Evolution of pacing for bradycardia: Autocapture
1 Institute of Cardiology, University of Bologna and Azienda Ospedaliera S.Orsola-Malpighi, Via Massarenti 9 40138 Bologna, Italy
2 Kerckhoff Klinik, Bad Nauheim, Germany
* Corresponding author. Tel: +39 051 345898; fax: +39 051 344859. E-mail address: mbiffi{at}aosp.bo.it
Many useful technological improvements have occurred since the first pacemaker implantation in 1958. A new paradigm of cardiac stimulation has been offered by the development of AutocaptureTM, which allows the implanting physician to adjust to the patient's clinical needs, thanks to device automaticity. Automatic verification of capture (AVC) is the ability of a cardiac pacing device to determine whether a delivered pacing stimulus results in stimulation of the myocardium, and, consequently, to adapt pacing output according to the measured threshold. The first single-chamber pacemaker featuring this capability for ventricular stimulation, termed Autocapture, was released by Pacesetter in 1994 (a subsidiary of St Jude since 1994). In 1999 the first Autocapture-featured dual-chamber pacemaker was also released by Pacesetter-St Jude. Autocapture is the most extensively studied algorithm for AVC, being the first to be developed. Over 1 000 000 Autocapture-featured units have now been implanted worldwide. More recently, Autocapture or automatic verification of atrial stimulation has also been proposed at the atrial level in DDDR devices and automatic verification of left ventricular stimulation has been implemented in devices for cardiac resynchronization therapy.
Key Words: Autocapture • Evoked response • Automatic threshold measurement • Pacemaker