What question did this study set out to answer?

To assess the exercise performance, hemodynamic efficacy, and clinical limitations of the Sensolog 703 activity-sensing rate-responsive pacemaker.

October 1, 1988Pacing and Clinical Electrophysiology

Clinical Experience with Sensolog 703: A New Activity Sensing Rate Responsive Pacemaker

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Why the study?

Does the Sensolog 703 pacemaker in rate responsive mode improve exercise capacity compared to VVI mode in patients with complete heart block and atrial arrhythmias?

Population

11 patients with complete heart block and atrial arrhythmias, mean age 58 (range 39-72) years.

Comparison

Sensolog 703 activity sensing rate responsive… vs VVI pacing mode

Design

Case_series

Authors

CLChu‐Pak LauElectrophysiology WTWANG‐SUM TSESt George's, University of London ACA. John CammSt George's, University of London

Discussion

Member takes

Implication

Rate-responsive pacing may improve exercise capacity in complete heart block; single case report leaves open confirmation in controlled trials.

Key Points

To assess the exercise performance, hemodynamic efficacy, and clinical limitations of the Sensolog 703 activity-sensing rate-responsive pacemaker.
Implanted the Sensolog 703 pacemaker in 11 patients (mean age 58 years, range 39–72) with complete heart block and atrial arrhythmias.
Evaluated exercise duration via graded treadmill testing using the Bruce protocol and peak cardiac output via continuous wave Doppler of the aortic root in rate-responsive versus fixed VVI pacing modes.
Compared pacing rate adjustments against a Medtronic Activitrax pacemaker during treadmill walking, stair climbing, isometric exercise, and the Valsalva maneuver.
Rate-responsive pacing significantly extended treadmill exercise duration compared to the fixed VVI mode (mean ± SEM: 462 ± 52 s vs. 368 ± 34 s, P < 0.02).
Peak exercise cardiac output showed a significantly greater increase over resting levels in rate-responsive mode compared to VVI mode (93 ± 22% vs. 57 ± 13%, P < 0.05).
Neither device adjusted heart rates to walking inclines, stair direction, or isometric exercise, and two Sensolog units experienced inappropriate rate acceleration at rest requiring reprogramming to VVI mode.

Structured PICO

Does the Sensolog 703 pacemaker in rate responsive mode improve exercise capacity compared to VVI mode in patients with complete heart block and atrial arrhythmias?

Population

11 patients with complete heart block and atrial arrhythmias, mean age 58 (range 39-72) years.

Intervention

Sensolog 703 activity sensing rate responsive pacemaker in rate responsive mode

Comparator

VVI pacing mode

Outcome

Exercise capacity assessed by duration of graded treadmill exercise using the Bruce protocolsurrogate

The Sensolog 703 rate responsive pacemaker improves exercise capacity and cardiac output compared to VVI pacing, but shares limitations of other vibration-sensing pacemakers regarding non-walking physiological stressors.

Limitations

Body vibration is not closely related to physiological needs
No appropriate response to walking up gradients, isometric exercise, or Valsalva maneuver
Technical problems with spontaneous rate acceleration at rest in 2 patients

Cite This Study

Lau et al. (1988) studied this question.

synapsesocial.com/papers/6a7316c40afd8c13312b2ece https://doi.org/10.1111/j.1540-8159.1988.tb04994.x

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Implication

Rate-responsive pacing may improve exercise capacity in complete heart block; single case report leaves open confirmation in controlled trials.

Clinical Experience with Sensolog 703: A New Activity Sensing Rate Responsive Pacemaker

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Clinical Experience with Sensolog 703: A New Activity Sensing Rate Responsive Pacemaker

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

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