Effect of short pulse width programming in AutoCapture devices

Chow Kok Lai, George P. Hanna, Sheldon Brownstein, Michael Kim, Paul A. Levine, Pugazhendhi Vijayaraman, Andre Go, Zaffer A. Syed

Research output: Contribution to journalArticlepeer-review

Abstract

Pacing chronaxie can increase over time. The impact of a short pulse duration on threshold (THR) variations, frequency of noncapture episodes, and overall patient safety has not been fully studied. AutoCapture (AC) pacemakers are capable of memorizing THR trends and loss of capture (LOC) episodes. The study included 20 recipients of AC pacemakers (mean age = 76 ± 9 years, 15 men) followed for 6 months. They were randomly assigned to pulse durations of 0.2 versus 1.0 ms at 1 month, and crossed over to the alternate programming at 3 months. Evoked response (ER) and AC tests were performed at follow-up. At 0.2 ms and 1.0 ms, the mean number of LOC/day was 2.37 ± 5.82 and 0.91 ± 0.49, respectively (ns). LOC trends between follow-up were significantly different with 0.2 versus 1.0 ms pulse duration (P < 0.01). AC THR at 1.0 ms was significantly lower (0.44 ± 0.77) than at 2.0 ms (0.97 ± 0.26, P < 0.05). No patient reported symptoms related to LOC during the study. Pulse duration programmed near the strength-duration curve is associated with greater variations in THR and LOC. AC responds to these changes by delivering 4.5 V pulses and keeping the capture THR at low, though safe values.

Original languageEnglish
Pages (from-to)S70-S72
JournalPacing and Clinical Electrophysiology
Volume28
Issue numberSUPPL. 1
DOIs
StatePublished - Jan 2005

ASJC Scopus Subject Areas

  • Cardiology and Cardiovascular Medicine

Keywords

  • AutoCapture
  • Cardiac pacing
  • Pacing pulse width
  • Pacing thresholds

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