Clinical Observation Of Autocapture Management In Zephyr5826Pacemaker

Objective To continuously observe the clinical effect of the atrial and ventricular autocapture management by regularly following up the patients with Zephyr5826pacemaker.Methods From November2008to December2010Zephyr5826pacemakers were implanted in74patients(47male,27female; mean age of68±9years; two patients use the primary unipolar leads:one is atrial unipolar lead, the other is ventricular unipolar lead). All patients were diagnosed in terms of the case history, physical examination, Holter, UCG, chest X-ray, and consistent with the indications for cardiac pacing approved on the guide-line of the AHA/ACC/NASPE. Both atrial and ventricular electrodes were programmed into bipolar pacing and bipolar sensing after implantation. Observe the operation of atrial and ventricular autocapture management function, and compare the atrial and ventricular thresholds tested manually with those tested by autocapture management function at the time of1day,7days,1month,2months,3months and6months after implantation.Results Of the74patients initially included, all completed the follow-up of3months and70completed follow-up of6months. One patient got persistent atrial fibrillation in the second day after pacemaker implantation. All patients’ventricular autocapture management functions were turned on at the time of1day after implantation except one with primary ventricular uinpolar lead.5patients’ventri-cular autocapture management functions had to be turned off before discharge due to the discomfort of palpitation caused by this function.The ventricular thresholds tested by ventricular autocapture management function have no statistical significant differ-ence with the thresholds tested manually.14,21,26,29,33and36patients’atrial autocapture management functions were turned on at the time of1day,7days,1month,2months,3months and6months after pacemaker implantation. The atrial thresholds tested by atrial autocapture management function have no statistical signifi-cant difference with those tested manually.36patients’atrial autocapture manage-ment function could not be turned on due to the insufficient atrial ER. The ECG and Holter monitoring in all patients showed a normal sensing and pacing function with -out loss of capture.Conclusion Testing the threshold and reducing the energy output automatically by atrial and ventricular autocapture management function are effective and safe in Zephyr5826pacemaker with bipolar pacing and bipolar sensing. The ventricular autocapture management function can be turned on after pacemaker implantation and work normally. The atrial autocapture management function could not be turned on in several cases patients after implantation due to the insufficient atrial ER,but the percent of atrial autocapture management function turned on was increasing during the follow-up.