Patterns of change in the pacing threshold of newly implanted pacemakers

                   The pacing threshold is the minimum amount of stimulus energy that can sustainably capture the myocardium. The pacing threshold is dynamic in vivo. During the first 24 h of electrode lead implantation, changes in myocardial pacing threshold are minimal and may decrease slightly. Over the next 7 to 10 days, myocardial tissue in contact with the electrodes undergoes damage, necrosis, and fibrosis, and the pacing threshold increases dramatically. The peak of the pacing threshold generally occurs 2 weeks after electrode lead implantation and then decreases gradually, stabilizing after 3 months.