Europace

Europace 2003 5(2):199-205; doi:10.1053/eupc.2002.0289
© 2003 by European Society of Cardiology

This Article Abstract FREE Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to citation manager Search for citing articles in: ISI Web of Science (7) Request Permissions Disclaimer Google Scholar Articles by Nürnberg, J.-H. Articles by Lange, P. E. Search for Related Content PubMed PubMed Citation Articles by Nürnberg, J.-H. Articles by Lange, P. E. Social Bookmarking          What's this?

Antibradycardia pacing in patients with congenital heart disease: experience with automatic threshold determination and output regulation (Autocapture^TM)

J.-H. Nürnberg, H. Abdul-Khaliq, P. Ewert and P. E. Lange

Department of Congenital Heart Disease/Pediatric Cardiology, German Heart Institute Berlin Augustenburger Platz 1, D-13353, Berlin

AIMS: The purpose of this study was to reevaluate whether St Jude Medical's Autocapture^TM algorithm (AC) with beat-to-beat capture confirmation, automatic pacing threshold determination and output adjustment can be applied to paced patients with congenital heart disease (CHD).

METHODS AND RESULTS: 30 patients with CHD received a transvenous (group A: n=22) or epicardial (group B: n=8) single (n=7) or dual chamber (n=23) AC pacemaker for antibradycardia pacing. As a safe AC function is ensured only if a sufficient evoked response (ER) and a low lead polarization amplitude (LPA) are present, these parameters were reevaluated from 112 follow-up studies with respect to AC-function. In all but one transvenous system AC correctly functioned. AC was recommended in 5/8 patients with epicardial leads but correct AC function was preserved in only 3 patients.

CONCLUSION: These data suggest that the application of the AC algorithm is safe in patients with CHD when transvenous leads are used. Whether appropriate AC function is possible with epicardial leads needs individual verification.

Key Words: Congenital heart disease, bradycardia, pacemaker, autocapture, stimulation threshold, evoked response

---

Correspondence: Jan-Hendrik Nürnberg, Department of Congenital Heart Disease/Pediatric Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany. Tel.: +49-30-4593 2800; Fax: +49-30-4593 2900; E-mail: nuernberg{at}dhzb.de

---

[1] Clarke M, Liu B, Schüller H, et al. Automatic adjustment of pacemaker stimulation output correlated with continuously monitored capture thresholds: a multicenter study. European Microny Study Group. Pacing Clin Electrophysiol 1998; 21: 1567–1575.[CrossRef][Medline]

[2] Schuchert A, Ventura R, Meinertz T. Automatic threshold tracking activation without the intraoperative evaluation of the evoked response amplitude. AUTOCAP Investigators. Pacing Clin Electrophysiol 2000; 23: 321–324.[CrossRef][Medline]

[3] Lau C, Cameron DA, Nishimura SC, et al. A cardiac evoked response algorithm providing threshold tracking: a North American multicenter study. Clinical Investigators of the Microny-Regency Clinical Evaluation Study. Pacing Clin Electrophysiol 2000; 23: 953–959.[CrossRef][Medline]

[4] Schuchert A, Ventura R, Meinertz T. Effects of body position and exercise on evoked response signal for automatic threshold activation. Pacing Clin Electrophysiol 1999; 22: 1476–1480.[Medline]

[5] Simeon L, Duru F, Fluri M, et al. The impact of automatic threshold tracking on pulse generator longevity in patients with different chronic stimulation thresholds. Pacing Clin Electrophysiol 2000; 23: 1788–1791.[Medline]

[6] Bauersfeld U, Nowak B, Molinari L. Low-energy epicardial pacing in children: the benefit of autocapture. Ann Thorac Surg 1999; 68: 1380–1383.[Abstract/Free Full Text]

[7] Bertram H, Jux C, Bökenkamp R. Herzschrittmachertherapie bei Kindern: Mittelfristige Erfahrungen mit epikardialer Autocapture-Stimulation. Z Kardiol (abstract) 2001; 90: 703.

[8] Tomita Y, Imoto Y, Tominaga R, et al. Successful implantation of a bipolar epicardial lead and an autocapture pacemaker in a low-body-weight infant with congenital atrioventricular block: report of a case. Surg Today 2000; 30: 555–557.[Medline]

[9] Bertram H, Fink C, Paul T. Schrittmachertherpaie bei einem Frühgeborenen (1800 g) mit kongenitalem AV-Block und postpartaler kardialer Insuffizienz. Herzschr Elektrophys 1998; 9: 112–114.

[10] Nowak B, Kampmann C, Schmid FX, et al. Schrittmachertherapie bei Frühgeborenen mit AV-Block: Erstmaliger Einsatz von "Autocapture" mit epikardialer Elektrode. Herzschr Elektrophys 1998; 9: 120–121.[CrossRef]

[11] Binner L, Brummer T, Jungwirth R, et al. Transvenous dual chamber pacing in children: Can pacemaker lifetime be extended with the use of autocapture^TM and steroid eluting screw-in leads? Europace Supplements (abstract) 2001; 2: A65.

[12] Nürnberg JH, Ewert P, Abdul-Khaliq H, et al. Schrittmachertherapie bei angeborenen Herzfehlern: Erfahrungen mit Algorithmen zur automatischen Reizschwellenbestimmung. Herzschr Elektrophys (abstract) 2002; 13:Suppl. 1, I/95.

[13] Boriani G, Biffi M, Branzi A, et al. Benefits in projected pacemaker longevity and in pacing related costs conferred by automatic threshold tracking. Pacing Clin Electrophysiol 2000; 23: 1783–1787.[Medline]

[14] Funke HD. Der Schwellwertschrittmacher. Ein neuartiges Prinzip der elektrischen Myokard-Stimulation 1972; Germany University of Bonn.

[15] Preston TA and Bowes DL. Report of a continuous threshold tracking system. In Hilbert J and Thalen Th (Eds.). Cardiac Pacing 1973; Assen Van Gorcum 295–299.

[16] Mugica J, Lazarus B, Buffet J, et al. Pacemaker with automatic adaptation to the pacing threshold. In Hilbert J and Thalen Th (Eds.). Cardiac Pacing 1973; Assen Van Gorcum 150–155.

[17] Preston TA, Fletcher RD, Lucchesi BR, et al. Changes in myocardial threshold. Physiologic and pharmacologic factors in patients with implanted pacemakers. Am Heart J 1967; 74: 235–242.[CrossRef][Web of Science][Medline]

[18] Binner L, Bondtke HJ, Brummer T, et al. Ein neuer Detektionsalgorithmus zum Einsatz von Autocapture^TM bei unipolaren ventrikulären Sonden. Herzschr Elektrophys (abstract) 2002; 13:Suppl. 1, I/97.

[19] Kennergren C, Gadler F, Binner L, et al. First clinical experience with unipolar Autocapture. Pacing Clin Electrophysiol (abstract) 1999; 22: A4.

[20] Cohen MI, Bush DM, Vetter VL, et al. Permanent epicardial pacing in pediatric patients: seventeen years of experience and 1200 outpatient visits. Circulation 2001; 103: 2585–2590.[Abstract/Free Full Text]

[21] Nürnberg JH, Schöpper H, Büsscher U, et al. Retrospective comparison of epicardial steroid-eluting and conventional leads for pacing after corrective surgery in congenital heart disease. Pacing Clin Electrophysiol 1997; 20: 1193.

[22] Dodge-Khatami A, Johnsrude CL, Backer CL, Deal BJ, Strasberger J, Mavroudis C, et al. A comparison of steroid-eluting epicardial versus transvenous pacing leads in children. J Card Surg 2000; 15: 323–329.[Medline]

[23] Nürnberg JH, Hebe J, Krutz J, et al. Automatic pacing threshold adjustment (Autocapture^TM): Evoked response behavior with steroid eluting epicardial leads. Pacing Clin Electrophysiol (abstract) 2001; 24: 620.

CiteULike    Connotea    Del.icio.us    What's this?

This article has been cited by other articles:

				M. S. Silvetti, A. De Santis, S. Marcora, T. De Santo, N. Grovale, and F. Drago Circadian pattern of atrial pacing threshold in the young Europace, February 1, 2008; 10(2): 147 - 150. [Abstract] [Full Text] [PDF]

				M. Tomaske, P. Harpes, R. Pretre, A. Dodge-Khatami, and U. Bauersfeld Long-term experience with AutoCapture(R)-controlled epicardial pacing in children Europace, August 1, 2007; 9(8): 645 - 650. [Abstract] [Full Text] [PDF]

				A. Çeliker, N. Ceviz, and O. Küçükosmanoglu Long-term results of endocardial pacing with AutocaptureTM threshold tracking pacemakers in children Europace, January 1, 2005; 7(6): 569 - 575. [Abstract] [Full Text] [PDF]

				M. I. Cohen, K. Buck, R. E. Tanel, V. L. Vetter, L. A. Rhodes, J. Cox, T. Sheldon, and L. Ruetz Capture management efficacy in children and young adults with endocardial and unipolar epicardial systems, Europace, January 1, 2004; 6(3): 248 - 255. [Abstract] [Full Text] [PDF]

This Article Abstract FREE Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to citation manager Search for citing articles in: ISI Web of Science (7) Request Permissions Disclaimer Google Scholar Articles by Nürnberg, J.-H. Articles by Lange, P. E. Search for Related Content PubMed PubMed Citation Articles by Nürnberg, J.-H. Articles by Lange, P. E. Social Bookmarking          What's this?