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A New Multisensor Pacing System Using Stroke Volume, Respiratory Rate, Mixed Venous Oxygen Saturation, And Temperature, Right Atrial Pressure, Right Ventricular Pressure, And dP/dt
Author(s) -
STANGL KARL,
WIRTZFELD ALEXANDER,
HEINZE ROLAND,
LAULE MICHAEL,
SEITZ KLAUS,
GÖBL GERHARD
Publication year - 1988
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1988.tb06021.x
Subject(s) - medicine , cardiology , stroke volume , heart rate , respiratory rate , sensitivity (control systems) , ventricular pacing , respiratory system , central venous pressure , anesthesia , blood pressure , heart failure , engineering , electronic engineering
A new multisensor pacing device using respiratory rate (RR), stroke volume fSV), oxygen saturation (SO2), temperature (T), right atrial pressure (RAPJ, right ventricular pressure (RVPJ and right ventricular dP/dt, has been developed. It consists of a 7F multisensor catheter and an external pacing unit. It allows simultaneous recording of the input signals and the corresponding data can be compared among the different parameters under identical conditions. Furthermore, several parameters can be combined in such a way as to form a new combination better suitable for rate responsive pacing. The response of each parameter to exercise was studied in 12 healthy volunteers (mean age:28 years). Exercise testing was carried out using a bicycle ergometer, with workloads up to 200 W. The dynamic characteristics, response and sensitivity to changes of workloads of each parameter were analyzed and compared to one another. SO 2 proved to be a quick responding parameter (<10 sec) with higher sensitivity in the low exercise range (<75 WJ, T, on the other hand, responded slowly (>30 sec) to exercise changes and had the highest sensitivity in the exercise range beyond 75 W. RR displayed a slow response (>30 sec) and an adequate sensitivity was only found in the upper exercise range (>100 W). SV reacted rapidly to workload changes (<10 sec) but showed poor sensitivity at all exercise levels. RAP, RVP and dP/dt displayed quick responses and constantly good sensitivity throughout the workload range. Furthermore, respiratory rate was easily‐derived from the RAP curve. Special algorithms were developed for each parameter so that pacing rate would reproduce sinus rate behavior. We found that SO 2 and all pressure parameter imitated sinus rate response quite well. When using parameter combinations, SO 2 and T proved to be superior. Five patients (mean age 68 years) with third degree AV‐block were stimulated temporarily using this system. Compared to fixed rate stimulation [VVI 70], exercise performance improved, using SO 2 as the input parameter for rate response, by 25% to 50%.