Intrinsic™ Dual Chamber ICD

With MVP™ Mode (Managed Ventricular Pacing)

MVP promotes intrinsic conduction and is clinically proven to reduce unnecessary right ventricular (RV) pacing to approximately 4%. ^1,2

Clinical Need

A growing body of evidence suggests that chronic RV apical pacing is associated with a variety of detrimental effects in patients, especially those with intact or intermittent AV conduction.
(DAVID ³, MOST ⁴, CTOPP ⁵, and Danish study ⁶)

• Increased risk of heart failure hospitalization and death
• Increased risk of atrial fibrillation

Based on the clinical need to reduce unnecessary RV pacing, Medtronic developed the Intrinsic™ Dual Chamber ICD with MVP Mode.

MVP Mode in the Intrinsic DR ICD

• Provides functional AAI(R) pacing with the safety of dual chamber ventricular support in the presence of transient or persistent loss of AV conduction⁷
• Delivers continuous automatic conduction checks by monitoring each heart beat⁷
• Recognizes when normal conduction is present and returns from DDD(R) to AAI(R)⁷

Clinically Proven MVP Mode²

The average relative reduction in percent of ventricular pacing with MVP ON versus MVP OFF was 95%.² This graph shows the change for each patient in the study. Recorded ECG strips confirmed that the patient who remained at 100% VP had complete heart block.

Features

Therapy Advantages

• Delivers 35J output (39J stored)
• Performs with short, consistent charge times:*
  • 7.0 seconds at BOL
  • 8.9 seconds at ERI
• Long battery life - longevity of 7.9 years with MVP ON**
• Includes clinically proven Enhanced PR Logic^® detection⁸ and painless therapies (ATP) to reduce shocks, which may improve a patient's quality of life^{9, 10}

Patient Management Advantages

Cardiac Compass Report

[+] Click to enlarge

• Leadless™ ECG allows tests to be performed and an ECG recorded without attaching separate ECG leads
• Cardiac Compass^® graphically displays a patient’s clinical progress for up to 14 months

Cardiac Compass^® monitors atrial and ventricular pacing. It may aid the physician in device and drug therapy management and monitor disease progression.

In the MVP clinical study², the Cardiac Compass report was used to visualize a patients' percent ventricular pacing (%VP). The patients were randomized to 1 month each in MVP ON and MVP OFF (DDD/R) mode. The above graph shows with MVP OFF, the %VP was over 90% and when MVP was turned ON the %VP was 4%. At the end of the study, MVP mode was OFF and the original DDD settings were implemented as the study protocol required. In DDD the %VP again rose significantly.

Cardiac Compass provides information on AF burden and ventricular rate during AT and AF.

Medtronic CareLink® Network

• The industry’s first Internet-based remote monitoring service that is comparable to an in-office device check
• Connects Intrinsic patients who are at home or traveling with physicians for “virtual office visits”
• Physicians can access device data anytime, from any Web-capable PC
• Provides comprehensive device data in approximately one-third the time of a typical office visit

*Based on fully formed capacitors
**Pacing parameters: 60 bpm, 2.5V, 0.4ms, 900Ω, EGM pre-storage OFF
Biannual charges: 50% atrial and 5% ventricular pacing. A charge is a full-energy therapy or capacitor reformation.

References

1. Sweeney M, Shea J, Fox V, et al. Randomized pilot study of a new atrial-based minimal ventricular pacing mode with dual chamber implantable cardioverter-defibrillators. Heart Rhythm 2004;1:160-167.
2. Mueller M. Medtronic Marquis^® MVP Mode Study. April 2004. Data on file.
3. DAVID Investigators. Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator. JAMA. 2002;288(24):3115-3123.
4. Sweeney MO, Hellkamp AS, Ellenbogen KA, et al. MOde Selection Trial Investigators. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003;107(23):2932-2937.
5. Connolly SJ, Kerr CR, Gent M, et al. Effects of physiologic pacing versus ventricular pacing on the risk of stroke and death due to cardiovascular causes. NEJM. 2000;342:1385-1391.
6. Anderson H, Nielsen J, Thomsen P, et al. Long-term follow-up of patients from a randomized trial of atrial versus ventricular pacing for sick sinus syndrome. Lancet. 1997;350:1210-1216.
7. Medtronic Intrinsic™ ICD Product Manual.
8. Willkoff B, Gillberg J, DeSouza C. The Enhanced PR Logic^® dual chamber tachyarrhythmia detection algorithm: Retrospective analysis of supraventricular tachycardia with long PR intervals. JACC. 2001:Abstract #873-4.
9. Wathen MS, Sweeney MO, DeGroot PJ, et al. Shock reduction using antitachycardia pacing for spontaneous rapid ventricular tachycardia in patients with coronary artery disease. Circulation. 2001;104(7):796-801.
10. Wathen MS, DeGroot PJ, Michael O. Sweeney MO et al., for the PainFREE Rx II Investigators; Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators: pacing fast ventricular tachycardia reduces shock therapies (PainFREE Rx II) Trial Results. Circulation. Oct 2004; 110: 2591 - 2596.

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