{"id":777,"date":"2025-07-31T14:19:11","date_gmt":"2025-07-31T14:19:11","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=777"},"modified":"2025-11-18T15:33:59","modified_gmt":"2025-11-18T15:33:59","slug":"pacing-sensing-medtronic","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/medtronic\/pacing-sensing-medtronic\/","title":{"rendered":"Pacing &amp; Sensing Medtronic"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"777\" class=\"elementor elementor-777\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-97c962d e-con-full e-flex e-con e-parent\" data-id=\"97c962d\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-60b957a e-con-full e-flex e-con e-child\" data-id=\"60b957a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-18a1d3d elementor-widget elementor-widget-heading\" data-id=\"18a1d3d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Medtronic - Pacing &amp; sensing<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4079d07 elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"4079d07\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h3&quot;,&quot;h4&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;fas fa-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;,&quot;rendered_tag&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-circle\\&quot; viewBox=\\&quot;0 0 512 512\\&quot; xmlns=\\&quot;http:\\\/\\\/www.w3.org\\\/2000\\\/svg\\&quot;&gt;&lt;path d=\\&quot;M256 8C119 8 8 119 8 256s111 248 248 248 248-111 248-248S393 8 256 8z\\&quot;&gt;&lt;\\\/path&gt;&lt;\\\/svg&gt;&quot;},&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tContent\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__4079d07\" aria-expanded=\"true\" aria-label=\"Ouvrir la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__4079d07\" aria-expanded=\"true\" aria-label=\"Fermer la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__4079d07\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5cfcd40 elementor-widget elementor-widget-heading\" data-id=\"5cfcd40\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Atrial and ventricular autothreshold<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-02c5883 elementor-widget elementor-widget-text-editor\" data-id=\"02c5883\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The strength of the pacing pulses in each cavity hinges on their individually programmed amplitude\u00a0and duration. While these values can be manually programmed, the \u201cCapture Management\u201d function\u00a0can be applied to manage the pacing outputs in the atrium and ventricle. This function presumes that\u00a0the device is able to recognize the efficacy versus inefficacy of a given pulse output amplitude.<\/p><p>At programmable time intervals (e.g. at 1 a.m.), the pulse generator measures the capture threshold\u00a0to determine the lowest pulse amplitude, combined with the shortest duration, which consistently\u00a0captures the myocardium. When verifying the capture threshold, the pulse generator prepares for a\u00a0search, carries out the search and measures the threshold. Over time, these measurements are used\u00a0to construct a curve of its trend.<\/p><p>The follow-up measurements of the capture threshold are scheduled when no other pending features\u00a0have a higher priority, starting with a device interrogation to determine whether some programmed\u00a0settings might interfere with its search. For example, the permanently programmed pulse amplitude\u00a0or duration may not exceed the 5-V or 1-ms limits, respectively, in each of the right heart cavity. In\u00a0case of unsuccessful measurement, no further attempt to find a capture threshold is scheduled until\u00a0the following day.<\/p><p>During the acute phase, i.e. the period of lead maturation following its implantation, the pacing output\u00a0may be adjusted, though not below the nominal 3.5 V or 0.4 ms,\u00a0respectively, or below the last\u00a0manually programmed output settings.<\/p><p><strong>Right ventricular capture management operation<\/strong>\u00a0<\/p><p>Right ventricular (RV) capture management (CM) is available when the device operates in DDD(R),\u00a0DDI(R), MVP [AAI(R)&lt;=&gt;DDD(R)] or VVI(R) modes. If MVP is the programmed pacing mode, the\u00a0pacemaker functions temporarily to DDD (R) mode during the search of capture threshold. RVCM can\u00a0only be launched at rest during a stable cardiac rhythm. The device performs a search for the RV\u00a0pacing threshold amplitude at a fixed pulse duration of 0.4 ms. RVCM varies the strength of the pacing\u00a0pulse to find the lowest amplitude that consistently captures the RV myocardium. The device confirms\u00a0the capture when it senses a signal in response to the test pulse.<\/p><p>The search for the capture threshold begins at a test amplitude 0.125 V below the last measured\u00a0value. In absence of prior search, the first test amplitude is 0.75 V, which is then decreased in\u00a00.125-V steps until a test amplitude is classified as below the pacing threshold. The pulse strength is\u00a0then increased in 0.125-V steps until a same test amplitude has been classified as above the pacing\u00a0threshold 3 times consecutively, defining the RV capture threshold. A backup pulse is systematically\u00a0delivered 100 ms\u00a0after each test, whether or not the test pulse captured the myocardium. The test\u00a0pulse is delivered at the programmed amplitude and a duration of 1.0 ms.<\/p><p>When RVCM is set on Adaptive, the device automatically adjusts the pacing output to guarantee\u00a0a capture with a high enough safety margin. When set on Monitor, no adjustment occurs and the\u00a0data collection is limited to the trend of the pacing threshold. The target amplitude relies on the\u00a0programmed settings for the \u201cRV Amplitude Safety Margin\u201d and the \u201cRV Minimum Adapted\u00a0Amplitude\u201d parameters. After a successful search of the capture threshold, the device calculates a\u00a0target amplitude by multiplying the programmed RV Amplitude Safety Margin by the threshold\u00a0amplitude measured at a pulse duration of 0.4 ms.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b4d931d elementor-widget elementor-widget-image\" data-id=\"b4d931d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/pm-medtronic-stim-001.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"pm-medtronic-stim-001\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NDI1MiwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL3BtLW1lZHRyb25pYy1zdGltLTAwMS5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"641\" height=\"217\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/pm-medtronic-stim-001.png\" class=\"attachment-large size-large wp-image-4252\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/pm-medtronic-stim-001.png 641w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/pm-medtronic-stim-001-300x102.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/pm-medtronic-stim-001-18x6.png 18w\" sizes=\"(max-width: 641px) 100vw, 641px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f8cef69 elementor-widget elementor-widget-text-editor\" data-id=\"f8cef69\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>This adaptation can only be accomplished in a range of outputs defined by a programmable inferior\u00a0limit (Minimum Adapted Amplitude parameter) and a superior threshold limit of 5.0 V and 1.0 ms.\u00a0The minimum pulse duration for the management of the ventricular threshold is 0.4 ms.<\/p><p><strong>Atrial capture management<\/strong><\/p><p>Atrial capture management (ACM) is available when the pacemaker operates in DDD or DDD(R) and\u00a0the MVP [AAI(R)&lt;=&gt;DDD(R)] modes. If the programmed pacing mode is MVP, the device switches\u00a0temporarily to DDD(R) mode for the duration of the pacing threshold search.<br \/><br \/>Before the launch of a pacing threshold search, the pacemaker examines whether the patient is being\u00a0paced or whether it is sensing a slow heart rate. A slow heart rate is desirable during the search of a\u00a0pacing threshold, to lower the risk of competition between forced pacing and rapid intrinsic rhythms.\u00a0An atrial capture threshold search is carried out when a stable atrial rhythm has been observed for 8\u00a0paced cycles and the sensor-indicated rate is slower than the AQ rate (sensor rate).<br \/><br \/>The pacemaker searches for the pacing threshold in a series of support cycles followed by a pacing\u00a0test at a slightly faster rate. Beginning at an output 0.125V below the last measurement (or 0.75 V in\u00a0absence of previous search), the amplitude is lowered in 0.125 V\/ 0.4 ms steps until the device senses\u00a0loss of capture. ACM monitors the synchronization of the sensed P and R waves (instead of an evoked\u00a0response) to determine the occurrence of capture.<br \/><br \/>ACM automatically selects one of the following 2 methods to evaluate atrial capture based on the\u00a0patient\u2019s rhythm at the time of the pacing threshold search:<br \/>1) if the patient is in normal and stable sinus rhythm, the device chooses the Atrial Chamber Reset\u00a0(ACR) method, or 2) if not, it selects the AV Conduction (AVC) method. The ACR method, which\u00a0requires a stable sinus rhythm, evaluates capture by observing the intrinsic rhythm response to the\u00a0test atrial pulse. If the latter fails to capture, the sinus node is not reset and an atrial event that follows\u00a0the test pulse occurs within the atrial refractory period. In absence of atrial event sensed in the\u00a0refractory period during the AV delay, ACR determines that pacing has captured the myocardium.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7abab66 elementor-widget elementor-widget-image\" data-id=\"7abab66\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec1.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"mdt_pm_spec1\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NDI0OCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL21kdF9wbV9zcGVjMS5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"605\" height=\"479\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec1.png\" class=\"attachment-large size-large wp-image-4248\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec1.png 605w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec1-300x238.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec1-15x12.png 15w\" sizes=\"(max-width: 605px) 100vw, 605px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-273e214 elementor-widget elementor-widget-text-editor\" data-id=\"273e214\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The AVC method is applied when stable 1:1 AV conduction is observed during atrial pacing. The atrial\u00a0pacing rate increases by 15 bpm (without, however, exceeding 101 bpm) and the AV delay is extended\u00a0in an attempt to obtain a stable AP-VS rhythm. AVC evaluates capture by observing the conducted\u00a0ventricular response to the test atrial pulse. Each atrial stimulus is followed by a backup pulse at a\u00a0programed amplitude and 1.0 ms duration to maintain a stable rhythm for the entire duration of the\u00a0test. When a conducted ventricular event is sensed at approximately the anticipated AP-VS interval\u00a0in response to the test atrial pulse, AVC determines that pacing has captured the myocardium.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f3adf15 elementor-widget elementor-widget-image\" data-id=\"f3adf15\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec2.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"mdt_pm_spec2\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NDI0OSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL21kdF9wbV9zcGVjMi5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img decoding=\"async\" width=\"541\" height=\"326\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec2.png\" class=\"attachment-large size-large wp-image-4249\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec2.png 541w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec2-300x181.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec2-18x12.png 18w\" sizes=\"(max-width: 541px) 100vw, 541px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-99d8b49 elementor-widget elementor-widget-text-editor\" data-id=\"99d8b49\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>A pacing threshold search begins at a test amplitude 0.125 V below the last measurement. In absence\u00a0of such, a new search begins at an amplitude of 0.75 V. The device keeps lowering the pulse strength\u00a0in 0.125 V steps until it reaches a test amplitude that is below the capture threshold. The test pulse is\u00a0then increased in 0.125 V steps until a same test amplitude has been classified as above the pacing\u00a0threshold 3 times consecutively, defining the RA capture threshold. The target amplitude is based on\u00a0the programmed settings for the Atrial Amplitude Safety Margin and the Atrial Minimum Adapted\u00a0Amplitude parameters.<br \/><br \/>Capture Management does not program atrial outputs &gt;5.0 V or 1.0 ms. If the patient needs a higher\u00a0pacing output, the amplitude and pulse width must be programmed manually.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2b34168 elementor-widget elementor-widget-heading\" data-id=\"2b34168\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Sensing<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aced483 elementor-widget elementor-widget-text-editor\" data-id=\"aced483\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Automatic sensing<\/strong><\/p><p>The amplitude of the cardiac depolarization signals are not stable and might vary as a function of\u00a0activity, use of medications, or metabolic changes. In addition, the\u00a0amplitude of signals associated\u00a0with atrial or ventricular arrhythmias might differ markedly from normal signals, often considerably\u00a0smaller, as in the case of atrial fibrillation. Thus, a fixed sensitivity does not assure the detection of all\u00a0events.<br \/><br \/>In presence of automatic sensing, the sensitivity level applied at the onset of a sensed event is a\u00a0percentage (usually 50 to 75%) of the amplitude of the sensed signal. Thereafter, and for a 120 ms\u00a0duration, the sensitivity level remains stable, before increasing progressively during diastole, until a\u00a0maximum programmable sensitivity has\u00a0been reached..<\/p><p><strong>Automatic sensitivity<\/strong><\/p><p>When the automatic sensitivity function is activated, the pacemaker monitors the amplitude of the\u00a0sensed signals. Depending on the results, the sensitivity is\u00a0automatically increased or decreased in\u00a0order to preserve a sufficient sensing margin, commensurate with the patient\u2019s sensed P and R waves.\u00a0When activated, automatic sensitivity continuously adjusts the sensitivity, as a function of the measured\u00a0amplitudes, to avoid under- or oversensing.<br \/><br \/>Depending on the age of the pacemaker series, from Kappa, EnPulse, Sensia, up to the Adapta\u00a0model, a fixed sensitivity value might be programmable for the entire duration of the cardiac cycle.\u00a0Alternatively, in Ensura, Advisa and later pacemaker series, as exists in the pulse generator of\u00a0defibrillators, automatic sensing is adapted to the amplitude of the previous signal, and changes\u00a0throughout the cardiac cycle.<\/p><p><strong>Automatic sensitivity in older pacemaker series, from Kappa, EnPulse, Sensia up to Adapta<\/strong><br \/><br \/>The amplitude of each spontaneous P or R wave is measured and compared with a safety interval,\u00a0which varies according to a) the ambient sensitivity, b) the lead, whether atrial or ventricular, and c)\u00a0the lead polarity.<br \/>The signal amplitude is then classified as large, adequate or low.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1e1c3f3 elementor-widget elementor-widget-image\" data-id=\"1e1c3f3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec3.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"mdt_pm_spec3\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NDI1MCwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL21kdF9wbV9zcGVjMy5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"454\" height=\"248\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec3.png\" class=\"attachment-large size-large wp-image-4250\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec3.png 454w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec3-300x164.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec3-18x10.png 18w\" sizes=\"(max-width: 454px) 100vw, 454px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e3ab24a elementor-widget elementor-widget-text-editor\" data-id=\"e3ab24a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>In presence of frequent low amplitude signals, the sensitivity is increased by 1 step (smaller numerical\u00a0value).<br \/>In presence of frequent high amplitude signals, the sensitivity is decreased by 1 step (larger numerical\u00a0value).<br \/>A minimum of 17 low amplitudes are needed to increase the sensitivity by 1 step and 36 large\u00a0amplitudes to decrease it by 1 step.<\/p><p>\u00a0<\/p><p><strong>Automatic sensitivity in recent series (Ensura, Advisa and later series)<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0e22b5e elementor-widget elementor-widget-image\" data-id=\"0e22b5e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"http:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec4.png\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"mdt_pm_spec4\" data-e-action-hash=\"#elementor-action%3Aaction%3Dlightbox%26settings%3DeyJpZCI6NDI1MSwidXJsIjoiaHR0cHM6XC9cL2NhcmRpb2Nhc2VzLmNvbVwvd3AtY29udGVudFwvdXBsb2Fkc1wvMjAyNVwvMTFcL21kdF9wbV9zcGVjNC5wbmcifQ%3D%3D\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"631\" height=\"403\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec4.png\" class=\"attachment-large size-large wp-image-4251\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec4.png 631w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec4-300x192.png 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2025\/11\/mdt_pm_spec4-18x12.png 18w\" sizes=\"(max-width: 631px) 100vw, 631px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0da24bc elementor-widget elementor-widget-text-editor\" data-id=\"0da24bc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>After a ventricular sensed event, the threshold value is adjusted to 75% of the R wave, up to a\u00a0maximum of 8 folds the programmed value, then decreases over 450 ms to reach the programmed\u00a0sensitivity (for example 0.9 mV).<br \/><br \/>After a ventricular paced event, the sensitivity to ventricular events remains unchanged and the device\u00a0is less sensitive to atrial events.<br \/><br \/>After an atrial sensed event, the threshold value is adjusted to 75% of the wave, up to a maximum of\u00a08 folds the programmed value, then decreases over 200 ms to reach the programmed sensitivity (for\u00a0example 0.3 mV).<br \/><br \/>After an atrial paced event, the sensitivity to atrial events remains unchanged and the device is less\u00a0sensitive to ventricular events.<br \/><br \/>After the post-pace blanking period, the device is temporarily less sensitive to ventricular events (for\u00a0example 120 ms).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Medtronic &#8211; Pacing &amp; sensing Content Atrial and ventricular autothreshold The strength of the pacing pulses in each cavity hinges on their individually programmed amplitude\u00a0and duration. While these values can be manually programmed, the \u201cCapture Management\u201d function\u00a0can be applied to manage the pacing outputs in the atrium and ventricle. This function presumes that\u00a0the device is [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":49,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-777","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Medtronic Pacemaker Pacing &amp; Sensing Guide | ECG | Cardiocases<\/title>\n<meta name=\"description\" content=\"Understand Medtronic pacemaker pacing &amp; sensing: output, sensitivity, lead parameters &amp; ECG interpretation \u2014 real device tracings &amp; programming examples.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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