St. Jude Medical Merlin PSA EX3100 Reference guide

Merlin™ PSA
Pacing System Analyzer, Model EX3100
Help Manual

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© 2020 St. Jude Medical, LLC. All Rights Reserved.

Merlin™ PSA Help Manual i
Table of Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
System Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-1
Operator Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-1
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-2
Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1-3
Adverse Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Tools Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
? Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-1
Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-1
Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-1
Audio Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Print Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-2
Export Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2-2
Rhythm Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Rhythm Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-1
ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-3
Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-3
Basic Event Markers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Interval and Refractory Markers (Full Markers) . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Special Event Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-5
Full-Display Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Waveform Channel Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
EGM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-7
Current of Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-7
Waveform Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-7
Rhythm Display Setup Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-8
Adjust Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-8
ECG Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
EGM Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Freeze Capture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3-9

ii
Merlin™ PSA Session Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Connect the Leads to the Merlin™ PSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Start a Merlin™ PSA session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
End a Merlin™ PSA Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Suspend the Merlin™ PSA Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Lead Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Enable/Disable Pacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Pacing, Mode, and V. Pacing Parameter Autoprogramming. . . . . . . . . . . . . . . 5-2
Intrinsic Signal Amplitude and Slew Rate Measurements . . . . . . . . . . . . . . . . . . . 5-3
Lead Impedance Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Capture Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4
Perform a Capture Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-4
Phrenic Nerve Stimulation Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Annotate Test Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Additional Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Ventricular Sensing Buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Burst Pacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
Burst Pacing Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1
Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
AV Delay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
Base Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
Interventricular Delay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
Low Frequency Attenuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1
Max Track Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Pacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Pulse Amplitude . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Pulse Width . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Refractory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
S1S1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Sensitivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
V. Pacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
V. Sensing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Ventricular Support Rate (VOO) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4

Merlin™ PSA Help Manual iii
Mode Descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
DDD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-1
DDI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-2
DOO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-2
VDD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-3
VVI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-4
VOO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-4
AAI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-5
AOO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-5
ODO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8-6
Additional Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
Technical Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-1
Main Programming Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-1
Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2
Patient Data: Lead Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2
On-Screen Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-2
Device Parameters and Settings Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3
Print Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3
Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3
Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-3
Safe Pacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-4
Emergency VVI Pacing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9-4
Parameter Settings and Availability . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
Technical Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Merlin™ PSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Mechanical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Electrical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2
LED States. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Measurement Ranges and Tolerances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4
Essential Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4
Electromagnetic Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-5
Battery Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-10
Merlin™ PSA Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-11
Storage and Operating Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-12
Cleaning, Disinfecting, and Sterilization Methods . . . . . . . . . . . . . . . . . . . . . . . A-12

iv
Special Instructions for the Patient Cable Model EX3150. . . . . . . . . . . . . . . . A-13
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-17
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-17
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .A-18
Loss of Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-18
System Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-18
Low Batteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-18
EGM Noise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-18
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Index-1

Merlin™ PSA Help Manual 1-1
1. Introduction
Contents:
•System Description
•Operator Profile
•Indications for Use
•Indications for Use
•Warnings
•Precautions
System Description
The Merlin™ Pacing System Analyzer (PSA) Model EX3100 system provides you with the ability to
assess the electrical performance of a lead system during pulse generator implantation or invasive
lead-system troubleshooting. The Merlin PSA system uses the St. Jude Medical™ Merlin™ Patient Care
System (PCS).
In addition to the Merlin PCS, the Merlin PSA system consists of:
• a sterilizable patient cable
The Merlin PSA Patient Cable Model EX3150 connects the Merlin PSA with one to three implanted
leads.
• patient-cable adapters
The Merlin PSA Cable Adapter Model EX3170 and the Merlin PSA “M” Adapter Model EX3180
connect the Merlin PSA to commonly used PSA patient cables (see Connect the Leads to the
Merlin™ PSA). The PSA patient cables are then connected to the implanted leads.
For information on the Merlin PCS, refer to the Merlin PCS Model 3650 User’s Manual. For technical
data and other information on the Merlin PSA and accessories, refer to Technical Data.
Operator Profile
The intended operators of the Merlin™ PSA system include trained St. Jude Medical employees and
clinical personnel trained in pacing and electrophysiology, for example, nurses, technicians, or
physicians.
Note
Only persons properly trained to operate the Merlin PSA should do
so.
If the user connects both the Merlin PSA Model EX3100 and the PSA
Wand Model 3150 to the Merlin PCS, the programmer only enables
the Merlin PSA Model EX3100.
Refer to the Merlin PCS Model 3650 User’s Manual for Merlin PSA
installation instructions.

1-2 Introduction
Indications for Use
The Merlin™ Pacing System Analyzer (PSA) is indicated for use at the time of surgery in patients with
bradyarrhythmias, tachyarrhythmias, and/or heart failure undergoing implantation or lead revision of a
pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization therapy system.
Intended Use
The Merlin™ PSA is intended to assess the pacing and sensing performance of the lead system prior to
pulse generator implantation, or during invasive lead system troubleshooting.
The Merlin PSA Patient Cable EX3150 is a three-channel resterilizable patient cable intended to
connect the Merlin PSA to as many as three IS-1, DF-1, or DF4 leads.
The Merlin PSA Patient Cable Adapter EX3170 is a three-channel adapter intended to connect the
Merlin PSA to as many as three disposable patient cables. The EX3170 Cable Adapter can connect to
the Model 4051L disposable patient cable for IS-1 leads or to the Model 4161 disposable patient cable
for DF4 leads. The opposite ends of the disposable patient cables connect to implantable pacing leads.
The Merlin PSA “M” Adapter Model EX3180 is intended to connect the Merlin PSA to the two-channel
Medtronic Model 2292 re-sterilizable patient cable. The opposite end of the Medtronic Model 2292
cable connects to implantable pacing leads.1
Following use, the patient cables must either be disposed or re-sterilized, depending on the
requirements of the cable.
Only use the Merlin PSA with the Merlin PCS.
Contraindications
There are no contraindications to the use of a lead-analysis device. The patient’s age and medical
condition, however, may dictate the pacing modes and lead assessment activities appropriate for the
patient.
The Merlin™ PSA is not intended for use as a temporary pacemaker or for life sustaining pacing
support.
The Merlin PSA is not intended for diagnostic purposes.
Warnings
Line-powered Equipment. An implanted lead or a lead with an extension cable constitutes a direct,
low-resistance current pathway to the myocardium. Due to the danger of tachyarrhythmias resulting
from alternating current leakage, extreme caution must be taken to only use line-powered equipment
according to its intended use as properly grounded line-powered Class I equipment used on or in the
vicinity of the patient.
Electrosurgical Cautery. Electrosurgical cautery could induce ventricular arrhythmias and/or
fibrillation, or may cause device malfunction or damage. If electrocautery is necessary, keep the current
path and groundplate as far away from the leads as possible.
1. The Medtronic Model 2292 re-sterilizable patient cable has an embedded resistor connected via connector pins P3
and P5 that enables Medtronic equipment to distinguish between different supported PSA cables. However, pins
P3 and P5 are not connected to the Merlin PSA which does not support this functionality.

Merlin™ PSA Help Manual 1-3
Burst Pacing. Use of atrial or ventricular burst pacing may result in ventricular tachycardia or
fibrillation. Defibrillation equipment should be readily available during the PSA session.
Handling Inserted Leads. Do not touch the terminal pins or exposed metal when handling inserted
leads. Do not allow the terminal pins or exposed metal to unintentionally contact electrically
conductive or wet surfaces.
Unconnected Atrial Leads. Do not operate the Merlin™ PSA in the DDD or VDD pacing mode with
only the ventricular pacing lead connected. Interference detected at the unconnected atrial input of
the Merlin PSA can result in false sensing and can drive the ventricular pacing rate to the Max Track
Rate setting.
Asystole. During threshold tests, asystole may result due to loss of capture.
Electromagnetic Interference (EMI). At high sensitivity (low numerical settings) and in the presence
of excessive levels of interference, the Merlin PSA may inhibit completely or revert to asynchronous
operation, pacing at the Base Rate. Additional sources of strong EMI that can temporarily affect the
operation of the Merlin PSA include the following:
• Electrosurgical equipment
• Diathermy equipment
• Some medical telemetry equipment, when operated within one meter of the Merlin PSA
• Communication transmitters such as cellular phones and “walkie talkies”.
Move the source of EMI as far from the Merlin PSA as possible.
Asynchronous Pacing. During asynchronous pacing operation, pacing stimuli may be inadvertently
delivered within the vulnerable period of the T-wave. This may be hazardous to patients with acute
myocardial infarction or who are otherwise predisposed to arrhythmias.
Precautions
Temporary Pacing. Do not use the Merlin™ PSA as a temporary pacemaker. It should not be used to
provide extended external pacing in situations where the patient is left unattended. Testing has not
been performed to support this function.
Power Loss. In the event of a power loss to the programmer, the Merlin PSA continues to pace in the
safe pacing mode for the length of backup battery life. Do not use the Merlin PSA as an external
temporary pacemaker. Connect the patient to an external temporary pacemaker as soon as possible.
For more information, see Safe Pacing.
High Output and Maximum Sensitivity. In the presence of large depolarization potentials or large
output pulses, use of high sensitivity settings (low numerical settings) may allow potentials to
inappropriately inhibit (or trigger) the output.
Connecting the Lead System. Install the Merlin PSA in the Merlin PCS storage compartment and
launch the PSA application. (For installation instructions, see the Merlin PCS Model 3650 User’s
Manual.) Then connect the sterile patient cables (and accessories, as necessary) to the Merlin PSA
before connecting the lead to the sterile patient cable.
Electrostatic Discharge (ESD). Pacing leads provide a low-impedance pathway to the heart.
Therefore, discharge any static electricity prior to touching the patient, the cables, or the leads.
Termination of Pacing. Abrupt termination of pacing stimuli may result in intervals of asystole before
an intrinsic rhythm is reestablished. Prior to terminating pacing, set the pacing mode to a demand
mode and then gradually reduce the pacing rate below the patient’s intrinsic rate. Once a spontaneous
rhythm is established, you can turn off pacing.

1-4 Introduction
Defibrillation/Cardioversion. The Merlin PSA may be damaged by defibrillation shocks when it is
connected to an implanted lead system. Test the Merlin PSA after it has been exposed to such charges
by launching the PSA application and verifying that the Merlin PSA is functional. Whenever possible,
for the safety of the patient, disconnect the Merlin PSA from the lead system before defibrillation or
cardioversion. After a typical defibrillation shock, the Merlin PSA will recover is less than five seconds.
Environmental Precautions. The Merlin PSA has been carefully designed and tested to ensure
reliability during normal use. However, electronic devices are susceptible to many environmental
stresses. Take precautions to avoid damaging the device, including (but not limited to) the following
examples:
• do not expose the Merlin PSA to extreme temperatures and/or humidity as that may result in
inaccurate measurements
• do not expose the Merlin PSA to mechanical shock as it may damage the Merlin PSA and result in
unreliable measurements
• do not store the Merlin PSA near magnets or magnetic-field-inducing coils as it may shorten its
lifetime.
Other environmental factors may affect proper performance of the device in the hospital setting. Use
of appropriate environmental health and safety practices helps prevent environmental damage to the
device.
Heart-Rate Monitoring. Monitor the patient’s heart rate with an ECG monitor while using the Merlin
PSA.
Liquid Immersion. Do not immerse the Merlin PSA in liquid or damage will result.
Adverse Events
Potential adverse events include:
• Prolonged surgery
• Arrhythmia
•Discomfort
• Additional surgical procedure
• Infection

Merlin™ PSA Help Manual 2-1
2. Tools Menu
Contents:
•? Button (Help)
•Tools
•Preferences
•Customer Support. Provides contact information for Technical Support representatives. See also
Technical Support.
•Print Screen
•Export Screen
? Button
The ? button opens a window that provides context-sensitive help. You can also get help if you select
Tools > Educational Materials > Help.
Accessed From: Help button
Tools
The Tools menu provides access to a number of programmer tools, including:
•PSA. Opens the PSA application (inactive during the PSA session).
•Session Records: Opens archived data (inactive during the PSA session).
•Educational Materials:
-Help. Opens links for on-line Help for all supported devices.
-Demos. Opens device demonstrations (inactive during the PSA session).
•Maintenance. Opens utilities for programmer maintenance (for use by St. Jude Medical personnel
only).
•Clinical Studies. Opens information for studies (for use by St. Jude Medical personnel only;
inactive during the PSA session).
•Preferences. Opens the Merlin™ PCS settings.
•Customer Support. See Technical Support.
•Print Screen
•Export Screen. Exports an image to a USB flash drive or floppy drive.
Accessed From: Tools menu
Preferences
The Preferences window sets the following for the programmer:
•Date (inactive during the PSA session)
•Time(inactive during the PSA session)
• Language for Display and Help (inactive during the PSA session)

2-2 Tools Menu
• Date, Time, and Number Formats (inactive during the PSA session)
•ECG Notch Filter Frequency. The ECG Notch Filter Frequency reduces ECG interference from the
programmer’s AC power line. Check with your local authorities for your power line frequency.
•Audio Preferences
• Printer Preferences. (inactive during the PSA session)1
Accessed From: Tools menu > Preferences button
Audio Preferences
The Audio Preferences window contains two panels:
•General Audio. Select the On button to allow audio cues for programmer activity. You can also
select a volume level. The Off button turns all sounds off (except Charging Audio).
•Charging Audio. Select the On button for an audio cue when the capacitors charge during a
programming session. An audio cue is always emitted during charging for an Emergency Shock,
regardless of the Charging Audio setting.
Accessed From: Tools menu > Preferences button > Audio tab
Print Screen
The Print Screen button prints an image of the current screen to the internal printer.
For more information on printing, see Print Menu.
Accessed From: Tools menu > Print Screen button
Export Screen
The Export Screen button opens a window which allows you to save the current screen as an electronic
(.png) file and send the file to any storage device (floppy drive or flash drive) connected to one of the
programmer’s USB ports. The Merlin PCS detects all connected devices and asks you to select the
device to receive the data.
Accessed From: Tools menu > Export Screen button
1. The reports printed during a PSA session are always printed to the internal printer and saved as a PDF file.
Note
It is important to set an accurate date and time because the device’s
functions use the date and time from the programmer. You must
exit the PSA session to set the date and time from the Tools menu.

Merlin™ PSA Help Manual 3-1
3. Rhythm Display
Contents:
•Rhythm Display
•ECG
•Markers
•EGM
•Waveform Control
•Rhythm Display Setup Instructions
•Adjust Display
•ECG Configuration
•EGM Configuration
•Freeze Capture
Rhythm Display
The Rhythm Display, seen on the Main Programming Window, can show up to five concurrent
waveforms (or channels) that can be individually configured and adjusted. You can also freeze the
display or print it in real time.
Three types of waveforms can be shown in the Rhythm Display:
•ECG (electrocardiogram)
•Markers
•EGM (intracardiac electrogram)

3-2 Rhythm Display
The controls for the Rhythm Display include the:
See also:
•Rhythm Display Setup Instructions
•Channel Control buttons.
Indicates the current waveform
for each channel. Select this
button to show the Waveform
Control buttons or the Marker
Control buttons.
•Waveform Control buttons.
Select the Channel Control
buttons on the left side of the
waveform to show the
Waveform Control buttons. Top
view shows buttons for ECG.
Bottom two views show buttons
for EGM. See also Current of
Injury.
•Marker Control buttons. Select
the Channel Control buttons on
the left side of the Marker
Control buttons. Select the
desired configuration or select
the “?” button to show help for
Markers.
•Adjust Display button
• Freeze Capture button

Merlin™ PSA Help Manual 3-3
ECG
The Rhythm Display shows up to five ECG waveforms simultaneously from seven possible ECG vectors.
There are two ways to change the ECG display:
•Adjust Display button. Selects the waveform source and configuration and the ECG filter.
•Waveform Control buttons, which set the gain and the waveform source.
For an example of a typical ECG setup, refer to the Merlin™ PCS Model 3650 User’s Manual.
See also:
•ECG Configuration
Markers
Markers are symbols that represent paced and sensed events, intervals, and refractory periods.
You can choose markers as one of the five channels. Markers can be configured either as:
•Basic. Basic Event Markers appear along a time line.
•Full. In addition to the Basic Event Markers, the Interval and Refractory Markers (Full Markers)
appear.
The following markers always appear in both the Basic and Full marker configurations:
•Special Event Markers
•Full-Display Markers
•Waveform Channel Markers
There are two ways to change the marker configuration:
• Select the Adjust Display button and select the desired configuration.
• Select the marker’s Waveform Control button on the left of the Rhythm Display and select the
desired configuration.
The following markers always appear in both the Basic and Full marker configurations:
Basic Event Markers
Marker Description Example
Atrial event
sensed in
refractory period
Table 3-1. Basic event markers

3-4 Rhythm Display
AS Atrial sensed
event
For CRT-Ds and CRT-Ps, when the V. Pacing
or V. Sensing parameter is set to:
•RV Only. The VP or VS marker has a
right-pointing tick mark.
•LV Only. The VP or VS marker has a
left-pointing tick mark.
•SeebelowforRV->LV, LV->RV, and
Simultaneous.
AP Atrial paced
event
VS Ventricular
sensed event
VP Ventricular paced
event
Ventricular
sensed event
within the
refractory period
BP Biventricular
paced event
For CRT-Ds and CRT-Ps, when the V. Pacing
parameter is set to:
•Simultaneous; RV->LV with a 10 ms
delay. The BP marker points down.
•RV->LV with a 15 ms or greater delay.
The BP marker points right.
•LV->RV with a 15 ms or greater delay.
The BP marker points left.
Marker Description Example
Table 3-1. Basic event markers (continued)

Merlin™ PSA Help Manual 3-5
Interval and Refractory Markers (Full Markers)
Interval and refractory markers are shown in the following diagram.
Figure 3-1. Interval and refractory markers (full markers)
Special Event Markers
Marker Description Example
--> A-Noise
or --> V-
Noise
Entry into noise
reversion mode
A-noise or V-
Noise
Continuation of
noise reversion
mode
<-- A-Noise
or <-- V-
Noise
Exit from noise
reversion mode
Burst--- Burst stimulation
Table 3-2. Special event markers
1
6
4
914
907
A-V Interval
A-A Interval
V-V Interval
Refractory
Period (Line)
Absolute Refractory
Period (Thicker Line)

3-6 Rhythm Display
Full-Display Markers
Waveform Channel Markers
Marker Description Example
Pulse
Amplitude
Updated Pulse
Amplitude
setting
A. Burst or
RV Burst
Started
Starting burst
stimulation
delivery
A. Burst or
RV Burst
Ended
Ending burst
stimulation
delivery
Table 3-3. Full-display markers
Marker Description Example
Signal
Amplitude
Measure-
ment
Intrinsic signal
amplitude mea-
surements above
the associated
complex
Impedance
Measure-
ment
Lead impedance
measurement
above the associ-
ated complex
Table 3-4. Waveform channel markers

Merlin™ PSA Help Manual 3-7
EGM
EGMs (intracardiac electrograms) show the sensed electrical activity of the heart. The shape and size of
the waveform depend on the available EGM Configuration and the Gain setting.
The configurations available are Unfiltered or Sense Amp (narrow band filtered data). The Sense Amp
filtering characteristics of the Merlin PSA are designed to match those of St. Jude Medical™ pulse
generators. The default configuration is Unfiltered, and once it’s changed, the new configuration is
saved for future sessions.
Select the Adjust Display button to select the waveform source and configuration, and also the sweep
speed and the ECG Filter.
Current of Injury
The Current of Injury view shows an unfiltered view of the EGM and an amplitude value measured
from peak-to-peak of the waveform. (The filtered EGM view measures the Sense Amp waveform from
baseline-to-peak.) The peak-to-peak amplitude of the unfiltered EGM is shown in the upper left corner
of the Current of Injury view. The Current of Injury view updates with every sensed beat.
Use the Plus (+) and Minus (-) buttons to manually set the gain. AutoGain is not available in the
Current of Injury view.
Select the Current of Injury button to return to the Rhythm Display.
Accessed From: Rhythm Display > Channel Control button
Waveform Control
The Waveform Control buttons on the left side of the Rhythm Display control the waveform’s
appearance. To open the controls, select one of the buttons. The buttons shown depend on the
selected Source for that channel.
Figure 3-2. Waveform control buttons
1Current of Injury button (EGM only). Toggles from the filtered baseline-to-peak view of the
EGM (pictured) to the unfiltered, peak-to-peak Current of Injury view of the EGM.
2Configuration button. Opens the ECG Configuration or the EGM Configuration window.
3AutoGain button. Allows the programmer to automatically set an appropriate gain.
4Plus (+) and Minus (-) buttons allow you to set the gain manually.
Accessed From: Rhythm Display > Channel Control button

3-8 Rhythm Display
Rhythm Display Setup Instructions
1. Select the Adjust Display button to the right of the Rhythm Display.
The Adjust Display window appears.
2. Locate position 1.
3. Select the Source you want to see in position 1 (ECG, EGM, Markers, or Off).
The programmer selects a default Configuration for the Source.
4. Select the Configuration button.
If you selected ECG or EGM for the Source, the ECG Configuration or EGM Configuration window
opens. If you selected Markers, select the Basic or Full button.
5. Choose the configuration.
6. Repeat these steps for the remaining waveforms.
7. Select the Sweep Speed button and choose a speed.
8. Select the ECG Filter button to enable the ECG filter
Electromagnetic interference is reduced when the ECG filter is enabled.
9. Select the AutoGain All button to refresh the AutoGain settings.
Adjust Display
The Adjust Display window changes the:
•Source for each waveform in the Rhythm Display window (ECG, Markers, or EGM)
•Configuration of the waveform
• Sweep Speed
•ECG Filter to reduce electromagnetic interference
The following buttons are also available:
•AutoGain All. Sets all waveforms to AutoGain and recalculates the gain of waveforms currently
displayed in the Rhythm Display.
See also:
•ECG Configuration
•EGM Configuration
•Rhythm Display Setup Instructions
Accessed From: Rhythm Display > Adjust Display button
ECG Configuration
The ECG Configuration window changes the ECG vector on the Rhythm Display.
For an example of a typical ECG setup, refer to the Merlin PCS Model 3650 User’s Manual.
To achieve the ECG vectors, select the following electrodes:
•I. L(+) to R(-)
•II. F(+) to L(-)
•III. F(+) to R(-)
•aVR. R(+) to [L(-) + F(-)]
•aVL. L(+) to [R(-) + F(-)]