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Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators.

Murgatroyd FD, Helmling E, Lemke B, Eber B, Mewis C, van der Meer-Hensgens J, Chang Y, Khalameizer V, Katz A - Europace (2010)

Bottom Line: Automatic CM data were compared with manual threshold measurements, the CM applicability was determined, and adjustments to pacing outputs were analysed.The differences between automatic and manual measurements were </=0.25 V in 97% (RA CM) and 96% (RV CM) and were all within the safety margin.Complete CM adjusts pacing output appropriately, permitting a reduction in office visits while it may maximize device longevity.

View Article: PubMed Central - PubMed

Affiliation: Kings College Hospital, Cardiac Catheter Suite, Level 1, Denmark Hill, SE5 9RS London, UK. francis@sinusrhythm.com

ABSTRACT

Aims: The Secura ICD and Consulta CRT-D are the first defibrillators to have automatic right atrial (RA), right ventricular (RV), and left ventricular (LV) capture management (CM). Complete CM was evaluated in an implantable cardioverter defibrillator (ICD) population.

Methods and results: Two prospective clinical studies were conducted in 28 centres in Europe and Israel. Automatic CM data were compared with manual threshold measurements, the CM applicability was determined, and adjustments to pacing outputs were analysed. In total, 160 patients [age 64.6 +/- 10.4 years, 77% male, 80 ICD and 80 cardiac resynchronization therapy defibrillator (CRT-D)] were included. The differences between automatic and manual measurements were 2.5 V) due to raised RA threshold in seven (4.4%), high RV threshold in nine (5.6%), and high LV threshold in three patients (3.8%). All high threshold detections and all automatic modulations of pacing output were adjudicated appropriate.

Conclusion: Complete CM adjusts pacing output appropriately, permitting a reduction in office visits while it may maximize device longevity. The study was registered at ClinicalTrials.gov identifiers: NCT00526227 and NCT00526162.

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Overall distribution of difference in atrial thresholds obtained by RA CM and manual testing (1-month data).
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EUQ053F1: Overall distribution of difference in atrial thresholds obtained by RA CM and manual testing (1-month data).

Mentions: Table 2 details 1-month paired (manual and CM) data that were available for 159 patients including 114 paired atrial measurements and 139 paired RV measurements. The combined results showed that for RA and RV CM, respectively, 86 and 84% of automatic measurements were within 0.125 V of the manual measurement, 97 and 96% were within 0.25 V of the manual measurement, and 100 and 99.3% were within 0.5 V. All differences were well within the standard two-fold safety margin for output automatically set by the device (Figures 1 and 2).Table 2


Manual vs. automatic capture management in implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillators.

Murgatroyd FD, Helmling E, Lemke B, Eber B, Mewis C, van der Meer-Hensgens J, Chang Y, Khalameizer V, Katz A - Europace (2010)

Overall distribution of difference in atrial thresholds obtained by RA CM and manual testing (1-month data).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875184&req=5

EUQ053F1: Overall distribution of difference in atrial thresholds obtained by RA CM and manual testing (1-month data).
Mentions: Table 2 details 1-month paired (manual and CM) data that were available for 159 patients including 114 paired atrial measurements and 139 paired RV measurements. The combined results showed that for RA and RV CM, respectively, 86 and 84% of automatic measurements were within 0.125 V of the manual measurement, 97 and 96% were within 0.25 V of the manual measurement, and 100 and 99.3% were within 0.5 V. All differences were well within the standard two-fold safety margin for output automatically set by the device (Figures 1 and 2).Table 2

Bottom Line: Automatic CM data were compared with manual threshold measurements, the CM applicability was determined, and adjustments to pacing outputs were analysed.The differences between automatic and manual measurements were </=0.25 V in 97% (RA CM) and 96% (RV CM) and were all within the safety margin.Complete CM adjusts pacing output appropriately, permitting a reduction in office visits while it may maximize device longevity.

View Article: PubMed Central - PubMed

Affiliation: Kings College Hospital, Cardiac Catheter Suite, Level 1, Denmark Hill, SE5 9RS London, UK. francis@sinusrhythm.com

ABSTRACT

Aims: The Secura ICD and Consulta CRT-D are the first defibrillators to have automatic right atrial (RA), right ventricular (RV), and left ventricular (LV) capture management (CM). Complete CM was evaluated in an implantable cardioverter defibrillator (ICD) population.

Methods and results: Two prospective clinical studies were conducted in 28 centres in Europe and Israel. Automatic CM data were compared with manual threshold measurements, the CM applicability was determined, and adjustments to pacing outputs were analysed. In total, 160 patients [age 64.6 +/- 10.4 years, 77% male, 80 ICD and 80 cardiac resynchronization therapy defibrillator (CRT-D)] were included. The differences between automatic and manual measurements were 2.5 V) due to raised RA threshold in seven (4.4%), high RV threshold in nine (5.6%), and high LV threshold in three patients (3.8%). All high threshold detections and all automatic modulations of pacing output were adjudicated appropriate.

Conclusion: Complete CM adjusts pacing output appropriately, permitting a reduction in office visits while it may maximize device longevity. The study was registered at ClinicalTrials.gov identifiers: NCT00526227 and NCT00526162.

Show MeSH