June 9, 2012Pacing and Clinical Electrophysiology
Closed Loop Stimulation is Effective in Improving Heart Rate and Blood Pressure Response to Mental Stress: Report of a Single‐Chamber Pacemaker Study in Patients with Chronotropic Incompetent Atrial Fibrillation
Why the study?
Does closed-loop stimulation (CLS) improve heart rate and blood pressure response to mental stress compared to VVI and VVIR modes in patients with chronotropic incompetent atrial fibrillation?
Population
36 patients with chronotropic incompetent atrial fibrillation, implanted with a pacemaker with the…
Comparison
Closed-loop stimulation pacing mode during a… vs Nonrate-adaptive mode and accelerometer sensor…
Design
Cross-sectional
Follow-up
5 minutes before, during, and 5 minutes after the test
Authors
Discussion
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Member takes
Implication
CLS may improve HR response to mental stress in chronotropic incompetent AF; leaves open outcome benefits and requires randomized confirmation.
Structured PICO
Does closed-loop stimulation (CLS) improve heart rate and blood pressure response to mental stress compared to VVI and VVIR modes in patients with chronotropic incompetent atrial fibrillation?
P
Population
36 patients (mean age 78.9 ± 6.4 years) with chronotropic incompetent atrial fibrillation, implanted with a pacemaker with the closed-loop stimulation (CLS) algorithm.
I
Intervention
Closed-loop stimulation (CLS) pacing mode during a mental stress test.
C
Comparator
Nonrate-adaptive mode (VVI) and accelerometer sensor (AS) mode (VVIR) during a mental stress test.
O
Outcome
Heart rate (HR) response (mean peak-HR and average HR increase) during mental stress test.surrogate
Closed-loop stimulation in a single-chamber pacemaker provides more appropriate rate-modulation during mental stress than accelerometer sensors in patients with atrial fibrillation and chronotropic incompetence.
Cite This Study
Proietti et al. (2012) studied this question.