Allied Professionals Community of Practice

  • 1.  Medtronic Recall and management in Murj

    Posted 10-11-2024 12:01

    I have a question for my HRS friends who utilize Murj for advisory management. The Medtronic recall (Increased potential for reduced energy or no energy delivered during HV Therapy) updated 7/1/24. Medtronic Tech Support stated that after recommended reprogramming and software update (for certain devices) that the risk is no different from other ICDs. Which status do you choose in Murj to indicate "current status" for these devices? Among the options are "reprogrammed", "monitoring", " resolved", "performed required action"? Thank you.



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    Linda Schwartz
    [Supervisor]
    Mayo Clinic Arizona, Heart Rhythm Services
    4802168898
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  • 2.  RE: Medtronic Recall and management in Murj

    Posted 10-11-2024 12:42

    HI Linda,

     

    We use the status "resolved" once the vectors are all reprogrammed and the software has been updated.  We also include the advisory  action "reprogrammed".  I believe the current Cobalt devices are arriving with updated software and  nominal settings of all shock vectors B>AX, so for these patients we use the status "opted out".  Interested to hear how other clinics are handling this.

     

    Sallie Gustafson, BSN, CCDS

    Senior Manager, Clinical Services and Operations

    Emory Cardiac Device Clinics




    Original Message


  • 3.  RE: Medtronic Recall and management in Murj

    Posted 10-11-2024 12:44

    Thanks for replying so quickly! This is very helpful. Also looking forward to hearing how others are using these tools in Murj. 



    ------------------------------
    Linda Schwartz
    [Supervisor]
    Mayo Clinic Arizona, Heart Rhythm Services
    4802168898
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    Original Message


  • 4.  RE: Medtronic Recall and management in Murj

    Posted 10-16-2024 15:49

    Regarding the Medtronic ICDs under advisory, we do not use resolved (except for the Smart Sync issue).  The advisory wording seems to indicate that with B>AX reprogramming the risk is lessened overall statistically however, it doesn't truly "fix" or resolve the issue.  The risk of a lower energy shock still exists.  We will mark it as reprogrammed/monitoring.

     

    Would love to hear what others are doing as well. When using the advisory tool, we try to promote consistency in the process with staff.  It is quite interesting to hear how other clinics manage their devices on these platforms.

     

    Thanks!

     

    Mike

     

    Michael Silva, RN, RCES, CCDS
    Supervisor, Arrhythmia Device Clinic

    WellSpan Heart & Vascular Center
    msilva@wellspan.org
    Office 717-741-8672
    30 Monument Rd York, PA 17403

    Chat with me on Microsoft Teams

     

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  • 5.  RE: Medtronic Recall and management in Murj

    Posted 12-12-2024 09:51

    Hi Linda,

       I went back and forth on this one with my medical director, and ultimately we went with marking it resolved and performed required action.  For the smartsync issue we mark it as software updated.  We also add that ICD vectors verified B>Ax in the patient note section as a backup, once the vectors are reprogrammed.  

    James



    ------------------------------
    James O'Hara PhD, DrPH, DMSc, PA-C
    EP APP Lead
    Technical Director of Ambulatory Monitoring and Cardiovascular Implantable Electronic Devices (CIEDs).
    Cardiac Electrophysiology
    ------------------------------

    Original Message


  • 6.  RE: Medtronic Recall and management in Murj

    Posted 12-12-2024 10:24

    HI Linda and James,

     

    We also go by the Medtronic Tech Support recommendations and use "Resolved" and "Reprogrammed" as the status in MURJ High Voltage advisory.

    The new Cobalt devices are Out of the Box  default programmed with all vectors B>AX, and the upgraded software is already included.  In the rare case that an old device (from the shelf) is implanted, as soon as it is interrogated with the programmer the software is updated.  So for the new  implants, we use Resolved, or even  Opted Out, since the advisory does not really apply once it is implanted and interrogated. However,  I usually check the vectors just by habit anyway!

    We do not make any other special notations as I feel the advisory action "reprogrammed" status in MURJ is very clear.

     

    Sallie

     

    Sallie Gustafson, BSN, CCDS

    Senior Manager, Clinical Services and Operations

    Emory Cardiac Device Clinics

    Office:  (404) 778-4942

     




    Original Message


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