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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

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Acute performance of a right ventricular automatic pacing threshold algorithm for implantable defibrillators.

Michael R Gold¹, Yanting Dong, Steve Greer

¹Medical University of South Carolina, Charleston, SC, USA. goldmr@musc.edu

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|December 14, 2011

Summary

A new automatic pacing threshold (AT) algorithm reliably measures pacing thresholds for implantable cardioverter defibrillators (ICDs). This method simplifies follow-up and enhances cardiac device longevity.

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Area of Science:

Cardiology
Biomedical Engineering
Medical Devices

Background:

Automatic pacing threshold (AT) testing can simplify follow-up and extend the longevity of cardiac rhythm devices.
Evaluating new algorithms for AT testing is crucial for improving device management.
This study focuses on a novel right ventricular (RV) AT algorithm for implantable cardioverter defibrillators (ICDs) utilizing RVcoil to Can evoked response sensing.

Purpose of the Study:

To evaluate the performance of a new RV AT algorithm for ICDs.
To assess the reliability of RVcoil to Can evoked response sensing for threshold measurement.
To determine the accuracy of the AT algorithm in detecting pacing capture.

Main Methods:

Patients undergoing ICD implantation or replacement were enrolled.
A pulse generator emulator (Can) and an external pacing system were used for data acquisition.
The new RV AT algorithm was compared against manual threshold measurements and visual electrocardiogram analysis.

Main Results:

144 out of 158 (91.1%) AT tests accurately measured pacing thresholds.
The algorithm demonstrated high accuracy in detecting capture (95%) and non-capture (99%) beats.
The difference between manual and AT measurements was minimal (-0.05 ± 0.43 V).

Conclusions:

The RVcoil to Can evoked response sensing based RV AT algorithm reliably measures pacing thresholds for ICDs.
This algorithm is suitable for use in ICDs, including those with cardiac resynchronization therapy (CRT-Ds).
The findings suggest potential for improved device follow-up and longevity.