PACING
Acute performance evaluation of a new ventricular automatic capture algorithm
Kerckhoff-Klinik GmbH, Department of Cardiology and Electrophysiology Benekestrasse 2-8, D-61231 Bad Nauheim Germany ; Cardioangiologisches Centrum Bethanien Im Prüfling 23, D-60389 Frankfurt Germany ; Johannes Gutenberg-Universität Mainz Klinikum, Langenbeckstrasse 1, D-55101 Mainz Germany ; Guidant Corporation 4100 Hamline Avenue North, St Paul, MN 55112-5798 USA ; Guidant Europe, Clinical Research Department Park Lane, Culliganlaan 2B, 1831 Diegem Belgium ; Universitätsklinikum des Saarlandes D-66421 Homburg/Saar Germany
Aims This study evaluated the acute clinical performance of a new ventricular automatic capture algorithm developed to work with all lead types and pacing vectors.
Methods and results During regular pacemaker implant or replacement, AutoThreshold and manual threshold tests were performed in ventricular unipolar (UP) and bipolar (BP, if applicable) pacing using a customized external prototype INSIGNIATM pacemaker. The success rate and accuracy of two different modes (commanded and ambulatory) of the automatic capture algorithm were used to evaluate the performance. Loss-of-capture events (two consecutive non-captured beats without backup pacing) were used to assess safety. Data of 53 patients (33 DDD/20 VVI) from four medical centres were analysed. Tested leads included 43 BP and 10 UP from nine manufacturers, and seven had electrodes with low polarization. The rate of successful commanded and ambulatory AutoThreshold tests was 96 and 94%, respectively, with an average absolute threshold difference compared with manual threshold of <0.1 V at 0.4 ms (commanded 0.07±0.07 V and ambulatory 0.08±0.07 V). There was no significant difference in performance between UP/BP pacing, polarization, and lead type. No loss-of-capture event was observed.
Conclusion When successful, the ventricular automatic capture algorithm accurately determined pacing thresholds in either a UP or BP pacing configuration among all leads tested.
Key Words: Pacemaker, Automatic capture verification, Pacing artifact, Polarization, Pacing threshold
Corresponding author. Tel: +49 6032 996 0; fax: +49 6032 996 3236. E-mail address: j.sperzel{at}kerckhoff-klinik.de
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