Evaluation of automated electrocardiogram interpretation in children: Modeling influential factors

or a 3 fold increase in pulse width above the 8 week threshold. Results: Two of 66 (3.0%) patients had a moderate increase in RV threshold at 3 and 15 months. Both thresholds stabilized and did not require lead revision. Moderate to severe increases (3-43 months post implant) in LV pacing thresholds (12 patients, 18.2%) were significantly more common (P 0.0088). Ten of these 12 patients were reprogrammed to maintain clinical efficacy with or without a standard energy (2 times voltage threshold or 3 times pulse width threshold) safety margin. Severe threshold increases (6) were seen only in LV leads (P 0.0112). Two patients with severe threshold increases required lead revision. Conclusion: Changes in pacing thresholds are significantly more common in LV than RV leads. Moderate pacing threshold changes did not require lead revision. Severe LV threshold changes may not require invasive intervention. A prospective trial designed to examine the impact of specific lead technologies on chronic LV lead performance seems warranted.