creators_name: Kam, Ruth editors_name: Singh, Balbir editors_name: Lokhandwala, Yash editors_name: Francis, Johnson editors_name: Gupta, Anup type: journalp datestamp: 2005-04-17 lastmod: 2011-03-11 08:55:57 metadata_visibility: show title: Automatic Capture Verification in Pacemakers (Autocapture) – Utility and Problems ispublished: pub subjects: ipej full_text_status: public keywords: pacemaker; Capture confirmation; Threshold search abstract: The concept of a closed – loop feedback system, that would automatically assess pacing threshold and self -adjust pacing output to ensure consistent myocardial capture, has many appeals. Enhancing patient safety in cases of an unexpected rise in threshold, reduced current drain, hence prolonging battery longevity and reducing the amount of physician intervention required are just some of the advantages. Autocapture (AC) is a proprietary algorithm developed by St Jude Medical CRMD, Sylmar, CA, USA, (SJM) that was the first to commercially provide these automatic functions in a single chamber pacemaker (Microny and Regency), and subsequently in a dual chamber pacemaker (Affinity, Entity and Identity family of pacemakers). This article reviews the conditions necessary for AC verification and performance and the problems encountered in clinical practice. date: 2004-04 date_type: published publication: Indian Pacing and Electrophysiology Journal volume: 4 number: 2 publisher: Indian Pacing and Electrophysiology Group pagerange: 73-78 refereed: TRUE referencetext: 1. Intraoperative Study of Polarization and Evoked response Signals in Different Endocardial Electrode Designs. Lau C, Nishimura SC, Yee Raymond, Lefeuvre C, Philippon F, Cameron DA. PACE 2001;24;1055-60. 2. Automatic Adjustment of Pacemaker Stimulation Output Correlated with Continuously Monitored Capture Thresholds: A Multicentre Study. Clarke M, Liu B, Schuller H, Binner L, Kennergren C, Guerola M et al. PACE 1998;21:1567-75. 3. Automatic Threshold Tracking Activation Without the Intraoperative Evaluation of the Evoked Response Amplitude. AUTOCAP Investigators. Schubert A, Ventura R, Meinertz T. PACE 2000;23:321-4. 4. Initial Experience with an Autocapture Pacemaker System. Kam R, Tan CS, Teo WS. Ann Acad Med Singapore 200;29:732-4. 5. Threshold Tracking Pacing Based on Beat by Beat Evoked Response Detection: Clinical Benefits and Potential Problems. Duru F,Bauersfeld U, Schuller H and Candinas R. Journal of Interventional Cardiac Electrophysiology 2000;4:511-22. 6. A Cardiac Evoked Response Algorithm Providing Threshold Tracking: A North American Multicentre Study. Ching L, Cameron DA, Nishimura SC, Ahern T, Freedman RA, Ellenbogen K et al. PACE 2000;23:953-9. 7. Automatically optimizing pacing output: an excellent idea, but with potentially lethal pitfalls. Suri R, Harthorne JW, Galvin J. PACE 2001;24: 520-3. 8. Improved differentiation of the ventricular evoked response from polarization by modification of the pacemaker impulse. Provenier F, Germonpre E, De Wagter X. PACE 2000;23:2073-7. 9. Low energy epicardial pacing in children- the benefit of Autocapture. Ann Thorac Surg, 1999;68:1380-3. 10. Pacemaker therapy in premature children with high degree AV block. Nowak B, Kampmann C, Schmid FX, Przibille O, Wippermann F, Himmrich E et al. Pacing Clin Electrophysiol 1998;21:2695-8. 11. Use of the Autocapture Pacing System with Implantable Defibrillator Leads. Marenco JP, Greenfield RA, Massumi A, Syed ZA,Mcintyre T, Hardage M et al. PACE 2003;26:471-3. 12. A new algorithm for minimizing polarization artifact: universally applicable in permanent pacing systems. Curtis AB, Vance F, Wuist SM, Domijan A, Keim S, Duran A et al. PACE 1991;14:1803-8. 13. Atrial Evoked Response Integral for Automatic Capture Verification in Atrial Pacing. Boriani G, Biffi M, Cameron D, Datteri S, Snell J, Holmstrom N et al. PACE 2003; 26:243-52. 14. Clinical validation of new pacing-sensing configurations for atrial automatic capture verification in pacemakers. Christian B, Wolfgang MH, Kay GN, Willems R, Zhang G, Lang DJ et al. PACE 2001;12:1104-8. citation: Kam, Ruth (2004) Automatic Capture Verification in Pacemakers (Autocapture) – Utility and Problems. [Journal (Paginated)] document_url: http://cogprints.org/4230/1/kam.htm document_url: http://cogprints.org/4230/2/kam.pdf