Advanced

Low-energy epicardial pacing in children : the benefit of autocapture

Bauersfeld, U; Nowak, B; Molinari, L; Malm, T LU ; Kampmann, C; Schönbeck, M H and Schüller, H LU (1999) In Annals of Thoracic Surgery 68(4). p.3-1380
Abstract

BACKGROUND: Permanent cardiac pacing in children results commonly in augmented energy consumption because of the high pacing rates and the ample stimulation safety margin applied in children. Cardiovascular anatomy and limited venous access sometimes preclude the otherwise preferred endocardial approach. In this multicenter patient series, we studied the feasibility, safety, and energy saving obtained by a combination of steroid-eluting epicardial leads with autocapture devices capable of ongoing adjustment of the stimulation output to the prevailing threshold.

METHODS: Autocapture devices (Pacesetter Microny SR+/- and Regency SR+/-; Pacesetter, Solna, Sweden) and steroid-eluting epicardial pacing leads (Medtronic CapSure Epi... (More)

BACKGROUND: Permanent cardiac pacing in children results commonly in augmented energy consumption because of the high pacing rates and the ample stimulation safety margin applied in children. Cardiovascular anatomy and limited venous access sometimes preclude the otherwise preferred endocardial approach. In this multicenter patient series, we studied the feasibility, safety, and energy saving obtained by a combination of steroid-eluting epicardial leads with autocapture devices capable of ongoing adjustment of the stimulation output to the prevailing threshold.

METHODS: Autocapture devices (Pacesetter Microny SR+/- and Regency SR+/-; Pacesetter, Solna, Sweden) and steroid-eluting epicardial pacing leads (Medtronic CapSure Epi 10366; Medtronic, Inc, Minneapolis, MN) were implanted in 14 children. Thresholds, telemetry data, evoked response, and polarization signals were obtained at discharge and follow-up, and battery service life was calculated.

RESULTS: During a median follow-up of 6.5 months, autocapture pacing was applied in 12 of 14 children. The automatically adjusted pulse amplitude of autocapture devices demonstrated low-energy pacing with no significant changes between discharge and 6 months follow-up (1.1 +/- 0.3 versus 0.9 +/- 0.3 V). Autocapture-programmed pacemakers had calculated life spans of 7.8 +/- 1.4 years (Microny) and 21.0 +/- 1.6 years (Regency). No adverse effects were noted.

CONCLUSIONS: Autocapture-controlled pacing with bipolar epicardial pacing leads is feasible and safe in children. Autocapture programming results in substantial energy savings and extends battery life markedly.

(Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Child, Child, Preschool, Electric Power Supplies, Electrocardiography, Electrodes, Implanted, Endocardium, Equipment Design, Equipment Failure Analysis, Feasibility Studies, Female, Humans, Infant, Male, Microcomputers, Pacemaker, Artificial, Pericardium, Signal Processing, Computer-Assisted/instrumentation, Software
in
Annals of Thoracic Surgery
volume
68
issue
4
pages
4 pages
publisher
Elsevier
external identifiers
  • scopus:0032716778
ISSN
0003-4975
DOI
10.1016/S0003-4975(99)00695-5
language
English
LU publication?
no
id
66154c5c-c29c-4a9e-ae65-126cd3e811cc
date added to LUP
2018-12-05 14:56:54
date last changed
2019-04-02 04:11:50
@article{66154c5c-c29c-4a9e-ae65-126cd3e811cc,
  abstract     = {<p>BACKGROUND: Permanent cardiac pacing in children results commonly in augmented energy consumption because of the high pacing rates and the ample stimulation safety margin applied in children. Cardiovascular anatomy and limited venous access sometimes preclude the otherwise preferred endocardial approach. In this multicenter patient series, we studied the feasibility, safety, and energy saving obtained by a combination of steroid-eluting epicardial leads with autocapture devices capable of ongoing adjustment of the stimulation output to the prevailing threshold.</p><p>METHODS: Autocapture devices (Pacesetter Microny SR+/- and Regency SR+/-; Pacesetter, Solna, Sweden) and steroid-eluting epicardial pacing leads (Medtronic CapSure Epi 10366; Medtronic, Inc, Minneapolis, MN) were implanted in 14 children. Thresholds, telemetry data, evoked response, and polarization signals were obtained at discharge and follow-up, and battery service life was calculated.</p><p>RESULTS: During a median follow-up of 6.5 months, autocapture pacing was applied in 12 of 14 children. The automatically adjusted pulse amplitude of autocapture devices demonstrated low-energy pacing with no significant changes between discharge and 6 months follow-up (1.1 +/- 0.3 versus 0.9 +/- 0.3 V). Autocapture-programmed pacemakers had calculated life spans of 7.8 +/- 1.4 years (Microny) and 21.0 +/- 1.6 years (Regency). No adverse effects were noted.</p><p>CONCLUSIONS: Autocapture-controlled pacing with bipolar epicardial pacing leads is feasible and safe in children. Autocapture programming results in substantial energy savings and extends battery life markedly.</p>},
  author       = {Bauersfeld, U and Nowak, B and Molinari, L and Malm, T and Kampmann, C and Schönbeck, M H and Schüller, H},
  issn         = {0003-4975},
  keyword      = {Child,Child, Preschool,Electric Power Supplies,Electrocardiography,Electrodes, Implanted,Endocardium,Equipment Design,Equipment Failure Analysis,Feasibility Studies,Female,Humans,Infant,Male,Microcomputers,Pacemaker, Artificial,Pericardium,Signal Processing, Computer-Assisted/instrumentation,Software},
  language     = {eng},
  number       = {4},
  pages        = {3--1380},
  publisher    = {Elsevier},
  series       = {Annals of Thoracic Surgery},
  title        = {Low-energy epicardial pacing in children : the benefit of autocapture},
  url          = {http://dx.doi.org/10.1016/S0003-4975(99)00695-5},
  volume       = {68},
  year         = {1999},
}