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Pacing thresholds increase significantly in the first 14 days after endocardial electrode insertion, highlighting the need for regular threshold checks to optimize pacemaker output.
The pacing threshold has been examined in patients with endocardial pacemaker electrode and external pacemaker. A mean increase in pacing threshold was observed in the first 7 to 14 days after insertion of the electrode, from 1.3 volt at the time of insertion to 2.5 volts after 7 days and 2.8 volts after 14 days. In some patients an initial and transitory decrease was found in the first few days. Great individual variations were seen. Because of these variations it is, in our opinion, necessary to check the threshold value in patients with myocardial infarction by daily measurements to adjust the pacemaker output at the lowest possible level. Significant variations during the day, and after meals, sleeping or physical activity, as reported by others, were not found.
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Grendahl et al. (1970) studied this question.
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