Clinical observation of atrial threshold monitoring algorithm: a single center experience

To observe the atrial capture management in an atrial threshold monitoring algorithm. By calculating the enabling rate of the atrial threshold monitoring algorithm and comparing atrial thresholds measured automatically and manually, we evaluate its safety, reliability and applicability in clinical practice.

Data were collected at implant, start of atrial threshold monitoring, visits scheduled 1 month, 2 months and 4 months thereafter, and upon notification of adverse events. Atrial threshold monitoring algorithm was enabled in 94 patients, while in 38 not, indicating an enabling rate of 71.2%. Causes of the unsuccessful attempts to enable automatic atrial threshold include tachycardia (2, 5.3%), and atrial safety margin not met (36, 94.7%). A total of 88 pairs of atrial thresholds measured automatically and manually were gained. The auto threshold was 0.528 ± 0.270 V, and the manual threshold was 0.580 ± 0.223 V. There is a strict correlation between the automatic measurements and those conducted manually by the physician with a P < 0.05. No significant differences were observed during the 1-month, 2-month and 4-month follow-up.

Atrial threshold monitoring algorithm is safe, reliable and applicable over time. Atrial threshold monitoring tested atrial threshold was demonstrated to be clinically equivalent to the manual atrial threshold test. The addition of atrial threshold monitoring will benefit the patients by reducing energy cost and enhancing pacemaker safety.