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Clinical Trial
. 2010 Jun;12(6):811-6.
doi: 10.1093/europace/euq053. Epub 2010 Mar 14.

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

Francis D Murgatroyd  1 , Erhard Helmling, Bernd Lemke, Bernd Eber, Christian Mewis, Judith van der Meer-Hensgens, Yanping Chang, Vladimir Khalameizer, Amos Katz
Affiliations
Clinical Trial

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

Francis D Murgatroyd et al. Europace. 2010 Jun.

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 </=0.25 V in 97% (RA CM) and 96% (RV CM) and were all within the safety margin. Fully automatic CM measurements were available within 1 week prior to the 3-month visit in 90% (RA), 99% (RV), and 97% (LV) of the patients. Results indicated increased output (threshold >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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Figures

Figure 1
Figure 1
Overall distribution of difference in atrial thresholds obtained by RA CM and manual testing (1-month data).
Figure 2
Figure 2
Overall distribution of difference in RV threshold obtained by RV CM and manual testing (1-month data).
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Comment in

References

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