Use of the AutoCapture Pacing System with implantable defibrillator leads

John P. Marenco, Ruth Ann Greenfield, Ali Massumi, Zaffer A. Syed, Timothy McIntyre, Michael Hardage, Mark S. Link, Munther K. Homoud, Mark Estes, Paul J. Wang

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)471-473
Number of pages3
JournalPACE - Pacing and Clinical Electrophysiology
Volume26
Issue number1 II
DOIs
StatePublished - Jan 1 2003

Keywords

  • AutoCapture
  • Implantable cardioverter defibrillator
  • Pacing leads

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Marenco, J. P., Greenfield, R. A., Massumi, A., Syed, Z. A., McIntyre, T., Hardage, M., Link, M. S., Homoud, M. K., Estes, M., & Wang, P. J. (2003). Use of the AutoCapture Pacing System with implantable defibrillator leads. PACE - Pacing and Clinical Electrophysiology, 26(1 II), 471-473. https://doi.org/10.1046/j.1460-9592.2003.00074.x