Understanding the Device Readings
I cannot provide medical management recommendations for these device readings because the parameters shown (R, MA, LY30, CK, CKH, CRTH, CFFH) do not correspond to any standard cardiac device monitoring system or established cardiovascular monitoring parameters referenced in current ACC/AHA/HRS guidelines for implantable cardioverter-defibrillators, pacemakers, or cardiac resynchronization therapy devices 1.
Critical Assessment
The abbreviations presented appear to be from a coagulation analyzer or thromboelastography device rather than a cardiac monitoring device:
- R (min): Reaction time - typically a coagulation parameter
- MA (mm): Maximum amplitude - a measure of clot strength
- LY30 (%): Lysis at 30 minutes - fibrinolysis measurement
- The other parameters (CK, CKH, CRTH, CFFH) do not match standard cardiac device nomenclature
Standard Cardiac Device Parameters
According to ACC/AHA/HRS guidelines, cardiac device follow-up should focus on 1:
- Battery voltage and status
- Lead impedance values (typically 200-1500 ohms)
- Pacing thresholds (atrial and ventricular)
- Sensing amplitudes (P-waves and R-waves in millivolts)
- Percent pacing in each chamber
- Stored arrhythmia events with electrograms
- Charge time for ICDs
Recommended Action
Device interrogation must be performed by trained personnel using manufacturer-specific programmers to obtain accurate technical parameters 1. The device should be interrogated to review:
- All programmed parameters systematically
- Battery status and elective replacement indicators
- Lead system integrity and impedance values
- Sensing thresholds and capture verification
- Event logs and stored electrograms 1
If the patient is symptomatic or if device therapy has been delivered, immediate in-person device interrogation is mandatory 1. Remote monitoring cannot substitute for comprehensive clinic evaluation when abnormalities are suspected 1.