Possible Pitfalls of Auto Capture and Automatic Capture Management Algorithms or Trust but Verify- Post Marketing Study
Background: Automatic pacing output management has been used for more than 20 years and it has been generally accepted as safe and device longevity prolonging mode of pacing. Despite that, accuracy of these algorithms in traditional VVI(R) and DDD(R) pacemakers on long term basis has not, to our knowledge, been defined. There is evidence that in patients with atrial fibrillation (AF) and low percentage of ventricular pacing (VP) this function might be less suitable.
Methods: We have followed up a population of 559 patients with permanent pacemakers for 3 years and 8 months. 274 of them had the automatic output management (AOM) function activated. We have prospectively searched for inappropriately set pacing output in both subgroups. That is, either too high or too low. We have compared this subgroup to that with fixed output pacing (FOP). Patients with any mechanical complication and those having pacemaker implanted for less than three months were excluded from the study.
Results: We have found 11 patients out of 274 in whom the value of pacing output was inappropriate.
Conclusions: In our study, 99.6% of patients with AOM functions activated always had effective pacing and the percentage of ideal performance of this function was 96%. These numbers confirm safety of AOM functions with only a few caveats.