Effect of pacemaker output coupling capacitor on intracardiac evoked response sensing

摘要

Intracardiac evoked response has been used in implantable pacemakers for the application of automatic capture verification. However, reliable detection of evoked response has always been hampered by large residual after potentials associated with pacing stimuli. This article analyzes the cause of the after potential and proposes a solution for evoked response detection through reducing the coupling capacitor in the pacemaker output circuitry. The proposal was tested clinically to evaluate the impact of the capacitance reduction on evoked response sensing as well as on the associated pacing threshold changes.