Automatic threshold capture proven to work well for apical pacing but not for His pacing

 The thresholds for capture of the ventricular muscle may change over time with changes in the myocardial excitability which may be related to disease progression , electrolyte variation ,exercise,temperaturre etc. 

With the development and proven effectiveness and safety of automatic threshold determinations pacemakers were able to have longer battery lives and  there was more assurance of ventricular capture than was possible with in office threshold determination every 3 or six months as was the practice.  Automatic capture management (ACM) s have clearly been a useful development in PM technology.Patients' threshold levels could be measured daily. 

Various pacemaker manufacturers have developed their own automatic capture management systems and have become commonplace..

However since the increasing use of conduction system pacing in the form of His Bundle pacing,problems have become evident with  ACM algorithms.

Journal articles by Haran Burri and P. Vijayaraman have described the problems with HBP and ACMs. In regards to ACM issue details vary with what port on the PM is the His lead attached and whether there is selective or non-selective His pacing.