Pacemaker Syndrome and Pacemaker Complications | Patient
patient.info/.../pacemaker-syndrome-and-pacemaker-co...
Deal with the complications of pacemakers, including pacemaker syndrome. ... to lead fracture, lead dislodgement, a break in lead insulation, an elevated pacing threshold, ... In patients with other pacing modes, symptoms usually resolve after upgrading ... atrial refractory period, sensing level, and pacing threshold voltage.

Pacemaker Syndrome: Background, Pathophysiology, Etiology
emedicine.medscape.com/article/159706-overview
The patient exhibited symptoms of pacemaker syndrome, including fatigue ... in postventricular refractory period; VS – Ventricular sensed event.

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Note added at 49 days (2016-11-27 22:55:53 GMT)
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So what is a Pacing Threshold?
The threshold is the minimum amount of energy the pacemaker sends down the lead to initiate a heart beat. Imagine a patient who had a pacing threshold of 0.75V (Volts). If the pacemaker sent a pulse of 0.75V down the lead this would be enough to make the heart beat as would any pulse larger/stronger than this. If the pacemaker in the same patient sent a pulse of 0.5V down the lead, this would not be enough and the pacemaker would fail to initiate a heart beat.
How do we test it?
Firstly for want of a better word we need to hijack the heart, we want the heart to be ‘Paced’ that is all the heart beats during the test are being initiated by the pacemaker. To do this we normally pace at a quicker rate so any natural beats can’t get in the way. The patient may feel their heart rate increase normally to the region of 80-100bpm. Now we are pacing the heart we do something quite simple, we decrease the amount of energy being sent down the lead until we fail to make the heart beat. The lowest amount of energy that successfully made the heart contract is the threshold.

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Note added at 49 days (2016-11-27 22:57:45 GMT)
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http://www.pacemakerplus.com/what-is-a-pacing-threshold-what... article and ends with this:

A complete explanation of these topics and more is available in the book Pacemakers Made Easy by Carl Robinson.

Time to watch some garbage on TV

Thanks Again
Cardiac Technician
:)


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Note added at 49 days (2016-11-27 23:02:19 GMT)
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Pacemaker Diagnostics - The University of Tennessee Health Science ...
https://www.uthsc.edu/.../PacemakerDiagnostics.ppt
Atrial/Ventricular Sensing/Pacing time; Sensing Thresholds; Pacing Thresholds ... Amplitude threshold determined at 0.4 ms pulse width; Threshold voltage
Pacemaker DiagnosticsRole of Pacing Thresholds in Maximizing Longevity...