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Sensors for rate‐adaptive pacing: How they work, strengths, and limitations
Author(s) -
Trohman Richard G.,
Huang Henry D.,
Larsen Timothy,
Krishnan Kousik,
Sharma Parikshit S.
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14733
Subject(s) - medicine , chronotropic , exercise intolerance , heart rate , cardiac pacing , heart failure , exertion , cardiology , node (physics) , intensive care medicine , work (physics) , blood pressure , mechanical engineering , structural engineering , engineering
Chronotropic incompetence is the inability of the sinus node to increase heart rate commensurate with increased metabolic demand. Cardiac pacing alone may be insufficient to address exercise intolerance, fatigue, dyspnea on exertion, and other symptoms of chronotropic incompetence. Rate‐responsive (adaptive) pacing employs sensors to detect physical or physiological indices and mimic the response of the normal sinus node. This review describes the development, strengths, and limitations of a variety of sensors that have been employed to address chronotropic incompetence. A mini‐tutorial on programming rate‐adaptive parameters is included along with emphasis that patients' lifestyles and underlying medical conditions require careful consideration. In addition, special sensor applications used to respond prophylactically to physiologic signals are detailed and an in‐depth discussion of sensors as a potential aid in heart failure management is provided.