6533b7d0fe1ef96bd125a408

RESEARCH PRODUCT

Acute performance evaluation of a new ventricular automatic capture algorithm

Andreas KönigBernd NowakGeng ZhangGerd FröhligAlok SathayeJohannes SperzelCraig ReisterEwald HimmrichR. Willems

subject

AdultMalePacemaker Artificialmedicine.medical_specialtyHeart VentriclesAbsolute thresholdlaw.inventionlawPhysiology (medical)Internal medicineHumansTelemetryMedicineProspective StudiesLead (electronics)AgedAged 80 and overbusiness.industrySignificant differenceClinical performancePacemaker implantMiddle AgedAmbulatoryElectrocardiography AmbulatoryCardiologyArtificial cardiac pacemakerFemaleCardiology and Cardiovascular MedicinebusinessAlgorithmAlgorithms

description

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 INSIGNIA™ 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.

https://doi.org/10.1093/europace/euj008