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Evaluation of a Dual Sensor Rate Responsive Pacing System Based on a New Concept
Author(s) -
BONNET JEANLUC,
GÉROUX LAURENCE,
CAZEAU SERGE
Publication year - 1998
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.1540-8159.1998.tb01152.x
Subject(s) - medicine , cardiology , correlation coefficient , treadmill , correlation , heart rate , ventilation (architecture) , sinus rhythm , physical therapy , blood pressure , statistics , atrial fibrillation , mathematics , mechanical engineering , geometry , engineering
The minute ventilation is known to be one of the most physiological indicators of exercise. A curvilinear relationship between VE and the normal sinus rhythm (NSR) has been demonstrated in healthy patients. The aim of this study is to show that a pacemaker based on a VE sensor can reproduce such a relationship. Eighty‐one patients received a Talent DR 213 (ELA Medical, Montrouge, France) pacemaker with a third‐generation rate responsive algorithm. At 1‐month follow‐up, the patients underwent a treadmill exercise test, after which three groups were defined: group 1 had 6 patients who were 100% paced throughout the exercise test; group 2 had 10 patients who maintained NSR throughout the test; and group 3 had 12 patients who had cardiopulmonary recording during the exercise test. In group 1 patients, the simulation function computed the simulated rate (sim‐rate), which was compared to the sensor‐driven rate (SDR). In group 2 patients, sim‐rate was compared to the NSR. In group 3 patients, cardiac and metabolic reserves were compared to determine the appropriateness of the rate response to exercise (HRR% vs MR%). The results showed that the mean correlation coefficient between sim‐rate and SDR was 0.983 ± 0.005 (P < 0.001); the mean correlation coefficient between NSR and SDR was 0.92 ± 0.07 (P < 0.001); and a linear relationship was found between HRR% and MR%, with a mean slope of 1.1 ± 0.2 that was significantly equal to the theoretical value of 1 (P = NS). In conclusion, combining an activity‐driven sensor with a physiological sensor allows the preservation of a physiological rate response during exercise.