Obviously as few as possible unless absolutely necessary. Only those where it will significantly improve patient outcome.
Our list at Basildon to date is as follows:
• Where battery is identified as near depleting and programming could be performed to reasonably extend the life of the device, if for any reason generator change is not possible or desired. E.g: Reducing lower rate, changing to single chamber mode etc..
• Chronic debilitating phrenic nerve pacing.
• Program changes required due to failed appropriate Tachy therapies
• Program changes to avoid in-appropriate therapies
• Audible or vibratory patient alerts (specific to patients not on remote monitoring)
• Patients identified to be at risk of lead failure where failure would be life threatening.