The Clinical Study Of Automatic Function Of EnPulse Pacemaker

Objective:To evaluate the safety and effectiveness of automatic function of EnPulse pacemaker,including auto atrial capture management,ventricular capture management and search AV+,and their clinical value.Methods:15 patients who received EnPulse pacemaker were selected,including 5 males and 10 females,ageing 35-80 years old,averaging 61.60±10.33 years old. The parameters of pacemakers were recorded 1 month and 6 months after operation. At pulse width 0.4ms,the atrial pacing thresholds were tested using the auto amplitude decrease method,then in the same way for ventricular pacing thresholds, while the pacing threshold tested by ACM and VCM were recorded.The percentage of cumulative ventricular sensing events to the total ventricular events were recorded using collected and stored data by pacemaker,as well as the percentage of cumulative ventricular sensing events to the total ventricular events from Search AV+.Results:All the patients completed the VCM.Oneof the patient's ventricular pacing threshold was as high as 4.00mV@0.4ms,which was identified by VCM and confirmed by manual test.As 97%of the patient's ventricular events were sensing events and the atrioventricular function was intact with sinus sick syndrome,no intervention was done.Using the paired t test,the thresholds between VCM and manual test at 1^stmonth and 6^thmonth has no significant difference(1^stmonth t=1.382,p=0.189;6^thmonth t=1.749,p=0.104).All the follow-up patients completed the ACM at 1^stmonth follow-up.A patient's atrial threshold＞2.5V@0.4ms,which was confirmed by manual test,and then the atrial electrode was repositioned.Another patient showed atrial fibrillation continuing for about 3 months and the ACM were closed.Using the paired t test,the thresholds between ACM and manual test at 1^stmonth and 6^thmonth has no significant difference(1^stmonth t=1.234,p=0.238;6st month t=1.171,p=0.264).The SSS patients' ventricular events were mostly sensing events(1^stmonth 96.93%±0.74%;6^thmonth 97.35±0.52%),including VS from Search AV+95.55±0.78%and 96.21±0.63%. The percentage of the ventricular sensing events were relatively low in patients with atrioventricula block.Conclusion:The Search AV+,ACM and VCM function of EnPulse pacemaker are safe and effective.Search AV+ can do benefit for the hemodynamics,and can reduce the risk of atrial fibrillation.ACM and VCM can make the pacemaker obtain effective pacing with minimal output,and prolong the longevity,and can identify the high threshold event and guaranty the safe pacing.