Picking up the Pace of a Slow Heartbeat Presented by: Insert Physician Name/Title

Does This Sound Familiar? © 2011 Medtronic Content is Confidential and Proprietary 2 This isn’t normal and may be the first signs of a heart rhythm problem. Out of breath ©iStockphoto.com Wears you out ©iStockphoto.com Makes you dizzy ©iStockphoto.com

Aging is Inevitable…Slowing Down Doesn’t Have to Be… © 2011 Medtronic Content is Confidential and Proprietary 3 A healthy heart beats between 60–100 times per minute A slower heartbeat can’t pump enough oxygen-rich blood to the body Can cause lethargy, shortness of breath, dizziness, fainting Limits ability to exercise, or even do normal daily activities. ©iStockphoto.com

There’s a Name for It! –What causes it? –At what age does this generally set in? –What are the symptoms? –How do I find out if I have it? © 2011 Medtronic Content is Confidential and Proprietary 4 Bradycardia: A slow or irregular heart rhythm, usually less than 60 beats per minute

How Can I Pick Up the Pace? Lifestyle changes Medication therapy Implantable pacemakers –What is a pacemaker? –How does it work? –How do I know if it is time for a pacemaker? –Living with a pacemaker © 2011 Medtronic Content is Confidential and Proprietary 5

Can I Lead a Normal Life with a Pacemaker? © 2011 Medtronic Content is Confidential and Proprietary 6 Let’s address some commonly asked questions: Yes – you can! Can I go through airport security systems? Can I use a cell or cordless phone? Are household appliances safe to use? Are physical activities safe? What happens when the battery runs out?

What Else Can Happen? © 2011 Medtronic Content is Confidential and Proprietary 7 It’s no secret; issues with our health increase as we age Cancer Stroke Joint or muscle pain/injuries Neurological diseases ©iStockphoto.com

Raise Your Hand… © 2011 Medtronic Content is Confidential and Proprietary 8 If you’ve ever undergone an MRI Magnetic resonance imaging (MRI) – is the preferred imaging technology among physicians to find out “what’s wrong” Speed and accuracy of the picture it provides allows for more rapid diagnosis

…And What If I Need a Pacemaker? © 2011 Medtronic Content is Confidential and Proprietary 9 Traditional pacemakers are not compatible with MRI because of a risk of harmful interaction between the device and the electromagnetic field 1,2,3,4 Historically, the FDA and doctors have recommended that pacemaker patients NOT undergo an MRI > 30,000 times 1.Faris OP, Shein M. Food and Drug Administration perspective: Magnetic resonance imaging of pacemaker and implantable cardioverter ‐ defibrillator patients. Circulation 2006;114:1232 ‐ Roguin A, Schwitter J, Vahlhaus C, et al. Magnetic resonance imaging in individuals with cardiovascular implantable electronic devices. Europace 2008;10:336 ‐ Levine GN, Gomes AS, Arai AE, et al. Safety of magnetic resonance imaging in patients with cardiovascular devices: an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization, Council on Clinical Cardiology, and the Council on Cardiovascular Radiology and Intervention: endorsed by the American College of Cardiology Foundation, the North American Society for Cardiac Imaging, and the Society for Cardiovascular Magnetic Resonance. Circulation 2007;116:2878 ‐ Kalin R and Stanton MS. Current clinical issues for MRI scanning of pacemaker and defibrillator patients. PACE 2005;28:326 ‐ 328. FPO ©iStockphoto.com

Did You Know…? © 2011 Medtronic Content is Confidential and Proprietary 10 Pacemaker patients in the US annually are denied access to an MRI scan 5 200, % probability that cardiac device patients will be indicated for an MRI over the lifetime of their devices 6 5.Medtronic calculations cited in Rod Gimbel and Ted McKenna, “Safety of Implantable Pacemakers and Cardioverter Defibrillators in the Magnetic Resonance Imaging Environment,” Business Briefing: Long ‐ Term Healthcare 2005 (2005) available at 6.Kalin R and Stanton MS. Current clinical issues for MRI scanning of pacemaker and defibrillator patients. PACE 2005;28:326 ‐ 328.

Why Is Access To MRI So Important? © 2011 Medtronic Content is Confidential and Proprietary 11 Provides highly detailed images of soft tissues (organs, blood vessels, muscles, joints, tumors, areas of infection, etc.) More accurate than X-ray or CAT scan Use of MRI* on the rise as the population ages Each year: ‾60 million MRIs are performed worldwide 8 ‾30 million MRI scans performed in the U.S. 9 * Commonly used to diagnose strokes, cancer, Alzheimer’s disease, muscle, bone and back pain – all commonly seen as we age 8.Sutton R, Kanal E, Wilkoff BL, Bello D, et al. Safety of magnetic resonance imaging of patients with a new Medtronic EnRhythm MRI SureScan pacing system: clinical study design. Trials 2008, 9:68. 9.IMV, “Benchmark Report: MRI 2007,” IMV Medical Information Division. Des Plaines, IL. 2008

Is There Anything I Can Do? © 2011 Medtronic Content is Confidential and Proprietary 12 Anyone needing a pacemaker now has a new option that allows MRI access Yes – you can! First and only pacemaker system FDA-approved for use in an MRI environment I am in the medical field. I am a radiologist and I didn’t even know that there was an MRI conditional pacemaker out there when I needed a pacemaker. It took me having to ask my doctor about it “ “ –Dr. Lee Friedman

Where To Go for More Information © 2011 Medtronic Content is Confidential and Proprietary 13 Important resources and informational tools: Disease and device information Frequently Asked Questions Quiz: My Pacemaker. My MRI. My Guide Personal stories: spokesperson Debbie Allen, pacemaker patients Share your story and become a Pace Maker!

Take an Active Role in Making Treatment Decisions with Your Doctor Ask me questions! © 2011 Medtronic Content is Confidential and Proprietary National Council on Aging (NCOA) Survey on Medical Imaging Safety, February ©iStockphoto.com

Important Safety Information An implantable pacemaker system relieves symptoms of heart rhythm disturbances. They do this by restoring normal heart rates. A normal heart rate provides your body with the proper amount of blood circulation. The pacemaker system is intended for patients who need rate-adaptive pacing or chronic pacing or for patients who may benefit from synchronizing the pumping of the heart chambers. Risks associated with pacemaker system implant include, but are not limited to, infection at the surgical site and/or sensitivity to the device material, failure to deliver therapy when it is needed, or receiving extra therapy when it is not needed. After receiving an implantable pacemaker system, you will have limitations with magnetic and electromagnetic radiation, electric or gas powered appliances, and tools with which you are allowed to be in contact. A complete SureScan pacing system including a Revo MRI SureScan IPG and two CapSureFix MRI SureScan leads is required for use in the MRI environment. Any other pacing system combination may result in a hazard to the patient during an MRI scan. When programmed to On, the MRI SureScan feature allows the patient to be safely scanned while the device continues to provide appropriate pacing. The Revo MRI SureScan pacing system is MR Conditional. This means the pacing system is designed to allow patients to undergo MRI, when your doctor determines you meet patient eligibility requirements and the scan is conducted according to Medtronic directions. This treatment is prescribed by your physician. This treatment is not for everyone. Please talk to your doctor to see if it is right for you. Your physician should discuss all potential benefits and risks with you. Although many patients benefit from the use of this treatment, results may vary. For further questions, contact patient services at 1 (800) , x © 2011 Medtronic Content is Confidential and Proprietary 15