title: Long-term experience with AutoCapture-controlled epicardial pacing in children.
abstract: OBJECTIVE
  To examine the feasibility and safety of AutoCapture (AC)-controlled pacing with epicardial leads in children, and study the effects on device longevity.
  
  
  METHODS
  A total of 62 children were prospectively enrolled. Pre-discharge testing precluded AC function in six children. In 56 (90%) children, devices with AC-controlled pacing were followed up to 9years. Calculated battery life in AC-controlled pacing was compared with theoretical calculations, using a two-fold stimulation output of measured thresholds.
  
  
  RESULTS
  In 53 of 56 children, no differences were observed for evoked response signals (13.3 vs. 11.5mV, P = 0.20) or lead polarization safety margins (5.5 vs. 4.1, P = 0.25) at 6-month and 4-year follow-up. A crossover to conventional pacing was required in 3 of 56 children. AC-controlled pacing prolonged the calculated battery life up to 15% for the identity and integrity devices with 0.95A h capacity, compared with theoretical conventional settings (P = 0.008). In patients with ventricular pacing thresholds >1.5V at 0.5ms, battery life was increased by 30% compared with theoretical conventional settings (P < 0.001).
  
  
  CONCLUSIONS
  AC-controlled pacing with epicardial leads is feasible and safe in children during long-term follow-up. An adequate lead polarization safety margin persists in most patients. Calculated battery life was prolonged up to 15% with AC-controlled pacing. Patients with high or fluctuating pacing thresholds benefit the most.
authors.affiliation: Division of Pediatric Cardiology, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland. maren.tomaske@kispi.uzh.ch
authors.forename: Maren
authors.initials: M
authors.lastname: Tomaske
authors.forename: Paul
authors.initials: P
authors.lastname: Harpes
authors.forename: Rene
authors.initials: R
authors.lastname: Pretre
authors.forename: Ali
authors.initials: A
authors.lastname: Dodge-Khatami
authors.forename: Urs
authors.initials: U
authors.lastname: Bauersfeld
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002648:Child; D004562:Electrocardiography / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010138:Pacemaker, Artificial; D010496:Pericardium; D013813:Therapy, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome