.

3 The clinician signs the device follow-up report.



The flow sheet is available in the patient record after sign off.



Appendix A – HL7 Message Structures The LATITUDE to EMR Integration solution relies on HL7 structured messages for the transferring of information. The out-of-box solution provides mappings and transformations of HL7 messages to internal GE CPO data structures. This section provides details concerning the structure and semantics of the HL7 messages for those doing custom work.

It is assumed that readers of this section are familiar with HL7 2.x terminology, specification syntax, data types, message structures and semantics for ORU messages. For more information concerning HL7 messaging visit HL7’s web site at www.hl7.org.

The LATITUDE to GE Healthcare EMR Integration solution consists of two sets of HL7 messages.

− HL7 messages generated by LATITUDE

− HL7 messages created by the LTS component for consumption by GE CPO

LATITUDE HL7 Message Specification The LATITUDE application generates one HL7 message for each remote device follow-up. These messages are retrieved by LTS for use within GE CPO. See the Follow-up Information Transfer section of this document for details concerning this process.

The LATITUDE HL7 file is structured according to the HL7 2.3.1 Observation Result Unsolicited (ORU) message type, which provides for the transmission of new observation information about patients in the form of a lab report document.

LATITUDE’s ORU message will contain useful follow-up summary data, including information from LATITUDE’s Quick Notes report plus leads information and device counters. The message consists of the following segment structures.

Message Structure

Segment Description Usage MSH Message Header The MSH segment contains information about the

Sender and Receiver of the message, the type of the message, a time stamp, etc., and is the first segment in each ORU message.

PID Patient Identification The PID segment contains demographic information about the patient such as name, id codes, zip code, and so on. This information is used for patient matching.

[{ NTE }] Notes and comments THE NTE segment contains alerts and events that have occurred for a particular patient.

PV1 Patient Visit The PV1 (Patient Visit) segment contains information regarding the patient's encounter, such as location assigned, referring doctor, etc.

{ --- grouping BEGIN OBR Observations Request The OBR segment contains information regarding

the characteristics of the last interrogation observation.

{[OBX]} Observation result The OBX segment contains the parameters and values of the last interrogation observation.

} --- grouping END

ZU1 Custom Segment The ZU1 custom segment contains a URL link description.

ZU2 Custom Segment The ZU2 custom segment contains the LATITUDE message version.



MSH Segment

ELEMENT NAME SEQ SUB SEQ

DT LEN USAGE CARD TBL# ITEM # Fixed Example Value

Field Separator 1 ST 1 R [1..1] 00001 Y |

Encoding Characters

2 ST 4 R [1..1] 00002 Y ^~\&

Sending Application

3 HD 180 R [1..1] 00003 Y LATITUDE

Sending Facility 4 HD 180 R [1..1] 00004 Y Boston Scientific

Receiving Facility 6 HD 180 RE [0..1] 00006 Clinic Name

Date/Time Of Message

7 TS 26 R [1..1] 00007 20060510150057+0000

Message Type 9 MSG 15 R [1..1] 00009

message code 1 ID 3 R [1..1] 0076 Y ORU

trigger event 2 ID 3 R [1..1] 0003 Y R01

Message Control ID 10 ST 20 R [1..1] 00010 2500144

Processing ID 11 ID 1 R [1..1] 0103 00011 P

Version ID 12 ID 5 R [1..1] 0104 00012 Y 2.3.1

Accept Acknowledgement Type

15 ID 2 R [1..1] 0155 00015 Y NE

Character Set 18 ID 6 R [1..1] 0211 00692 Y 8859/1



PID Segment



Set ID – PID 1 SI 1 R [1..1] 00104 Y 1

Patient ID 2 CX 20 R [1..1] 00105

ID 1 ST 20 R [1..1] 4234793618 see NOTE 2

Patient Identifier List

3 CX 20 R [1..1] 00106

ID 1 ST 20 R [1..1] 4234793618~ abc123456 see NOTE 2 & 3

Patient Name 5 XPN 140 R [1..1] 00108

family+last name prefix

1 CM 40 R [1..1] Doe

given name 2 ST 40 R [1..1] John

middle initial or name

3 ST 40 RE [0..1] Jimmy

suffix 4 ST 20 RE [0..1] Jr.

Date/Time Of Birth 7 TS 1 RE [0..1] 00110 19271209

Sex 8 IS 1 RE [0..1] 0001 00111 M

zip or postal code 5 ST 10 RE [0..1] 55408

PID NOTES

1. The PID segment contains data used for patient matching (see Appendix C – Patient Matching)

2. Patient ID and Patient Identifier List contains a unique patient number that is generated and maintained by LATITUDE.

3. LATITUDE allows an authorized user to enter their own patient identifier. The Patient Identifier List may contain the user entered patient identifier as a second patient identifier.



NTE Segment



Set ID - NTE 1 SI 1 R [1..1] 00096 1

Source of comment 2 ID 8 R [1..1] 00097 Y LATITUDE

Comment 3 FT 65536 R [1..*] 00098 See content descriptions in NOTE 1

NTE NOTES

1. There is the potential for 4 NTE segments within each device follow-up message. The Set ID and description for these segments will be as follows:

o Set ID 1 – This NTE segment contains a report consisting of an array of alerts that have occurred for a particular patient. There may be more than one alert associated with the given patient/physician pair. The alerts are sorted such that all red alerts appear first followed by yellow alerts. Secondary sorting within each alert type is newest to oldest.

o Set ID 2 – This NTE segment contains information concerning the LATITUDE patient record dismissal. It will contain information about who performed the dismissal and when it was performed.

o Set ID 3 – This NTE segment contains a report consisting of an array of events (stored episodes) that have occurred for a particular patient since the last device follow-up. There may be more than one event associated with the given patient/physician pair. Events are sorted newest to oldest.

o Set ID 4 – This NTE segment contains information about the device if it is in a fault condition. It will contain a fault warning statement and information concerning the fallback mode.



PV1 Segment



Set ID - PV1 1 SI 4 R [1..1] 00131 Y 1

Patient Class 2 IS 1 R [1..1] 00132 Y R

Attending Doctor 7 XCN 60 RE [0..1] 00137

ID Number (ST) 1 ST 8 R [1..1]

JHopkins see NOTE 1

family+last name prefix 2 CM 40 R [1..1] Hopkins

given name 3 ST 40 RE [0..1] John

middle initial or name 4 ST 1 RE [0..1] L

suffix 5 ST 20 RE [0..1] Sr.

PV1 NOTES

1. Attending Doctor ID Number is the LATITUDE login name of the responsible physician.



OBR Segment



Set ID – OBR 1 SI 4 R [1..1] 00237 Y 1 thru 4 see NOTE 1

Filler Order Number 3 EI 22 R [1..1] 00217

entity identifier 1 ST 10 R [1..1] Unique identifier see NOTE 2

Universal Service ID 4 CE 200 R [1..1] 00238

identifier 1 ST 10 R [1..1]

Boston Scientific -LastInterrogationsee NOTE 1

text 2 ST 50 R [1..1]

Last Interrogation see NOTE 1

Observation Date/Time # 7 TS 26 R [1..1] 00241

20060429080005+0000

Observation End Date/Time # 8 TS 26 RE [0..1] 00242

20060429080005+0000

Ordering Provider 16 XCN 120 RE [0..1] 00226

ID Number 1 ST 10 RE [0..1] JHopkins see NOTE 3

Placer Field 1 18 ST 2 R [1..1] 00253 Y DR see Note 4

Results Rpt/Status Chng – Date/Time + 22 TS 26 RE [0..1] 00255

20060429080005+0000

Result Status + 25 ID 1 R [1..1] 0123 00258 Y F

OBR Notes

1. The LATITUDE ORU message supports four OBRs (Observation Reports). Each OBR will contain multiple OBX records with context specific observations. Details concerning the specific OBX observations are listed in the OBX Segment section of this documentation. CPO will initially support two flow sheet views for the LATITUDE interface – one for the Lead Information OBR, and one for the remaining three OBRs. The CPO flow sheet groups observation results into columns by date/time stamp of the observation. As a result, one LATITUDE HL7 export file will be disbursed into separate CPO flow sheet columns for each Last Interrogation, Implant, and Leads Information OBR, plus each unique last in-office lead test date. The four types of OBRs will have different Set IDs, and Universal Service IDs as follows.

ORU Name Description Set ID Universal Service ID identifier

Universal Service ID text

Last Interrogation

This OBR contains observations from the last remote monitoring session.

1 Boston Scientific-LastInterrogation

Last Interrogation

Implant This OBR contains observations generated at the time the PG was implanted.

2 Boston Scientific-Implant

Implant

Last In-Office Lead Test

This OBR contains observations from the latest in-office Lead Test.

3 Boston Scientific-LastInOffice

Lead Test: In-Office



ORU Name Description Set ID Universal Service ID identifier

Universal Service ID text

Lead Information

This OBR contains information about implanted leads.

4 Boston Scientific-Leads

Lead Information

2. Filler Order Number is a unique identifier generated by LATITUDE for all four OBRs. The Filler Order Number will not change for observations that are resent.

3. Ordering Provider is the LATITUDE login name of the responsible physician.

4. Placer Field 1 is a value that CPO uses to identify the type of observation being sent. It is always set to DR which stands for Diagnostic Report.



OBX Segment


DT LEN USAGE CARD TBL# ITEM # Fixed Example Values

Set ID - OBX 1 SI 4 R [1..1] 00569

Sequential Integer starting with 1

Value Type 2 ID 2 R [1..1] 0125 00570 ST or NM or DT see NOTE 1

Observation Identifier 3 CE 80 R [1..1] 00571

identifier 1 ST 80 R [1..1] see NOTE 2

text 2 ST 256 R [1..1] see NOTE 2

name of coding system 3 ST 20 R [1..1] Y GDT-LATITUDE

Observation Value 5 -- 4000 RE [0..1] see NOTE 3

Units 6 CE 60 RE [0..1]

identifier 1 ST 20 RE [0..1] see NOTE 4

Observation Result Status 11 ID 1 R [1..1] 0085 00579 Y F

Date/Time of the Observation 14 TS 26 R [0..1] 00582

20060317170000+0006

OBX Notes

1. The value types will be ST – String, NM – Number, or DT – Date.

2. All observations are coded using LATITUDE specific terms. Specifications concerning these terms are in Appendix B – LATITUDE Terms.

3. Observation Value is the value of the observation and will be of the type Value Type.

4. Units of the observation if applicable.



Z Segments



Segment Type 1 ST 3 R [1..1] Y ZU1 or ZU2 see NOTE 1

Value 2 ST 40 R [1..1] URL or Report Type see NOTE 1

Z NOTES

1. The Z Segments are customized segments used to transfer LATITUDE specific information. The two types of Z segments used are described below.

o ZU1 – Value contains the URL string that allows a system user to link to the Patient Details screen. Ex. https://www.test.bostonscientific.com/access/physician/patientDetails?=123456789

o ZU2 – Value contains Latitude message description and version. Ex. Device Summary Report Version 1



GE CPO HL7 Message Specification The LATITUDE HL7 message is transferred and transformed by the LTS component (see section Follow-up Information Transfer for details). Refer to the GE CPO documentation for specifics concerning the structure of the resulting HL7 ORU and MDM messages that are imported directly into CPO.

The terms used in the LTS transformed OBX records generally remain unchanged from the original LATITUDE HL7 message. Some conversions such as unit identifiers are performed. The ZU1 segment is transformed into an MDM message. Refer to Appendix B – LATITUDE Terms for detailed information concerning OBX terminology.

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LI-9

0647

G

DT-

0001

6 X

ATR

Mod

e S

witc

hes

ATR

Mod

e S

witc

hes:

The

num

ber o

f mod

e sw

itche

s de

tect

ed s

ince

the

"Cou

nter

s S

ince

" dat

e

T

ATR

MO

DE

SW

CH

S

MLI

-906

48

GD

T-00

017

X

AFi

b E

piso

des

Atri

al F

ibril

latio

n E

piso

des:

Atri

al F

ibril

latio

n ep

isod

es d

etec

ted

sinc

e th

e "C

ount

ers

Sin

ce" d

ate

T

AF

EP

ISO

DE

S

MLI

-906

49

GD

T-00

018

X

SV

T E

piso

des

Sup

rave

ntric

ular

(Atri

al) T

achy

card

ia

Epi

sode

s: S

VT

(AT)

epi

sode

s de

tect

ed s

ince

th

e "C

ount

ers

Sin

ce" d

ate

T

AT

EP

ISO

DE

S

MLI

-906

50

GD

T-00

019

X

Atri

al P

erce

nt P

aced

R

ight

Atri

al P

acin

g P

erce

nt: T

he p

erce

nt o

f al

l Rig

ht a

trial

eve

nts

dete

cted

sin

ce th

e C

ount

ers

Sin

ce d

ate

that

wer

e pa

ced.

N

%

RA

% P

AC

ED

M

LI-9

0651

G

DT-

0002

0 X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

28

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

RV

Per

cent

Pac

ed

Rig

ht V

entri

cula

r Pac

ing

Per

cent

: The

pe

rcen

t of a

ll R

ight

ven

tricu

lar e

vent

s de

tect

ed s

ince

the

Cou

nter

s S

ince

dat

e th

at

wer

e pa

ced.

N

%

RV

% P

AC

ED

M

LI-9

0652

G

DT-

0002

1 X

LV P

erce

nt P

aced

Le

ft V

entri

cula

r Pac

ing

Per

cent

: The

per

cent

of

all

left

vent

ricul

ar e

vent

s de

tect

ed s

ince

th

e C

ount

ers

Sin

ce d

ate

that

wer

e pa

ced.

N

%

LV %

PA

CE

D

MLI

-906

53

GD

T-00

022

X

Rig

ht A

trial

Lea

d S

tatu

s Th

e cu

rren

t sta

tus

of th

e R

ight

Atri

al L

ead

dete

rmin

ed b

y th

e de

vice

bas

ed o

n an

alys

is

of th

e le

ad a

mpl

itude

and

impe

danc

e. If

a

valu

e en

coun

tere

d is

out

side

of t

he e

xpec

ted

rang

e, it

s st

atus

is p

rese

nted

.

T

RA

LEA

DS

TATU

S

MLI

-906

54

GD

T-00

023

X

RA

Intri

nsic

Am

plitu

de

Rig

ht A

trial

Intri

nsic

Am

plitu

de (P

-Wav

e)

mea

sure

d du

ring

an In

trins

ic A

mpl

itude

Tes

t. T

mV

R

A IN

TRN

SA

MP

M

LI-9

0692

G

DT-

0002

4G

DT-

0009

8G

DT-

0010

9

X

X

RA

Pac

e Im

peda

nce

Rig

ht A

trial

Lea

d Im

peda

nce

mea

sure

d du

ring

a Le

ad Im

peda

nce

Test

. T

ohm

s R

A P

AC

E IM

PD

M

LI-9

0693

G

DT-

0002

5G

DT-

0009

9G

DT-

0011

0

X

X

Rig

ht V

entri

cula

r Lea

d S

tatu

s Th

e cu

rren

t sta

tus

of th

e R

ight

Ven

tricu

lar

Lead

det

erm

ined

by

the

devi

ce b

ased

on

anal

ysis

of t

he le

ad a

mpl

itude

and

im

peda

nce.

If a

val

ue e

ncou

nter

ed is

out

side

of

the

expe

cted

rang

e, it

s st

atus

is

pres

ente

d.

T

RV

LEA

DS

TATU

S

MLI

-906

55

GD

T-00

026

X

RV

Intri

nsic

Am

plitu

de

Rig

ht V

entri

cula

r Int

rinsi

c A

mpl

itude

(R-

Wav

e) m

easu

red

durin

g an

Intri

nsic

A

mpl

itude

Tes

t.

T m

V

RV

INTR

NS

AM

P

MLI

-906

95

GD

T-00

027

GD

T-00

101

GD

T-00

112

X

X

X

RV

Pac

e Im

peda

nce

Rig

ht V

entri

cula

r Lea

d Im

peda

nce

mea

sure

d du

ring

a Le

ad Im

peda

nce

Test

. T

ohm

s R

V P

AC

E IM

PD

M

LI-9

0696

G

DT-

0002

8G

DT-

0010

2G

DT-

0011

3

X

X

X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

29

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

LV L

ead

Sta

tus

The

curr

ent s

tatu

s of

the

Left

Ven

tricu

lar

Lead

det

erm

ined

by

the

devi

ce b

ased

on

anal

ysis

of t

he le

ad a

mpl

itude

and

im

peda

nce.

If a

val

ue e

ncou

nter

ed is

out

side

of

the

expe

cted

rang

e, it

s st

atus

is

pres

ente

d.

T

LVLE

AD

STA

TUS

M

LI-9

0656

G

DT-

0002

9 X

LV In

trins

ic A

mpl

itude

Le

ft V

entri

cula

r Int

rinsi

c A

mpl

itude

(R-W

ave)

m

easu

red

durin

g an

Intri

nsic

Am

plitu

de T

est.

T m

V

LV IN

TRN

SA

MP

M

LI-9

0685

G

DT-

0003

0G

DT-

0010

4G

DT-

0011

5

X

X

X

LV P

ace

Impe

danc

e Le

ft V

entri

cula

r Lea

d Im

peda

nce

mea

sure

d du

ring

a Le

ad Im

peda

nce

Test

. T

ohm

s LV

PA

CE

IMP

D

MLI

-906

58

GD

T-00

031

GD

T-00

105

GD

T-00

116

X

X

X

Sho

ck V

ecto

r Sta

tus

The

curr

ent s

tatu

s of

the

Sho

ck V

ecto

r de

term

ined

by

the

devi

ce b

ased

on

anal

ysis

of

the

impe

danc

e. If

a v

alue

enc

ount

ered

is

outs

ide

of th

e ex

pect

ed c

onfig

urat

ion,

its

stat

us is

pre

sent

ed.

T

SH

CK

VC

TRS

TAT

MLI

-906

59

GD

T-00

032

X

Sho

ck Im

peda

nce

Last

Del

iver

ed V

entri

cula

r Sho

ck L

ead

Impe

danc

e: T

he s

hock

ing

impe

danc

e fro

m

the

last

ven

tricu

lar s

hock

del

iver

ed.

T oh

ms

SH

CK

LEA

DIM

PD

M

LI-9

0699

G

DT-

0003

3G

DT-

0010

7G

DT-

0011

8

X

X

X

V-T

achy

Mod

e V

entri

cula

r Tac

hy th

erap

y m

ode

T

V-T

AC

HY

MO

DE

M

LI-9

0660

G

DT-

0003

4 X

A-T

achy

Mod

e A

trial

Tac

hy th

erap

y m

ode

T

A-T

AC

HY

MO

DE

M

LI-9

0661

G

DT-

0003

5 X

Bra

dy M

ode

Bra

dy M

ode

(i.e.

, pac

ing

mod

e): T

he m

anne

r in

whi

ch a

dev

ice

prov

ides

rate

and

rhyt

hm

supp

ort.

T

BR

AD

Y M

OD

E

MLI

-906

62

GD

T-00

036

X

Low

er R

ate

Lim

it Lo

wer

Rat

e Li

mit

(LR

L) is

the

rate

at w

hich

th

e im

plan

ted

devi

ce p

aces

the

atriu

m a

nd/o

r ve

ntric

le in

the

abse

nce

of s

ense

d in

trins

ic

activ

ity.

N

bpm

LR

L M

LI-7

5540

G

DT-

0003

7 X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

30

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

Max

imum

Tra

ckin

g R

ate

Max

imum

Tra

ckin

g R

ate:

In th

e D

DD

(R) a

nd

VD

D(R

) mod

es, t

he M

axim

um T

rack

ing

Rat

e (M

TR) i

s th

e m

axim

um ra

te a

t whi

ch th

e ve

ntric

ular

pac

ing

will

trac

k 1:

1 w

ith

nonr

efra

ctor

y se

nsed

atri

al e

vent

s.

T bp

m

MTR

UR

L M

LI-9

6739

G

DT-

0003

8 X

Max

imum

Sen

sor R

ate

The

fast

est s

enso

r-dr

iven

pac

ing

rate

that

ca

n be

ach

ieve

d in

a ra

te-a

dapt

ive

paci

ng

syst

em.

T bp

m

MA

XS

EN

SR

ATE

M

LI-9

6740

G

DT-

0003

9 X

Sen

sitiv

ity R

A

Rig

ht A

trial

Sen

sitiv

ity: T

he A

trial

Sen

sitiv

ity

para

met

er in

dica

tes

the

smal

lest

sig

nal t

hat

will

be

sens

ed in

the

right

atri

um.

T

SE

NS

TVTY

-RA

M

LI-9

0700

G

DT-

0004

0 X

Sen

sitiv

ity R

V

Rig

ht V

entri

cula

r Sen

sitiv

ity: T

he R

ight

V

entri

cula

r Sen

sitiv

ity p

aram

eter

indi

cate

s th

e sm

alle

st s

igna

l tha

t will

be

sens

ed in

the

right

ven

tricl

e.

T

SE

NS

TVTY

-RV

M

LI-9

0701

G

DT-

0004

1 X

Sen

sitiv

ity L

V

Left

Ven

tricu

lar S

ensi

tivity

: The

Lef

t V

entri

cula

r Sen

sitiv

ity p

aram

eter

indi

cate

s th

e sm

alle

st s

igna

l tha

t will

be

sens

ed in

the

left

vent

ricle

.

T

SE

NS

TVTY

-LV

M

LI-9

0702

G

DT-

0004

2 X

Pac

ed A

V D

elay

Th

e va

lue

of th

e A

V D

elay

set

ting.

T

ms

PA

CE

DA

VD

ELA

Y M

LI-9

4268

G

DT-

0004

3 X

Sen

sed

AV

Offs

et

Sen

sed

AV

Offs

et: T

he A

V D

elay

is

shor

tene

d by

the

prog

ram

med

Sen

sed

AV

O

ffset

afte

r a s

ense

d at

rial e

vent

.

T m

s S

EN

SE

DA

VO

FFS

M

LI-9

0687

G

DT-

0004

4 X

AV

Sea

rch

Hys

tere

sis

Sea

rch

Inte

rval

N

umbe

r of p

aced

AV

cyc

les

betw

een

A-V

ra

te s

earc

hes

T

AV

SR

CH

HYS

-SI

MLI

-906

63

GD

T-00

045

X

AV

Sea

rch

Hys

tere

sis

AV

Incr

ease

Th

e pe

rcen

tage

incr

ease

in A

V d

elay

to b

e ap

plie

d to

the

next

car

diac

cyc

le w

hen

AV

S

earc

h is

act

ive.

T %

A

VS

RC

HH

YSA

VI

MLI

-906

64

GD

T-00

046

X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

31

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

A-R

efra

ctor

y (P

VA

RP

) P

ost-V

entri

cula

r Atri

al R

efra

ctor

y P

erio

d (P

VA

RP

) is

the

time

perio

d af

ter a

ven

tricu

lar

even

t, ei

ther

pac

ed o

r sen

sed,

whe

n ac

tivity

in

the

atriu

m d

oes

not r

eset

the

card

iac

cycl

e no

r trig

ger a

ven

tricu

lar s

timul

us.

T m

s P

VA

RP

M

LI-9

0665

G

DT-

0004

7 X

RV

-Ref

ract

ory

(RV

RP

) R

ight

Ven

tricu

lar R

efra

ctor

y P

erio

d is

the

time

perio

d fo

llow

ing

a rig

ht v

entri

cula

r ev

ent,

eith

er p

aced

or s

ense

d, w

hen

sens

ed

elec

tric

activ

ity in

the

right

ven

tricl

e do

es n

ot

rese

t the

tim

ing

cycl

es.

T m

s R

VR

P

MLI

-906

66

GD

T-00

048

X

LV-R

efra

ctor

y (L

VR

P)

Left

Ven

tricu

lar R

efra

ctor

y P

erio

d (L

VR

P) i

s de

fined

as

the

time

perio

d fo

llow

ing

a le

ft ve

ntric

ular

eve

nt, e

ither

pac

ed o

r sen

sed,

w

hen

intri

nsic

LV

eve

nts

will

not

be

used

to

rese

t the

tim

ing

cycl

es.

T m

s L

VR

P

MLI

-967

41

GD

T-00

049

X

LV P

rote

ctio

n P

erio

d Le

ft V

entri

cula

r Pro

tect

ion

Per

iod

(LV

PP

): LV

PP

is th

e pe

riod

afte

r a le

ft ve

ntric

ular

ev

ent,

eith

er p

aced

or s

ense

d, w

hen

the

devi

ce w

ill n

ot p

ace

the

left

vent

ricle

T m

s L

VP

P

MLI

-967

42

GD

T-00

050

X

Ven

tricu

lar P

acin

g C

ham

ber

Pac

ing

Cha

mbe

r: Th

is p

aram

eter

det

erm

ines

th

e ve

ntric

ular

pac

ing

conf

igur

atio

n - e

ither

rig

ht o

r bi-v

entri

cula

r pac

ing.

T

CH

MB

R P

AC

ED

M

LI-7

5554

G

DT-

0005

1 X

Ven

tricu

lar P

acin

g C

ham

ber L

V

Offs

et

Offs

et b

etw

een

deliv

ery

of R

V a

nd L

V p

acin

g pu

lses

. The

offs

et is

app

lied

to th

e LV

pac

ing

puls

e, b

ased

on

the

timin

g of

the

RV

pac

ing

puls

e. T

he o

ffset

may

hav

e a

nega

tive

or

posi

tive

valu

e.

T m

s LV

PC

ELV

OFF

ST

MLI

-906

67

GD

T-00

052

X

Pac

ing

Out

put -

RA

Th

e co

mbi

natio

n of

the

Rig

ht A

trial

A

mpl

itude

and

the

Rig

ht A

trial

Pul

se W

idth

. T

P

AC

EO

UTP

UTR

A

MLI

-906

88

GD

T-00

053

X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

32

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

Pac

ing

Out

put -

RV

Th

e co

mbi

natio

n of

the

Rig

ht V

entri

cula

r A

mpl

itude

and

the

Rig

ht V

entri

cula

r Pul

se

Wid

th.

T

PA

CE

OU

TPU

TRV

M

LI-9

0689

G

DT-

0005

4 X

Pac

ing

Out

put -

LV

Th

e co

mbi

natio

n of

the

Left

Ven

tricu

lar

Am

plitu

de a

nd th

e Le

ft V

entri

cula

r Pul

se

Wid

th.

T

PA

CE

OU

TPU

TLV

M

LI-9

0690

G

DT-

0005

5 X

ATR

Mod

e S

witc

h M

ode

ATR

Mod

e S

witc

h M

ode:

Non

-trac

king

pa

cing

mod

e ch

ange

whe

n pa

tient

ex

perie

nces

atri

al ta

chya

rrhy

thm

ia.

T

MO

DE

SW

TCH

ST

MLI

-755

67

GD

T-00

056

X

ATR

Mod

e S

witc

h R

ate

Atri

al T

achy

Res

pons

e R

ate

is th

e pa

cing

ra

te to

whi

ch th

e m

ode

switc

hes

in a

new

th

erap

y se

tting

.

T bp

m

MO

DE

SW

CH

RA

TE

MLI

-906

91

GD

T-00

057

X

AFi

b Zo

ne

AFi

b R

ate

Thre

shol

d: T

he ra

te a

bove

whi

ch

an A

-A in

terv

al is

cla

ssifi

ed in

the

AFi

b zo

ne.

T bp

m

AFI

B Z

ON

E

MLI

-906

68

GD

T-00

058

X

AFi

b Zo

ne A

TP1

Type

A

TP T

hera

py fo

r the

firs

t the

rapy

set

T

A

FATP

1TYP

E

MLI

-906

69

GD

T-00

059

X

AFi

b Zo

ne A

TP1

Num

ber o

f Bur

sts

The

prog

ram

med

num

ber o

f atri

al A

ntita

chy

Pac

ing

burs

ts d

eliv

ered

in th

e A

Fib

Zone

by

an im

plan

ted

devi

ce fo

r the

firs

t pro

gram

med

at

rial t

hera

py s

et.

T

AFA

TP1

#BR

ST

MLI

-906

70

GD

T-00

060

X

AFi

b Zo

ne A

TP2

Type

A

TP T

hera

py fo

r the

sec

ond

prog

ram

med

th

erap

y se

t. T

A

FATP

2TYP

E

MLI

-906

71

GD

T-00

061

X

AFi

b Zo

ne A

TP2

Num

ber o

f Bur

sts

The

prog

ram

med

num

ber o

f atri

al A

ntita

chy

Pac

ing

burs

ts d

eliv

ered

in th

e A

Fib

Zone

by

an im

plan

ted

devi

ce fo

r the

sec

ond

prog

ram

med

atri

al th

erap

y se

t.

T

AFA

TP2

#BR

ST

MLI

-906

72

GD

T-00

062

X

AFi

b Zo

ne S

hock

1 E

nerg

y A

Fib

Sho

ck 1

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

first

sho

ck o

f the

AFi

b zo

ne.

T jo

ules

A

FIB

SH

OC

K 1

M

LI-9

0703

G

DT-

0006

3 X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

33

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

AFi

b Zo

ne S

hock

2 E

nerg

y A

Fib

Sho

ck 2

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

seco

nd s

hock

of t

he A

Fib

zone

.

T jo

ules

A

FIB

SH

OC

K 2

M

LI-9

0704

G

DT-

0006

4 X

AFi

b Zo

ne S

hock

3 E

nerg

y A

Fib

Sho

ck 3

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

third

sho

ck o

f the

AFi

b zo

ne.

T jo

ules

A

FIB

SH

OC

K 3

M

LI-9

0705

G

DT-

0006

5 X

SV

T Zo

ne

SV

T (A

T) R

ate

Thre

shol

d: T

he ra

te a

bove

w

hich

an

A-A

inte

rval

is c

lass

ified

in th

e S

VT

Zone

(i.e

., A

T Zo

ne).

N

bpm

A

T ZO

NE

M

LI-7

5573

G

DT-

0006

6 X

SV

T Zo

ne A

TP1

Type

Th

e ty

pe o

f atri

al A

ntita

chy

Pac

ing

burs

ts

deliv

ered

in th

e S

VT

Zone

(i.e

., A

T Zo

ne) b

y an

impl

ante

d de

vice

for t

he fi

rst p

rogr

amm

ed

atria

l the

rapy

set

.

T

ATA

TP1T

YPE

M

LI-9

0673

G

DT-

0006

7 X

SV

T Zo

ne A

TP1

Num

ber o

f Bur

sts

The

num

ber o

f atri

al A

ntita

chy

Pac

ing

burs

ts

deliv

ered

in th

e S

VT

Zone

(i.e

., A

T Zo

ne) b

y an

impl

ante

d de

vice

for t

he fi

rst p

rogr

amm

ed

atria

l the

rapy

set

.

T

ATA

TP1

#BR

ST

MLI

-906

74

GD

T-00

068

X

SV

T Zo

ne A

TP2

Type

Th

e ty

pe o

f atri

al A

ntita

chy

Pac

ing

burs

ts

deliv

ered

in th

e S

VT

Zone

(i.e

., A

T Zo

ne) b

y an

impl

ante

d de

vice

for t

he s

econ

d pr

ogra

mm

ed a

trial

ther

apy

set.

T

ATA

TP2T

YPE

M

LI-9

0675

G

DT-

0006

9 X

SV

T Zo

ne A

TP2

Num

ber o

f Bur

sts

The

num

ber o

f atri

al A

ntita

chy

Pac

ing

burs

ts

deliv

ered

in th

e S

VT

Zone

(i.e

., A

T Zo

ne) b

y an

impl

ante

d de

vice

for t

he s

econ

d pr

ogra

mm

ed a

trial

ther

apy

set.

T

ATA

TP2

#BR

ST

MLI

-906

76

GD

T-00

070

X

SV

T Zo

ne S

hock

1 E

nerg

y S

VT

(AT)

Sho

ck 1

Ene

rgy:

The

am

ount

of

ener

gy d

eliv

ered

in th

e fir

st s

hock

of t

he S

VT

Zone

(i.e

., A

T Zo

ne).

T jo

ules

A

T S

HO

CK

1 M

LI-9

0706

G

DT-

0007

1 X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

34

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

SV

T Zo

ne S

hock

2 E

nerg

y S

VT

(AT)

Sho

ck 2

Ene

rgy:

The

am

ount

of

ener

gy d

eliv

ered

in th

e se

cond

sho

ck o

f the

S

VT

Zone

(i.e

., A

T Zo

ne).

T jo

ules

A

T S

HO

CK

2 M

LI-9

0707

G

DT-

0007

2 X

SV

T Zo

ne S

hock

3 E

nerg

y S

VT

(AT)

Sho

ck 3

Ene

rgy:

The

am

ount

of

ener

gy d

eliv

ered

in th

e th

ird s

hock

of t

he

SV

T Zo

ne (i

.e.,

AT

Zone

).

T jo

ules

A

T S

HO

CK

3 M

LI-9

0708

G

DT-

0007

3 X

VF

Zone

V

F R

ate

Thre

shol

d: T

he ra

te a

bove

whi

ch a

n R

-R in

terv

al is

cla

ssifi

ed in

the

VF

zone

N

bp

m

VF

ZON

E

MLI

-755

78

GD

T-00

074

X

VF

Sho

ck 1

Ene

rgy

VF

Sho

ck 1

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

first

sho

ck o

f the

VF

zone

. N

jo

ules

V

F S

HO

CK

1

MLI

-755

80

GD

T-00

075

X

VF

Sho

ck 2

Ene

rgy

VF

Sho

ck 2

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

seco

nd s

hock

of t

he V

F zo

ne.

N

joul

es

VF

SH

OC

K 2

M

LI-7

5581

G

DT-

0007

6 X

VF

Max

Sho

ck E

nerg

y V

F M

axim

um S

hock

Ene

rgy:

The

am

ount

of

ener

gy d

eliv

ered

in e

ach

rem

aini

ng s

hock

af

ter t

he s

econ

d sh

ock

of th

e V

F zo

ne.

N

joul

es

VF

MA

X S

HO

CK

M

LI-7

5582

G

DT-

0007

7 X

VF

Num

ber O

f Add

ition

al S

hock

s V

F N

umbe

r Of A

dditi

onal

Sho

cks:

The

nu

mbe

r of a

dditi

onal

max

ene

rgy

shoc

ks in

th

e V

F zo

ne p

rogr

amm

ed fo

r del

iver

y.

T

VF

AD

DL

SH

KS

M

LI-9

0709

G

DT-

0007

8 X

VT

Zone

V

T R

ate

Thre

shol

d: T

he ra

te a

bove

whi

ch a

n R

-R in

terv

al is

cla

ssifi

ed in

the

VT

zone

N

bp

m

VT

ZON

E

MLI

-755

84

GD

T-00

079

X

VT

Zone

ATP

1 Ty

pe

The

type

of v

entri

cula

r Ant

itach

y P

acin

g bu

rsts

del

iver

ed in

the

VT

Zone

by

an

impl

ante

d de

vice

for t

he fi

rst p

rogr

amm

ed

vent

ricul

ar th

erap

y se

t.

T

VTA

TP1T

YPE

M

LI-9

0677

G

DT-

0008

0 X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

35

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

VT

Zone

ATP

1 N

umbe

r of B

urst

s Th

e nu

mbe

r of v

entri

cula

r Ant

itach

y P

acin

g bu

rsts

del

iver

ed in

the

VT

Zone

by

an

impl

ante

d de

vice

for t

he fi

rst p

rogr

amm

ed

vent

ricul

ar th

erap

y se

t.

T

VTA

TP1

#BR

ST

MLI

-906

78

GD

T-00

081

X

VT

Zone

ATP

2 Ty

pe

The

type

of v

entri

cula

r Ant

itach

y P

acin

g bu

rsts

del

iver

ed in

the

VT

Zone

by

an

impl

ante

d de

vice

for t

he s

econ

d pr

ogra

mm

ed v

entri

cula

r the

rapy

set

.

T

VTA

TP2T

YPE

M

LI-9

0679

G

DT-

0008

2 X

VT

Zone

ATP

2 N

umbe

r of B

urst

s Th

e nu

mbe

r of v

entri

cula

r Ant

itach

y P

acin

g bu

rsts

del

iver

ed in

the

VT

Zone

by

an

impl

ante

d de

vice

for t

he s

econ

d pr

ogra

mm

ed v

entri

cula

r the

rapy

set

.

T

VTA

TP2

#BR

ST

MLI

-906

80

GD

T-00

083

X

VT

Sho

ck 1

Ene

rgy

VT

Sho

ck 1

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

first

sho

ck o

f the

VT

zone

. T

joul

es

VT

SH

OC

K1

MLI

-907

10

GD

T-00

084

X

VT

Sho

ck 2

Ene

rgy

VT

Sho

ck 2

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

seco

nd s

hock

of t

he V

T zo

ne.

T jo

ules

V

T S

HO

CK

2 M

LI-9

0711

G

DT-

0008

5 X

VT

Max

Sho

ck E

nerg

y V

T M

axim

um S

hock

Ene

rgy:

The

am

ount

of

ener

gy d

eliv

ered

in e

ach

rem

aini

ng s

hock

af

ter t

he s

econ

d sh

ock

of th

e V

T zo

ne.

T jo

ules

V

T M

AX

SH

OC

K

MLI

-907

12

GD

T-00

086

X

VT

Num

ber O

f Add

ition

al M

ax

Ene

rgy

Sho

cks

VT

Num

ber O

f Add

ition

al S

hock

s: T

he

num

ber o

f add

ition

al m

ax e

nerg

y sh

ocks

in

the

VT

zone

pro

gram

med

for d

eliv

ery.

T

VT

AD

DL

SH

KS

M

LI-9

0713

G

DT-

0008

7 X

VT-

1 Zo

ne

VT-

1 R

ate

Thre

shol

d: T

he ra

te a

bove

whi

ch

an R

-R in

terv

al is

cla

ssifi

ed in

the

VT-

1 zo

ne

N

bpm

V

T1 Z

ON

E

MLI

-936

13

GD

T-00

088

X

VT-

1 A

TP1

Type

Th

e ty

pe o

f ven

tricu

lar A

ntita

chy

Pac

ing

burs

ts d

eliv

ered

in th

e V

T-1

Zone

by

an

impl

ante

d de

vice

for t

he fi

rst v

entri

cula

r th

erap

y se

t

T

VT1

ATP

1TYP

E

MLI

-906

81

GD

T-00

089

X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

36

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

VT-

1 A

TP1

Num

ber o

f Bur

sts

The

num

ber o

f ven

tricu

lar A

ntita

chy

Pac

ing

burs

ts d

eliv

ered

in th

e V

T-1

Zone

by

an

impl

ante

d de

vice

for t

he fi

rst v

entri

cula

r th

erap

y se

t

T

VT1

ATP

1#B

RS

T M

LI-9

0682

G

DT-

0009

0 X

VT-

1 A

TP2

Type

Th

e ty

pe o

f ven

tricu

lar A

ntita

chy

Pac

ing

burs

ts d

eliv

ered

in th

e V

T-1

Zone

by

an

impl

ante

d de

vice

for t

he s

econ

d ve

ntric

ular

A

TP th

erap

y se

t.

T

VT1

ATP

2TYP

E

MLI

-906

83

GD

T-00

091

X

VT-

1 A

TP2

Num

ber o

f Bur

sts

The

num

ber o

f ven

tricu

lar A

ntita

chy

Pac

ing

burs

ts d

eliv

ered

in th

e V

T-1

Zone

by

an

impl

ante

d de

vice

for t

he s

econ

d ve

ntric

ular

A

TP th

erap

y se

t.

T

VT1

ATP

2#B

RS

T M

LI-9

0684

G

DT-

0009

2 X

VT-

1 S

hock

1 E

nerg

y V

T-1

Sho

ck 1

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

first

sho

ck o

f the

VT-

1 zo

ne.

T jo

ules

V

T1 S

HO

CK

1

MLI

-907

14

GD

T-00

093

X

VT-

1 S

hock

2 E

nerg

y V

T-1

Sho

ck 2

Ene

rgy:

The

am

ount

of e

nerg

y de

liver

ed in

the

seco

nd s

hock

of t

he V

T-1

zone

.

T jo

ules

V

T1 S

HO

CK

2

MLI

-907

15

GD

T-00

094

X

VT-

1 M

ax S

hock

Ene

rgy

VT-

1 M

axim

um S

hock

Ene

rgy:

The

am

ount

of

ene

rgy

deliv

ered

in e

ach

rem

aini

ng s

hock

af

ter t

he s

econ

d sh

ock

of th

e V

T-1

zone

.

T jo

ules

V

T1 M

AX

SH

OC

K

MLI

-907

16

GD

T-00

095

X

VT-

1 N

umbe

r Of A

dditi

onal

Max

E

nerg

y S

hock

s V

T-1

Num

ber O

f Add

ition

al S

hock

s: T

he

num

ber o

f sho

cks

in th

e V

T-1

zone

pr

ogra

mm

ed fo

r del

iver

y.

T

VT1

AD

DL

SH

KS

M

LI-9

0717

G

DT-

0009

6 X

RA

Pac

e Th

resh

old

The

min

imum

ele

ctric

al s

timul

atio

n (p

acem

aker

out

put p

ulse

) req

uire

d to

co

nsis

tent

ly in

itiat

e R

ight

Atri

al

depo

lariz

atio

n.

T

RA

PA

CE

THR

SH

M

LI-9

0694

G

DT-

0010

0G

DT-

0011

1 X

X

X

EMR

Inte

grat

ion

Tech

nica

l App

licat

ion

Ove

rvie

w –

357

729-

003

P

age

37

LATI

TUD

E® P

atie

nt M

anag

emen

t

O

BR

Sec

tion

Term

Nam

e D

escr

iptio

n D

ata

Type

U

nit

CPO

Flo

w S

heet

La

bel

CPO

MLI

C

ode

GD

T C

ode

Last Interrogation

Implant

Lead Test

Lead Information

RV

Pac

e Th

resh

old

The

min

imum

ele

ctric

al s

timul

atio

n (p

acin

g ou

tput

pul

se) r

equi

red

to c

onsi

sten

tly in

itiat

e R

ight

Ven

tricu

lar d

epol

ariz

atio

n.

T

RV

PA

CE

THR

SH

M

LI-9

0697

G

DT-

0010

3G

DT-

0011

4 X

X

X

LV P

ace

Thre

shol

d Th

e m

inim

um e

lect

rical

stim

ulat

ion

(pac

ing

outp

ut p

ulse

) req

uire

d to

con

sist

ently

initi

ate

Left

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Appendix C – Patient Matching

Patient records sent from LATITUDE will be matched to patient records in CPO using the matching algorithm depicted in the following CPO screen. See your CPO technical documentation for details on configuring Patient Matching.

The first time data for a particular patient is sent to CPO, a demographics match will need to occur. If such a match cannot be made, the imported file goes into an exception queue waiting for the LinkLogic Manager to manually resolve the problem.

Upon a successful match (either automatically via a demographics match, or manually by the LinkLogic manager), LATITUDE's External ID for the patient will be automatically paired with the CPO Patient ID in a CPO table.1 For that patient, subsequent transmissions will then match on LATITUDE’s External ID for the patient and either Birth Date or Last Name.

There can be duplicate patient records in LATITUDE that later get combined through a merge. Prior to the merge, the duplicate records will have different external patient IDs. Thus, the interface should be configured to update the external patient ID upon a successful demographics match, in order to record the one external ID for the patient that is retained following a merge. 1 LinkLogic can be configured to create a new ID set and associate it with a specific interface.



Boston Scientific 4100 Hamline Avenue North St. Paul, MN 55112-5798 USA Telephone: 651.582.4000 Medical Professionals: 1.800.CARDIAC (227.3422) Patients and Families: 1.866.484.3268

www.bostonscientific.com

© 2008 Boston Scientific or its affiliates. All rights reserved. 357729-003 EN US 05/08

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