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Related Experiment Video

Updated: Jun 27, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

Performance of a ventricular automatic-capture algorithm in a wide clinical setting.

Domenico Pecora¹, Francesca Morandi, Mattia Liccardo

¹Fondazione Poliambulanza, Brescia, Italy. pecora-domenico@poliambulanza.it

Pacing and Clinical Electrophysiology : PACE

|December 11, 2008

Summary

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Pulse rhythm

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac muscle...

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Automatic capture (AC) algorithms reliably determine pacemaker (PM) ventricular pacing thresholds in most patients. Backup pacing is rarely needed and not dependent on patient or lead characteristics.

Area of Science:

Cardiology
Biomedical Engineering

Background:

Optimal pacemaker (PM) programming balances battery longevity and patient safety via adequate safety margins.
Automatic capture (AC) algorithms aim to ensure safe stimulation threshold determination and pacing.

Purpose of the Study:

Evaluate backup pacing in patients with AC-featured PMs and various ventricular leads.
Identify predictors of ventricular threshold increase or missed threshold detection.
Analyze day-to-day fluctuations in ventricular pacing thresholds.

Main Methods:

Prospective observational study with short-term follow-up.
Involved 579 patients with AC-featured Boston Scientific Insignia PMs and 89 different ventricular leads.
Multivariate analysis to identify predictors of backup pacing and threshold fluctuations.

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Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

Main Results:

92.5% of patients never failed automatic threshold testing; 98.6% avoided permanent high-energy backup pacing.
No patient or lead characteristics predicted high-energy backup pacing.
Day-to-day threshold fluctuations correlated only with higher thresholds (>1 V).

Conclusions:

AC algorithms reliably measure ventricular pacing thresholds in the majority of patients (1.4% failure rate).
Backup pacing requirements are independent of lead or patient characteristics, including lead maturation or polarity.