What’s your experience so far with Proclaim XR?

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drusso

drusso

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The things are flying off the shelf like TV’s on Black Friday at Best Buy!

What’s your hot takes on the pro’s and con’s of this innovative technology? #LiveXR
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So exciting. Can’t wait to use a battery that has therapy cycled off 75% of the time.
 
It’s the same device, just a different program. The 3 proclaim 5’s I did yesterday are the exact same device as the XR’s. These patients will have the XR warranty as well if they don’t exceed the programming parameters.

Different box and roll mark, essentially only difference.
 
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paindoc007 said:
So exciting. Can’t wait to use a battery that has therapy cycled off 75% of the time.
Click to expand...

Good point, what about when you leave it on 24/7 and you have heat increases in the spinal cord and/or tolerance/habituation of therapy? Trying to figure out positives/negatives of all data myself
 
Needlejockeys said:
Good point, what about when you leave it on 24/7 and you have heat increases in the spinal cord and/or tolerance/habituation of therapy? Trying to figure out positives/negatives of all data myself
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Sorry for the salty comment. Never liked Abbott, a company who buys out doctors to use their product.

Anyway, I’ve been very happy with nevro. Never thought about/seen the hot cord thing before though
 
BobBarker said:
It’s the same device, just a different program. The 3 proclaim 5’s I did yesterday are the exact same device as the XR’s. These patients will have the XR warranty as well if they don’t exceed the programming parameters.

Different box and roll mark, essentially only difference.
Click to expand...

Interesting. What do you mean by "roll mark"?
 
I was told exact same device but with a warranty on battery life. Essentially burst only with a brief allowance for tonic to map. So, if it fails you get a new device for free. Device only. There is still all of the surgery related fees. Doesn’t sound terribly earth shattering.

Is there more to this??
 
NJPAIN said:
I was told exact same device but with a warranty on battery life. Essentially burst only with a brief allowance for tonic to map. So, if it fails you get a new device for free. Device only. There is still all of the surgery related fees. Doesn’t sound terribly earth shattering.

Is there more to this??
Click to expand...

 
I would hope they're doing something similar to binning for other hardware parts, where the XRs may have higher tolerances/quality parts, but it's probably just a software/insurance thing on the back side with a marketing push.

This is part of the reason I like something like Stimwave or the external pulse generators. I've gotten tired of replacing prime cells that "should've" lasted longer than they did.
 
Needlejockeys said:
Good point, what about when you leave it on 24/7 and you have heat increases in the spinal cord and/or tolerance/habituation of therapy? Trying to figure out positives/negatives of all data myself
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I don't believe there have been any studies showing heat increases of the spinal cord or any research showing increased habituation from HF10.
 
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I saw bremer mention something about that on LinkedIn but haven’t seen or heard anything about it otherwise. I have several implanted in early 2016 that are doing fine still.
 
I read the study in Neuromodulation earlier this year. Long story short, HF10 heats up water bath immediately around the lead when the lead is submerged.
 
I never understood how the Sunburst study showed these results (taken directly from the Abbott manual), yet docs still flock to it. Am I missing something?
 

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Green Grass said:
I read the study in Neuromodulation earlier this year. Long story short, HF10 heats up water bath immediately around the lead when the lead is submerged.
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www.ncbi.nlm.nih.gov

Tissue Temperature Increases by a 10 kHz Spinal Cord Stimulation System: Phantom and Bioheat Model - PubMed

Heating of spinal tissues by this 10 kHz SCS system theoretically increases quickly with stimulation level and load impedance, while dampened by IPG pulse bandwidth and voltage compliance limitations. If validated in vivo as a mechanism of kHz SCS, bioheat models informed by IPG limitations...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

At most at 2 degree celsius increase in temperature in this model system
 
Green Grass said:
I never understood how the Sunburst study showed these results (taken directly from the Abbott manual), yet docs still flock to it. Am I missing something?
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After reading the Sunburst study in fellowship, I really wondered about this too. These are the data promoted by the company so I’m sure this is the best they have.
 
Yep, you guys are spot on regarding burst. Level 1 study showing the worst pain relief of any level 1 study in SCS yet docs in our specialty use it saying “in my experience it works”. It’s embarrassing. I used it a lot in training and a lot my first year in practice. It was hard sitting down with the St Jude rep and telling him I wasn’t going to use his product anymore knowing it would have an impact on his livelihood.

As for HF10 heating up tissue.... So what if it does. I mean, sure there’s cause for some concern but tens of thousands of patients have been implanted and many with the system for years at this point. If it doesn’t cause any problems then I don’t worry about it.
 
Looks amazing on LinkedIn and Instagram. Very happy to see so many pain doctors to be the first to implant one in the south-west region of the eastern part of their respected states. Look like chumps and monkeys for industry instead of doctors.
 
Sorry...There's no difference in which device you use.

All that matters is the rep.
 
I have not done a social media post bragging about my proclaim XR implant yet, so I must suck. I feel very left out, I must be a terrible physician. I need to post more free advertising for these companies on social media!
 
Ligament said:
I have not done a social media post bragging about my proclaim XR implant yet, so I must suck. I feel very left out, I must be a terrible physician. I need to post more free advertising for these companies on social media!
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The first step in recovery is recognizing that you have a problem. I’m really proud of you and I wish you only the best of luck in resolving your social media deficiency. I have planted a tree in Jerusalem in honor of your epiphany.
 
I find it interesting that Abbott was the last hold out on the “ point to the box and say cheese” money shot. They have now caved in and are doing the same as all of the rest.
 
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