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Use of Automatic Threshold Tracking Function with Non‐Low Polarization Leads:
Author(s) -
LURIA DAVID,
GUREVITZ OSNAT,
LEV DAVID BAR,
TKACH YANA,
ELDAR MICHAEL,
GLIKSON MICHAEL
Publication year - 2004
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 - 10.1111/j.1540-8159.2004.00463.x
Subject(s) - medicine , polarization (electrochemistry) , cardiology , chemistry
The AutoCapture (AC) function of new pacemakers (PM) from St Jude Medical (SJM) was originally recommended for use with low polarization (LP) ventricular leads only.However, recent reports have encouraged the use of the AC function with various leads, including those lacking a special LP design. The objective of this study was to analyze the reliability and safety of the AC algorithm application with different types of pacing leads.The study group comprised 30 consecutive patients with AC PMs connected to three different types of non‐LP leads. Ten patients with SJM LP leads served as the control group. The study protocol included a complete AC function test using four different pulse widths (PW). The pacing threshold was independently assessed by a manual/semiautomatic check. Erratic behavior of polarization measurements with increasing PWs was demonstrated in 43% (n = 13) of the study group. Invalid polarization measurements resulted in erroneous algorithm recommendation to apply AC function in 17% (n = 5) of the study patients. Subsequent AC function activation lead to incorrect threshold determination due to missed noncapture in three patients. AC function should be applied with caution with non‐LP leads. “Off label” use of these leads may cause erroneous polarization signal measurements which, in some cases, may result in incorrect pacing threshold determination, rendering a potential risk to dependent patients. (PACE 2004; 27:453–459)