Serial trials of different wave forms with one set of leads

[NJPAIN]

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For better or for worse I don't typically trial multiple manufacturers wave forms from a single pair of leads during a trial. I have heard that some of you do that to some extent. I have a patient with CIDP set for Abbott trial. If he fails I'd like to trial DTM or HF10. I asked my NEW very young and green Medtronic rep if this could be done. He became really nervous and said that the official answer was no. When I pushed him he agreed to find out if it was possible. He called a few minutes ago to confirm that the answer was no, going on to state that the leads would not fit their trial generator. If they won't do it there is no reason for me to push it but I'd really like to know if I am being told the truth. Am I?

 

[BobBarker]

yes, the leads won’t fit. Start with mdt if you want to have them part of the mix. The mdt leads are just a touch more narrow than the rest.

 

[Orin]

Everyone connects to MDT leads, so I prefer to start with them, but they don't all interchange perfectly.

The bigger problem/deciding factor is that only the first rep gets paid by insurance for the trial lead. There's no way I'm aware of to bill for an external pulse generator swap and the adapters after the trial has started. I've done BSx to MDT, Nevro to MDT, and MDT to Abbott.

The other reps seen not to care if they capture the battery but I try not to make a habit of pushing my luck.

You can do a proper buried trial or just tunnel and pray. The issue is the duration of the trial correlates with infection.

 

[BobBarker]

No, they don’t get paid by insurance. They get paid by you, your employer, or the facility.

 

[DODOCSS]

legit, CIDP?

 

[ragnathor]

For those trialing two companies, how long will you leave the leads in?

 

[10KHertz]

There are adapters to switch to any stim company . They are lying to you...

 

[pmrmd]

For those trialing two companies, how long will you leave the leads in?

7-8 days with orals instead of usual 5 without. Equal time for each but if the trial requires a redirect the second company has the advantage and the patient will always choose them when it’s over.

 

[BobBarker]

Medtronic has no connectors.

 

[10KHertz]

Medtronic has no connectors.

But their competitors do.

 

[BobBarker]

But their competitors do.

Yes. Every other company has connectors. You can typically plug Nuvectra’s right into a ABT, BSX, NEVRO IPG and get enough contacts to work to be ok.


BSX and NVRO will slide right into a ABT IPG with no connector if you cut the plastic tips off the leads.

 

[Green Grass]

I do this pretty frequently and haven't had any issues swapping back and forth between multiple companies. Company doesn't charge for the second EPG. I don't bill for the extended trial. The second company is eager to hook up to the prior leads because they might get the implant.