Product summary

Dual chamber pacemaker in action. The blue side is the right heart. The atrial lead will fire first (notice the blue spark), followed by the ventricular lead (blue spark).


NASPE/BPEG code for pacemakers.
Typically only the first 4 letters are used. The fifth letter is only used in the case of triple chamber devices, see CRT.

• Talos S and Philos II S are single chamber devices, typically implanted with a ventricular lead (VVI configuration), occasionally with an atrial lead (AAI configuration). The Philos II S offers automatic capture control to automatically adjust the amplitude of the pacing pulse, thus saving battery and extending service life. It also has rate smoothing to ease the symptoms of atrial fibrillation. 
• Talos SR (AAIR/VVIR) provides rate adaptation. It also offers automatic capture control. 
• Talos D (DDD): basic dual chamber device with automatic capture control. 
• Talos DR (DDDR): dual chamber device with automatic capture control and rate adaptation. Suitable for all patients.
• Talos SLR (VDDR): a restricted version of the Talos DR which does not provide pacing in the atrium. Suitable for patient with a good sinus node and with AV conduction problem. Typically sinus node capable of 70 bpm is required. Implanted with a single lead with 4 electrodes capable of sensing in the atrium and with pacing and sensing capability in the ventricle.
• Cylos DR (DDDR). The world best dual chamber pacemaker. The only one with Closed Loop Stimulation (CLS) rate control that responds not only to activity but also to emotions. Proven to reduce atrial fibrillation burden. Ideal for older people who cannot have fast enough activities to trigger the accelerometer in the Talos DR, but who wants to have an active life. This is a premium device with premium features.

For a young patient, the selection of a high quality lead may be even more critical than that of the pacemaker. We offer one of industry's best longevity lead. While a pacemaker service life is  7-12 years, depending on how it operates, a high quality pacing lead can last 2 to 3 times as long. This is important since most cardiologists will leave the lead in the body should it become defective, clogging the vein of the patient. The cumulative survival rate of the Polyrox lead that we have been selling in Vietnam the last 10 years is shown in the graph below. None of the competing leads in Vietnam can boast such survival rate.

Polyrox survival probability.
Extract from Biotronik performance reports.

We have in the past 3 years introduced the Selox family of leads with equally impressive survival rate.

Selox survival probablity
Extract from Biotronik performance reports.

So, why not use the best?

Implantable cardioverter-defibrillator

ICDs are devices used to treat patients with life threatening fast heart rate, namely ventricular fibrillation. We offer the following products:

Lexos VR ventricular ICD	Lexos A+ dual chamber ventricular ICD with single lead	Lexos DR dual chamber ventricular ICD
Lumax DR-T dual chamber ventricular ICD	Kronos LV-T Triple chamber ventricular ICD also used as dual chamber ICD	Lumax HF-T Triple chamber ventricular ICD
Lumax 340 VR-T XL 10 year full service life ventricular ICD	Kentrox SL Shock lead

All the above devices provide ventricular tachyarrhythmia (fast heart rhythm) therapy and either single, dual or triple chamber bradycardia (slow heart rate, see pacemaker above) therapy.

The main device is the Lexos VR. The Kronos LV-T is an older generation triple-chamber device that can also be used as a dual chamber device when used with 2 leads, and a 3 chamber device when used with 3 leads. The Lexos DR is a dual chamber device that requires that 2 leads be implanted. The Lexos A+ is an innovative dual chamber device that requires a single lead. It is suitable for patients with a good sinus node. The Lumax 300 DR-T is the latest generation of dual chamber ICD, a successor of the Lexos DR. The Lumax 340 VR-T XL is a full featured (all therapy features by default are ON) with 40 Joule (the other devices are only 30 Joules) shock capability and 10 years of service life.

The above ICDs reflect a number of generations. For ICDs in the same generation, i.e. the year of product introduction, Biotronik ICDs lead others in the following

• Thickness. Biotronik are typically thinner than others. The Kronos, being a 3 chamber device and the older device, is 13 mm thick. The Lexos are 11,8 mm thin. The Lumax are 12 mm thin.
• Memory available for storing two or three electrograms prior to and during an episode of ventricular tachyarrhythmia. This is a key diagnostic capability. Two electrograms are needed to diagnose the true nature of the tachyarrhythmia and help adjust device therapy (either your medication or the parameters of the device). Pre-episode electrogram can help your cardiologist adjust your medication to prevent recurrence of the tachyarrhythmia episode. Length of electrogram helps understand the progression of the arrhythmia during therapy progress and again helps your cardiologist adjust the ICD parameters for optimal and less painful therapy.
• Number of channels. Lumax DR, HF-T: 3 channels. All other: 2 channels.
• Duration: Lumax: 32 minutes; all other: 60 minutes
• Pre-storage: Lumax: up to 30 s; all others: up to 50 s.
• Long term R-R : up to 24 hours in Lexos and Kronos.

In general dual chamber devices are implanted because either the patient requires pacing due to slow heart rate or because the patient has episodes of ventricular tachycardia (an organized high rate ventricular rhythm that reduces blood circulation and thus requires therapy). A single chamber device has a high probability of misdiagnosing a supraventricular (above the ventricle) tachyarrhythmia, which normally does not require therapy because it is typically not life threatening, for an episode of ventricular tachycardia leading to therapy being delivered in the ventricle causing pain and possibly generating an episode of ventricular tachycardia or ventricular fibrillation. All the Biotronik dual chamber ICDs use the SMART Detection discrimination algorithm to prevent inappropriate therapy from being delivered. This algorithm was developed by Dr. Tran Thong and his engineers at Biotronik, and is currently the best discrimination algorithm with sensitivity (ability to detect a ventricular tachyarrhythmia) in excess of 99+%, and a specificity (ability to hold off therapy when not a ventricular tachyarrhythmia) of 93-97%. A single chamber ICD typically has specificity in the 50-75% range, thus delivers a lot of inappropriate therapies, especially painful shocks, in patients with ventricular tachycardia! This is one of the reasons why over half of the ICD implants in the US are dual chamber devices!

The triple chamber devices such as the Kronos LV-T and the Lumax HF-T are ICDs for patient with congestive heart failure. It provides pacing in the right atrium and the left and right ventricles.

The shock lead used with our devices, the Kentrox SL, has an excellent survival record, still unmatched by its competitor.

Kentrox SL survival probability.
Extract from Biotronik performance reports.

Cardiac Resynchronization therapy

Stratos LV-T	Lumax HF-T

Sudden cardiac death risk stratification

An overview of micro-Volt T-wave alternans in Vietnamese is available.


While this is not a product that we would market directly to patients, we would like to to refer patients who meet the following indications

• 3+ month survivor of a heart attack
• chronic heart failure with a left ventricular ejection fraction (LVEF) of less than 40% ... a normal heart has an LVEF > 50%
• who does not have atrial fibrillation
• who has a narrow (<120 ms) QRS ... if you have a wide QRS, you are likely a candidate for Cardiac Resynchronization therapy (see section above)

For our visitors from Cambodia and Laos

We are currently working with a clinic in Phnom-Penh and have a representative in Phnom Penh. However the clinic in Phnom-Penh is implanting only single chamber devices. We have a large number of customers who have come to Vietnam from Laos and Cambodia for device implant. If you have a cardiac rhythm problem and believe you need to implant a device and would like to come to Vietnam, we can make arrangements for you to be examined by a Vietnamese cardiologist and to receive an implant, if needed. The Biotronik devices have a worldwide warranty. The cost of Vietnamese care is less than what it would cost you in Singapore or Thailand. Please feel free to contact us at nwspi@comcast.net

For our visitors from the US

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The US is one of the few major countries without universal health insurance. If you are a US resident, in particular a Vietnamese-American, not covered by medical insurance and have been diagnosed to need a pacemaker implant, the alternative to an expensive US procedure is to come back for a vacation to Vietnam and have a Vietnamese cardiologist examine you and if needed, implant a device. The cost of the trip, the exams and implant of a top of the line pacemaker, for example the Cylos DR, is significantly less than what a basic device alone would cost you in the US. Marketing cost is very high in the US. The Biotronik devices have a worldwide warranty and can be followed at US clinics, if needed. If you have a need for such a device, please feel free to contact us at nwspi@comcast.net and we can provide you with the introduction to a Vietnamese hospital close to where your relatives/friends live in Vietnam. If you prefer to stay at one of the excellent private clinics, and the clinic does not have the appropriate cardiologist on their staff, we can make arrangements for you to have an experienced cardiologist from a nearby implanting hospital come and perform the implant, and follow you during your stay. Follow-ups in the US and Europe are not a problem since a number of our patients in Vietnam have emigrated to the US and Europe and they have not experienced any problem having their devices monitored at US and European clinics.

In general we do not recommend the implant of a defibrillator or a triple chamber device since these devices need to be followed closely. However if you already have a US cardiologist, you can still come to Vietnam for the implant and then visit your local cardiologist for any needed follow-up. Your cardiologist should have the equipment provided by Biotronik to perform any needed follow-up. Again, the total cost of the implant of these advanced devices is significantly lower in Vietnam. An estimate, about 5 years ago, for the implant cost of a basic single chamber defibrillator in the US ranges from USD100K to USD150K. For that amount, you can afford to have a top of the line defibrillator implanted in Vietnam, for example the Lumax 300 DR-T or, in the case of heart failure, a Lumax 300 HF-T, the latest Biotronik dual/triple chamber ICDs, and then fly back to Vietnam every 3-6 month for follow-up, and still have cash left over! 
The most expensive devices are normally not stocked in Vietnam. But we can import on a week's notice directly from Biotronik. Insist on a device legally imported to preserve your rights! Certain companies will have a device hand carried to Vietnam. In those cases, should there be complication, you are on your own since typically those companies do not have the required import licenses from the Ministry of Health and the sales is not legal (official bills of sales, supplied by the Ministry of Finance, are the "hóa đơn đỏ", red receipts. Also insist on an official receipt from the company that sold the device to you, not from some unknown store!) since there is no traceable import document! At Systolic, all devices sold are legally imported, and being a medical product import-export company (the "xuất nhập khẩu trang thiết bị y-tê" in our legal name) we are allowed to import directly, saving time and expenses!

Medical Tourism

Found the following article recently. It quotes a pacemaker implant costing $7,500 in Bangkok, versus $83,600 in the US. For $7.500 you can get the best pacemaker AND have a nice vacation in Vietnam! So, try Saigon, not Bangkok!
We can make arrangements for you to stay at a comfotable private clinic and we will invite the best implanter to come to the hospital to put in the device. In a couple of days time, you can be off to some beach to spend the rest of your vacation.

Sick? Find your doctor, then call a travel agent
Published Thursday, August 13, 2009

To the gentleman who listed his ailments of the past four years and anyone interested in health care, mainly the underinsured and uninsured population, please read the article, "Need Surgery? Call a Travel Agent," in the October 2008 issue of Men's Health magazine (www.menshealth.com).Type the name of the article in the search box, and you should be able to click on the five-page article.

Medical tourism patient costs are lower mainly because of hospital labor costs, administrative costs and malpractice costs.

Payments essentially are cash only at a Bangkok hospital, with health insurance being less than 15 percent. The hospital is the busiest in the world, with labor representing 17 percent of hospital revenue. In the U.S., it is almost 50 percent. In 2007, doctors treated 420,000 foreign patients from 190 nations. Among the 900 doctors, 200 are U.S.-board certified.

Ready for the bill? Here are some medical tourism treatments and prices:lumbar disc excision, $7,500, Mexico and $37,500, U.S.; angioplasty, $8,200, Bangkok and $45,200, U.S.; new knee, $6,500 India and $39,800, U.S.; spinal fuse, $13,500, India and$59,100, U.S.; new hip, $6,500, India and $42,400, U.S.; coronary-artery bypass, $8,500, India and $96,400, U.S.; and cardiac pacemaker, $7,500, Bangkok and $83,600, U.S.

Medical tourism generally involves better care, price, recovery and lower infection rate than the U.S.

Mexico anyone?

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Systolic Medical Products

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Systolic Medical Products Import-Export Limited (Công ty trách nhiệm hữu hạn xuất nhập khẩu trang thiết bị y-tế Tâm Thu) is currently the largest supplier of cardiac rhythm management products in Vietnam. Our main implant centers are in Hanoi, Hue, Hochiminh City. We got to our current dominant position by providing

• outstanding service to our customers. For example this extensive website with over a Gigabyte of materials to help Vietnamese customers understand the underlying disease, the treatment and the therapeutic devices available. Literature is available in Vietnamese, and other languages upon request, to patients to explain the function of the device and how the patients should care for the implanted devices. Our competitors have copied our literature, but cannot match the information provided at our website.
• and outstanding support to implanting cardiologist with frequent training seminars and consultation whenever needed. In March 2008, we just finished a series of 3 training workshops in Hanoi, Hue, Hochiminh City to train cardiologists on the programming of our devices. Without the knowledge to program the devices, a top of the line device may be no better than a basic device! Dr. Tran Thong, who led the pacemaker and defibrillator design team of Biotronik, and now is a Professor of Biomedical Engineering researching heart rhythm, is available to Vietnamese cardiologists for consultation should they have any question on the devices implanted. Since he has given many seminars over the past 14 years delivered in Vietnamese, unlike support from other companies that is provided in English, language is no barrier for him when Vietnamese implanting cardiologists encounter a problem with an implant. No other supplier provides such support for Vietnamese cardiologists.  

So, you owe it to yourself and your health to deal with the best!


Our pacemaker implant centers in Vietnam are located at hospitals in the following cities

• Hanoi
• Haiphong
• Thanh Hoa
• Hue
• Danang
• Nha Trang
• Hochiminh City
• Vung Tau