Adjustment of the evoked response sensitivity after hospital discharge in pacemaker patients with automatic ventricular threshold tracking activated
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Adjustment of the evoked response sensitivity after hospital discharge in pacemaker patients with automatic ventricular threshold tracking activated. / Schuchert, Andreas; Ventura, Rodolfo; Meinertz, Thomas.
in: PACE, Jahrgang 24, Nr. 2, 2001, S. 212-216.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Adjustment of the evoked response sensitivity after hospital discharge in pacemaker patients with automatic ventricular threshold tracking activated
AU - Schuchert, Andreas
AU - Ventura, Rodolfo
AU - Meinertz, Thomas
PY - 2001
Y1 - 2001
N2 - Automatic threshold tracking in cardiac pacemakers allows ventricular capture verification and self-adaptive pacing output regulation. The Autocapture algorithm detects the evoked response (ER) signal immediately after the pacing pulse to verify the efficacy of ventricular pacing. Before hospital delivery, the ER sensitivity must be programmed individually so that the pacemaker detects the ER signal adequately without sensing lead polarization. The aims of the study were to assess the frequency of patients in whom Autocapture could be activated and whether the ER sensitivity had to be adjusted after hospital discharge. The study included 44 patients who received the VVIR pacemaker Regency SR + (St. Jude Medical) connected to the model 1450 T pacing lead. ER signal, lead polarization, and ER sensitivity were evaluated before hospital discharge and 1, 3, and 6 months after implantation. The system recommended activating Autocapture in 42 of 44 patients. The mean ER signal was 8.4 ± 1.2 mV at discharge, 9.0 ± 3.9 mV at month 1, 8.9 ± 4.9 m V at month 3, and 9.3 ± 4.5 mV at month 6. Polarization was 1.0 ± 0.1 mV at discharge, 1.1 ± 0.5 mV at month 1, 1.1 ± 0.2 mV at month 3, and 1.1 ± 0.5 mV at month 6. Mean ER sensitivity was 3.7 ± 1.8 mV at discharge, 4.0 ± 1.8 mV after 1, 4.1 ± 2.2 mV after 3, and 4.1 ± 1.8 mV after 6 months. ER sensitivity could remain unadjusted in 14 patients. Programming to a less sensitive ER setting from 2.9 ± 1.2 mV to 4.3 ± 1.5 mV was possible in 21 patients. Programming to a more sensitive ER setting from 4.1 ± 1.1 mV to 2.5 ± 0.9 mV was required in nine patients because of the decrease of the ER signal. The automatic threshold tracking algorithm Autocapture could be activated in 95% of patients. Programming to more sensitive ER settings was recommended in 21% of the patients after hospital discharge. Therefore, ER signal and polarization must be checked at each follow-up, as a decrease in ER signal amplitude can make reprogramming of the ER sensitivity necessary. There is no risk for the patient if the ER is not sensed, as high voltage backup stimulation is present.
AB - Automatic threshold tracking in cardiac pacemakers allows ventricular capture verification and self-adaptive pacing output regulation. The Autocapture algorithm detects the evoked response (ER) signal immediately after the pacing pulse to verify the efficacy of ventricular pacing. Before hospital delivery, the ER sensitivity must be programmed individually so that the pacemaker detects the ER signal adequately without sensing lead polarization. The aims of the study were to assess the frequency of patients in whom Autocapture could be activated and whether the ER sensitivity had to be adjusted after hospital discharge. The study included 44 patients who received the VVIR pacemaker Regency SR + (St. Jude Medical) connected to the model 1450 T pacing lead. ER signal, lead polarization, and ER sensitivity were evaluated before hospital discharge and 1, 3, and 6 months after implantation. The system recommended activating Autocapture in 42 of 44 patients. The mean ER signal was 8.4 ± 1.2 mV at discharge, 9.0 ± 3.9 mV at month 1, 8.9 ± 4.9 m V at month 3, and 9.3 ± 4.5 mV at month 6. Polarization was 1.0 ± 0.1 mV at discharge, 1.1 ± 0.5 mV at month 1, 1.1 ± 0.2 mV at month 3, and 1.1 ± 0.5 mV at month 6. Mean ER sensitivity was 3.7 ± 1.8 mV at discharge, 4.0 ± 1.8 mV after 1, 4.1 ± 2.2 mV after 3, and 4.1 ± 1.8 mV after 6 months. ER sensitivity could remain unadjusted in 14 patients. Programming to a less sensitive ER setting from 2.9 ± 1.2 mV to 4.3 ± 1.5 mV was possible in 21 patients. Programming to a more sensitive ER setting from 4.1 ± 1.1 mV to 2.5 ± 0.9 mV was required in nine patients because of the decrease of the ER signal. The automatic threshold tracking algorithm Autocapture could be activated in 95% of patients. Programming to more sensitive ER settings was recommended in 21% of the patients after hospital discharge. Therefore, ER signal and polarization must be checked at each follow-up, as a decrease in ER signal amplitude can make reprogramming of the ER sensitivity necessary. There is no risk for the patient if the ER is not sensed, as high voltage backup stimulation is present.
KW - Automatic capture Verification function Autocapture
KW - Evoked response signal
KW - Lead polarization
KW - Pacemaker follow-up
KW - VVIR pacemaker
UR - http://www.scopus.com/inward/record.url?scp=0035092796&partnerID=8YFLogxK
U2 - 10.1046/j.1460-9592.2001.00212.x
DO - 10.1046/j.1460-9592.2001.00212.x
M3 - SCORING: Journal article
C2 - 11270702
AN - SCOPUS:0035092796
VL - 24
SP - 212
EP - 216
JO - PACE
JF - PACE
SN - 0147-8389
IS - 2
ER -