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Related Experiment Videos

Effect of short pulse width programming in AutoCapture devices.

Lai Chow Kok1, George P Hanna, Sheldon Brownstein

  • 1McGuire VAMC, Richmond, Virginia 23249, USA. laichow@yahoo.com

Pacing and Clinical Electrophysiology : PACE
|February 3, 2005
PubMed
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Shorter pacing pulse durations (0.2 ms) in pacemakers led to more frequent loss of capture (LOC) episodes compared to longer durations (1.0 ms). AutoCapture (AC) technology effectively managed threshold variations, ensuring patient safety.

Area of Science:

  • Cardiovascular Medicine
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Pacing chronaxie, a measure of electrical excitability, can increase over time, potentially affecting pacemaker function.
  • The impact of short pulse durations on pacemaker capture thresholds (THR) and loss of capture (LOC) episodes requires further investigation.
  • AutoCapture (AC) pacemakers offer advanced capabilities for monitoring THR trends and LOC events.

Purpose of the Study:

  • To evaluate the effect of short pulse durations (0.2 ms vs. 1.0 ms) on pacemaker THR variations and LOC frequency.
  • To assess the safety and efficacy of AC pacemaker technology in managing these parameters.
  • To understand the relationship between pulse duration programming and pacing system performance.

Main Methods:

Related Experiment Videos

  • A 6-month follow-up study involving 20 recipients of AC pacemakers.
  • Randomized crossover design with pulse durations programmed to 0.2 ms and 1.0 ms.
  • Regular monitoring of evoked responses (ER) and AC tests to assess THR and LOC episodes.

    • Main Results:

    • A significantly higher mean number of LOC episodes per day was observed at 0.2 ms (2.37) compared to 1.0 ms (0.91).
    • LOC trends showed significant differences between the 0.2 ms and 1.0 ms pulse durations (P < 0.01).
    • AC THR at 1.0 ms was significantly lower (0.44 V) than at 2.0 ms (0.97 V, P < 0.05), with no reported patient symptoms related to LOC.

    Conclusions:

    • Programming pacemaker pulse durations near the strength-duration curve is associated with increased THR variations and LOC.
    • AC pacemakers effectively respond to these variations by adjusting output pulses to maintain capture at safe THR levels.
    • Short pulse durations may increase the risk of non-capture, highlighting the importance of appropriate programming and monitoring.