Influence of output capacitor, electrode and pulse width on power consumption in cardiac pacing

Three different types of unipolar endocardial electrodes--47 in all--were compared in regard to power consumption at stimulation threshold with six different output capacitors and seven pulse widths. Fifteen were conventional large surface electrodes (area 47 mm2); 18 were conventional small surface electrodes (area 6 mm2), and 14 had a specially designed tip with a large area but small active surface of 8 mm2. Pulse widths ranged from 0.15 to 2.0 msec and output capacitors from 1.0 to 22.0 microFarads. All in all about 2,000 measurements were performed. The average current drain to the pacemaker output stage was measured and power consumption was calculated for each electrode--pulse width--output capacitor combination. In all combinations, the two small surface electrodes consumed approximately the same amount of power and, in both cases, significantly less than the larger one. With regard to power economy at stimulation threshold, the pulse width of choice was about 0.5 msec and, furthermore, power consumption decreased with increasing capacitor size. The optimal combination was a small surface electrode, an output capacitor of 22 microF and a pulse width of 0.5 msec.