Department of Cardiology, Hospital Universitario Fundación Jiménez Díaz-IDCsalud, Universidad Autónoma de Madrid, Madrid 28040, Spain
Department of Cardiology, Hospital Universitario Fundación Jiménez Díaz-IDCsalud, Universidad Autónoma de Madrid, Madrid 28040, Spain.
Europace. 2014 Oct;16(10):1469-75. doi: 10.1093/europace/euu080. Epub 2014 Apr 30.
AutoCapture (St Jude Medical) is a technological development that confirms ventricular capture analysing the evoked response after a pacing impulse and adjusts the energy output to changes in the stimulation threshold. Although this algorithm is aimed to assure capture minimizing energy consumption, some patients might not benefit from it. The objective of this study is to identify them.
Long-term AutoCapture efficiency was assessed using the data recorded in the programmer reports of patients undergoing scheduled pacemaker check-ups during 2012 in our institution. We have evaluated 160 consecutive patients (58% men) aged 78 ± 9 years. Pacemaker stimulation mode was DDD in 116 patients (72.5%) and VVI in 44 patients (27.5%). During the scheduled visits for pacemaker check-up, 73 patients (45.6%) showed abnormalities in the long-term AutoCapture function report (high variability in the AutoCapture stimulation threshold and/or out-of-range values). After multivariate analysis, abnormal AutoCapture pattern was associated to the presence of atrial fibrillation [odds ratio (OR) 3.96 (1.59-9.82; P < 0.05)]; and a ventricular pacing ≤25% of the time [OR 4.80 (2.09-11.05; P < 0.05)]. AutoCapture abnormalities were also described in three (1.8%) patients with very low stimulation threshold.
Although AutoCapture algorithm has shown both efficacy and safety, our findings suggest that some patients with atrial fibrillation or those requiring ventricular pacing ≤25% of the time may not benefit from it. Activation of the algorithm should be individualized according to the patient's characteristics and long-term AutoCapture pattern checked in the routine follow-up.
AutoCapture（美敦力）是一项技术创新，可在起搏脉冲后分析诱发反应来确认心室捕获，并根据刺激阈值的变化调整能量输出。虽然该算法旨在确保以最小能量消耗实现捕获，但有些患者可能无法从中受益。本研究旨在确定这些患者。
使用我院 2012 年程控仪记录的患者定期起搏器检查报告中的数据评估长期 AutoCapture 效率。我们评估了 160 例连续患者（58%为男性），年龄为 78 ± 9 岁。116 例患者（72.5%）采用 DDD 起搏刺激模式，44 例患者（27.5%）采用 VVI 起搏刺激模式。在定期起搏器检查时，73 例患者（45.6%）的长期 AutoCapture 功能报告显示异常（AutoCapture 刺激阈值变化大且/或超出范围值）。多变量分析后，异常 AutoCapture 模式与房颤的存在相关[比值比（OR）3.96（1.59-9.82；P < 0.05）]；以及心室起搏比例≤25%[OR 4.80（2.09-11.05；P < 0.05）]。在 3 例（1.8%）刺激阈值非常低的患者中也描述了 AutoCapture 异常。
尽管 AutoCapture 算法已显示出疗效和安全性，但我们的研究结果表明，一些患有房颤或需要心室起搏比例≤25%的患者可能无法从中受益。应根据患者的特征和常规随访中检查的长期 AutoCapture 模式来个体化激活该算法。
