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Stratos LV/LV-T Technical Manual  5 
Transcutaneous Electrical Nerve Stimulation (TENS) – 
Transcutaneous electrical nerve stimulation may interfere with 
CRT-P function.  If necessary, the following measures may 
reduce the possibility of interference: 
•  Place the TENS electrodes as close to each other as 
possible. 
•  Place the TENS electrodes as far from the CRT-P/lead 
system as possible. 
•  Monitor cardiac activity during TENS use. 
 
Defibrillation – The following precautions are recommended to 
minimize the inherent risk of CRT-P operation being adversely 
affected by defibrillation: 
•  The paddles should be placed anterior-posterior or along 
a line perpendicular to the axis formed by the CRT-P 
and the implanted lead. 
•  The energy setting should not be higher than required to 
achieve defibrillation. 
•  The distance between the paddles and the CRT-P/leads 
should not be less than 10 cm (4 inches). 
 
Radiation – The CRT-P’s internal electronics may be damaged 
by exposure to radiation during radiotherapy.  To minimize this 
risk when using such therapy, the CRT-P should be protected 
with local radiation shielding. 
Lithotripsy – Lithotripsy treatment should be avoided for CRT-P 
patients since electrical and/or mechanical interference with the 
CRT-P is possible.  If this procedure must be used, the greatest 
possible distance from the point of electrical and mechanical 
strain should be chosen in order to minimize a potential 
interference with the CRT-P.  
Electrocautery – Electrocautery should never be performed 
within 15 cm (6 inches) of an implanted CRT-P or leads because 
of the danger of introducing fibrillatory currents into the heart 
and/or damaging the CRT-P.  Pacing should be asynchronous 
and above the patient’s intrinsic rate to prevent inhibition by 
interference signals generated by the cautery.  When possible, a 
bipolar electrocautery system should be used.