Pacing failure caused by automatic pacing threshold adjustment system

J Arrhythm. 2017 Dec;33(6):637-639. doi: 10.1016/j.joa.2017.05.005. Epub 2017 Oct 13.

Abstract

Ventricular capture management is an automatic pacing threshold adjustment algorithm that automatically measures pacing threshold through detection of the evoked response after a pacing stimulus. Although it is principally designed to save device battery under the maintenance of the patient׳s safety, we experienced a rare case with serious pacing failure due to a weakness of this algorithm. This pacing failure might be explained by a large variation in the ventricular pacing threshold depending on the atrioventricular interval and daily variation of pacing threshold and concomitant steroid use in this patient.

Keywords: Automatic pacing threshold adjustment algorithm; Pacing failure.