Precautions - Abbott Merlin PSA EX3100 Help Manual

input of the Merlin PSA can result in false sensing and can drive the ventricular pacing rate to the
Max Track Rate setting.
Asystole. During threshold tests, asystole may result due to loss of capture.
Electromagnetic Interference (EMI). At high sensitivity (low numerical settings) and in the
presence of excessive levels of interference, the Merlin PSA may inhibit completely or revert to
asynchronous operation, pacing at the Base Rate. Additional sources of strong EMI that can
temporarily affect the operation of the Merlin PSA include the following:
Electrosurgical equipment
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Diathermy equipment
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Some medical telemetry equipment, when operated within one meter of the Merlin PSA
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Communication transmitters such as cellular phones and "walkie talkies".
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Move the source of EMI as far from the Merlin PSA as possible.
Asynchronous Pacing. During asynchronous pacing operation, pacing stimuli may be
inadvertently delivered within the vulnerable period of the T-wave. This may be hazardous to
patients with acute myocardial infarction or who are otherwise predisposed to arrhythmias.

Precautions

Temporary Pacing. Do not use the Merlin™ PSA as a temporary pacemaker. It should not be
used to provide extended external pacing in situations where the patient is left unattended.
Testing has not been performed to support this function.
Power Loss. In the event of a power loss to the programmer, the Merlin PSA continues to pace in
the safe pacing mode for the length of backup battery life. Do not use the Merlin PSA as an
external temporary pacemaker. Connect the patient to an external temporary pacemaker as soon
as possible. For more information, see Safe Pacing.
High Output and Maximum Sensitivity. In the presence of large depolarization potentials or
large output pulses, use of high sensitivity settings (low numerical settings) may allow potentials to
inappropriately inhibit (or trigger) the output.
Connecting the Lead System. Connect the Merlin PSA to the Merlin PCS or Merlin 2 PCS. (For
installation instructions, see the Merlin PCS Model 3650 User's Manual or Merlin 2 PCS Manual)
Then connect the sterile patient cables (and accessories, as necessary) to the Merlin PSA before
connecting the lead to the sterile patient cable.
Electrostatic Discharge (ESD). Pacing leads provide a low-impedance pathway to the heart.
Therefore, discharge any static electricity prior to touching the patient, the cables, or the leads.
Termination of Pacing. Abrupt termination of pacing stimuli may result in intervals of asystole
before an intrinsic rhythm is reestablished. Prior to terminating pacing, set the pacing mode to a
demand mode and then gradually reduce the pacing rate below the patient's intrinsic rate. Once a
spontaneous rhythm is established, you can turn off pacing.
Defibrillation/Cardioversion. The Merlin PSA may be damaged by defibrillation shocks when it is
connected to an implanted lead system. Test the Merlin PSA after it has been exposed to such
charges by launching the PSA application and verifying that the Merlin PSA is functional.
Whenever possible, for the safety of the patient, disconnect the Merlin PSA from the lead system
before defibrillation or cardioversion. After a typical defibrillation shock, the Merlin PSA will
recover is less than five seconds.
Environmental Precautions. The Merlin PSA has been carefully designed and tested to ensure
reliability during normal use. However, electronic devices are susceptible to many environmental
stresses. Take precautions to avoid damaging the device, including (but not limited to) the
following examples:
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