Device function & interrogation.

Technical reference for the Medtronic Micra (VR, AV) and Abbott Aveir (VR, DR) leadless pacing systems — hardware, anatomy, indications, implant technique, programming, retrieval, and how to choose between them.

Step-by-step approach to a clinic pacemaker check — from connecting the programmer to printing the final report. Covers what each programmable parameter does, how to read counters and histograms, and the red flags that need an EP call.

Technical overview of the three pacemaker categories we implant and follow — transvenous single/dual chamber, leadless capsules (Micra, Aveir), and CRT-P resynchronization devices. Covers hardware, modes, indications, and how to pick between them.

The Medtronic Aurora EV-ICD with the Epsila lead places the defibrillator lead in the substernal space — outside the heart and outside the vasculature but close enough to deliver lower-energy shocks and ATP. Sits between TV-ICD and S-ICD on capability.

Clinic and remote ICD interrogation workflow with emphasis on shock review, detection programming, lead diagnostics, and the high-stakes decisions an ICD interrogation can trigger.

The S-ICD (Boston Scientific EMBLEM) places the generator and shocking lead entirely outside the vasculature. Covers screening EKG, pocket and lead anatomy, sensing vectors and SMART algorithms, defibrillation testing, and how to pick the right candidate.

The traditional implantable cardioverter-defibrillator — generator under the clavicle, defibrillator lead in the RV with one or two shock coils. Covers single vs dual chamber, primary vs secondary prevention, lead architecture, DFT testing, and zone programming.

Cardiac resynchronization therapy combined with defibrillator — three leads (RA, RV ICD, LV via coronary sinus) for HFrEF patients who meet both resynchronization and ICD criteria. Covers when to pick CRT-D over CRT-P, BiV pacing targets, and how to optimise response.

CRT-P and CRT-D interrogation focused on the unique parameters of biventricular pacing — BiV pacing percentage, AV/VV optimization, LV vector selection, and the phrenic surveillance that protects this therapy.

Implantable loop recorder review workflow — battery, sensing, episode triage, and how to handle the high volume of false positives that come with long-term continuous monitoring.

Insertable cardiac monitors — Medtronic LINQ II and Abbott Confirm Rx — provide multi-year arrhythmia surveillance through a single sub-Q device. Covers indications, insertion site, the LINQ vs Confirm Rx differences, and how to manage the false-positive burden.

The Abbott Amplatzer Amulet is a dual-component lobe-and-disc LAA closure device — distal lobe anchors in the appendage neck, proximal disc seals the ostium against the LA wall. Covers design rationale, sizing, the simpler post-implant antithrombotic regimen, and Amulet-vs-WATCHMAN anatomical fit.

The Boston Scientific WATCHMAN FLX is a left atrial appendage closure device deployed via transseptal catheter under TEE guidance. Covers device design, sizing, deployment criteria, the post-implant antithrombotic bridge, and the 45-day seal confirmation.