November 1, 2000Pacing and Clinical Electrophysiology

Neurohumoral Behavior in Recipients of Cardiac Pacemakers Controlled by a Closed‐Loop Autonomic Nervous System‐Driven Sensor

Q: What is the clinical evidence from this study?

Study design: Observational. Population: AV block (n=15). Intervention: Sympathetically driven pacemaker (DDDR mode) vs. DDDC mode (sensor off) or normal sinus function. Primary outcome: Changes in heart rate and catecholamine levels during physiological maneuvers (p=<0.05).

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Key result

Sympathetically driven pacing provided physiological heart rate modulations in AV block patients with chronotropic incompetence, yielding lower catecholamines during DDDR vs DDDC pacing (P<0.05).

Why the study?

Does a sympathetically driven pacemaker with a closed-loop sensor improve physiological heart rate modulation in patients with AV block and chronotropic incompetence?

Population

15 patients with AV block and a pacemaker controlled by a closed-loop system, including 8 patients with…

Comparison

Sympathetically driven pacemaker pacing with… vs Pacing with sensor activity Off.

Design

Cohort

Authors

MFMartino Martinelli FilhoElectrophysiology SNSILVANA A.D. NISHIOKAUniversidade de São Paulo HLHeno Ferreira LopesHospital do Coração

Discussion

Member takes

Implication

May lower catecholamines with closed-loop pacing in AV block; hypothesis-generating, needing RCTs before practice change.

Study Design

Type

Observational (n=15)

Structured PICO

Does a sympathetically driven pacemaker with a closed-loop sensor improve physiological heart rate modulation in patients with AV block and chronotropic incompetence?

Population

15 patients (9 men, 6 women, age 37-80 years) with AV block and a pacemaker controlled by a closed-loop system, including 8 patients with chronotropic incompetence and 7 patients with normal sinus function.

Intervention

Sympathetically driven pacemaker pacing with sensor activity On (DDDR mode for chronotropic incompetence, VVIR mode for normal sinus function).

Comparator

Pacing with sensor activity Off (DDDC mode at lower rate 60 ppm).

Outcome

Changes in heart rate, plasma catecholamines, and renin activity during Valsalva maneuver, tilt table testing, nitroglycerin and phenylephrine infusions, and physiological provocative maneuvers.surrogate

Main Result

p-value: p=<0.05

A closed-loop autonomic nervous system-driven sensor provides physiological heart rate modulation and reduces catecholamine levels in patients with AV block and chronotropic incompetence.

Cite This Study

Filho et al. (2000) conducted an observational in AV block (n=15). Sympathetically driven pacemaker (DDDR mode) vs. DDDC mode (sensor off) or normal sinus function was evaluated on Changes in heart rate and catecholamine levels during physiological maneuvers (p=<0.05). Sympathetically driven pacing provided physiological heart rate modulations in AV block patients with chronotropic incompetence, yielding lower catecholamines during DDDR vs DDDC pacing (P<0.05).

synapsesocial.com/papers/6a12d154c031bb6829a75b59 https://doi.org/10.1111/j.1540-8159.2000.tb07017.x

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Neurohumoral Behavior in Recipients of Cardiac Pacemakers Controlled by a Closed‐Loop Autonomic Nervous System‐Driven Sensor

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Neurohumoral Behavior in Recipients of Cardiac Pacemakers Controlled by a Closed‐Loop Autonomic Nervous System‐Driven Sensor

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider