Use of the AutoCapture Pacing System with implantable defibrillator leads.

Conference Paper

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 mV vs 3.70 +/- 2.33 mV, P = 0.013) while the mean evoked response was higher (18.04 +/- 8.29 mV vs 10.13 +/- 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.

Full Text

Duke Authors

Cited Authors

  • Marenco, JP; Greenfield, RA; Massumi, A; Syed, ZA; Mcintyre, T; Hardage, M; Link, MS; Homoud, MK; Estes, M; Wang, PJ

Published Date

  • January 2003

Published In

Volume / Issue

  • 26 / 1P2

Start / End Page

  • 471 - 473

PubMed ID

  • 12687870

International Standard Serial Number (ISSN)

  • 0147-8389

Digital Object Identifier (DOI)

  • 10.1046/j.1460-9592.2003.00074.x

Conference Location

  • United States