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Use of the AutoCapture Pacing System with Implantable Defibrillator Leads
Author(s) -
MARENCO JOHN P.,
GREENFIELD RUTH ANN,
MASSUMI ALI,
SYED ZAFFER A.,
MCINTYRE TIMOTHY,
HARDAGE MICHAEL,
LINK MARK S.,
HOMOUD MUNTHER K.,
ESTES MARK,
WANG PAUL J.
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.00074.x
Subject(s) - medicine , cardiology , implantable cardioverter defibrillator , electromagnetic coil , ventricular pacing , cardiac resynchronization therapy , ejection fraction , heart failure , electrical engineering , engineering
MARENCO, J.P., et al.: Use of the AutoCapture Pacing System with Implantable Defibrillator Leads.Introduction: Previous studies using various bipolar pacemaker leads have shown that the AutoCapture (AC) Pacing System is able to verify ventricular capture and regulate pacing output, increasing patient safety with respect to unexpected threshold changes and potentially prolonging device longevity. An increasing number of patients with implantable cardioverter defibrillators (ICDs) require ventricular pacing that contributes to a shortening of longevity of these systems. This prospective study tested the compatibility of the AC system with bipolar ICD leads. Methods: The AC algorithm was evaluated prior to ICD testing in 30 ICD recipients. A single coil, active fixation, true bipolar ventricular lead was implanted in 21 patients, and a dual coil, passive fixation, integrated bipolar ventricular lead was implanted in 9 patients. A ventricular evoked response sensitivity test and an AC threshold test were performed using a pacemaker with the ventricular AC algorithm. Results: AC was recommended in 22/30 (73.3%) of implants, including 20/21 (95.2%) with the single coil and 2/9 (22.2%) with the dual coil lead. Mean polarization was lower (1.23 ± 0.95 mVvs3.70 ± 2.33 mV, P = 0.013) while the mean evoked response was higher (18.04 ± 8.29 mVvs10.13 ± 4.22 mV, P = 0.002) with the single coil leads. Conclusion: Automatic threshold tracking using the AC is compatible with ICD leads. Leads with lower polarization and greater evoked response are more likely to result in recommendation of AC use. Use of this system offers the potential for increasing ICD generator longevity and improving patient safety in response to late unexpected threshold increases. (PACE 2003; 26[Pt. II]:471–473)