Objective: To contrast and compare the Medtronic Clinician 8840 and the newer Samsung Tablet based programming interface.

Background: The FDA approved Medtronic’s use of the Samsung Galaxy Tab S2 tablet programming interface for DBS on June 13th 2018. As part of the clinical phase-in procedure of this technology at our center, we examined repeated back to back interrogations using the Clinician 8840 and Samsung Galaxy interfaces within a single programming session.

Method: The impedances of 20 DBS patients were assessed twice by each interface, alternating between the Clinician 8840 and the Samsung Galaxy tablet. The sequence of interrogation was counterbalanced across the sessions. The Clinician 8840 employed endogenous parameters of 3.0V, 80µs and 100Hz. The Samsung Galaxy Tab S2 tablet similarly employed 80µs, and 100Hz, but the amplitude was automatically adjusted from 0.7V to 1.5V, if the impedance exceeded 10KOhms, and it was further adjusted from 1.5V to 3.0V, if the impedance exceeded 20KOhms. A further set of 10 other DBS patients, underwent interrogations by Clinician 8840, with the amplitude set at 3.0V and subsequently at 0.7V, followed by the Samsung Galaxy interface with the automated impedance assessment.

Results: None of the Clinician 8840 3.0V impedance measurements exceeded the monopolar 2000Ohm or bipolar 4000Ohm thresholds. Regardless, for the first 20 patients the Samsung tablet impedance measurements (1647 Ohms) resulted in statistically greater values (p<0.0005) then the Clinician 8840 (1375 Ohms). For the further set of 10 patients the Samsung tablet measurements (1441 Ohms) were also statistically greater than (p<0.001) the Clinician 8840 3.0V (1284 Ohms), but not greater than the 0.7V measurements (1452 Ohms; p=ns). Control analyses of interrogation order, monopolar/bipolar, and contact spacing returned expected results.

Conclusion: Our results verify anecdotal reports suggesting that the Samsung Galaxy interface’s automated system consistently overshoots the impedance assessments made by the 8840 Clinician programmer at its default settings. When both systems are compared at 0.7V settings then these differences are not present. It is our understanding that manual selection of the amplitude for impedance measurement will be re-implemented during the next update.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-dbs-clinical-impedance-measurements-of-the-medtronic-clinician-8840-versus-the-samsung-galaxy-tab-s2-tablet-interface/