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What an Abbott Technician Can See in the Merlin Programmer
1. Leadless Pacemaker Status Overview
- Battery status: Estimated longevity (years) and current battery voltage
- Device information: Model, serial number, implant date, session timestamps
- Programmed settings: Mode (e.g., VVI), base rate, max sensor rate
2. Capture and Sensing Parameters
- Capture threshold: Voltage @ pulse width (manual or automatic trends)
- Sensing amplitude: R-wave amplitude in millivolts (mV)
- Lead impedance: Measured in ohms, indicates electrode–tissue interface condition
3. Pacing Behavior
- Pacing percentage: Total, day vs. night, hourly histogram
- Capture logs: Successful or failed capture events
- Rate histogram: Distribution of ventricular rates over time
- Sensor response: Passive accelerometer data and rate modulation behavior
4. Diagnostic Trends and Graphs
- Historical data: Trends of impedance, threshold, battery voltage, and sensing amplitude
- Timeline display: Weeks-to-months progression shown in graphs
5. Event Logs and Alerts
- Capture loss events: Including timestamps and frequency
- Sensing issues: Undersensing or oversensing detection
- Bradycardia or asystole alerts
- System alerts: Integrity events such as impedance shifts
6. Programming Controls
- Output voltage and pulse width adjustment
- Base rate and maximum sensor rate
- Mode selection: VVI, OOO, etc.
- Sensor settings: Passive or disabled
7. Manual Testing Options
- Manual threshold test: To find the minimum voltage for reliable capture
- Sensing test: Measures ability to detect intrinsic ventricular activity
- Impedance test: Evaluates contact and electrical interface
- Magnet test: Optional, tests safety and pacing margins
What They Cannot See
- Imaging data (e.g., fibrosis must be inferred, not visualized)
- Autonomic status (vagal tone), preload, or positional data
- Patient-reported symptoms (unless entered manually)