Key result
Closed loop rate responsive pacing based on ventricular depolarization gradient analysis showed high correlation with intrinsic P wave during exercise (r = 0.91) and mental activity (r = 0.87).
Why the study?
Does a closed loop control rate adaptive pacing system sensing the ventricular depolarization gradient produce an appropriate pacing response to physiological stimuli in patients?
Observational (n=10)
Does a closed loop control rate adaptive pacing system sensing the ventricular depolarization gradient produce an appropriate pacing response to physiological stimuli in patients?
Effect estimate: r = 0.91 for exercise; r = 0.87 for mental activity
The first available closed loop rate responsive pacing system based on ventricular depolarization gradient analysis produces an appropriate rate response to most physiological stimuli.
Supports physiologic rate adaptation in this case; leaves open randomized validation before clinical adoption.
Closed loop control of rate adaptive pacing has theoretical advantages over current rate responsive pacemakers. The first available system (which senses the ventricular depolarization gradient) has been evaluated in ten patients. The pacing response to a variety of exercise and nonexercise stimuli was assessed. Response to isotonic exercise was prompt and proportional to the exertion involved while isometric exercise and mental stress produced obvious but more gradual increases in pacing rate. In seven patients, comparison between the intrinsic P wave and pacing rate showed a high correlation during exercise (r = 0.91) and mental activity (r = 0.87). Postural changes induced a paradoxical response. Closed loop rate responsive pacing based upon analysis of the ventricular depolarization gradient produces a fast and appropriate rate response to most physiological stimuli.
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Paul et al. (1989) reported an observational. Closed loop control of rate adaptive pacing (sensing ventricular depolarization gradient) vs. Intrinsic P wave was evaluated on Pacing response to exercise and nonexercise stimuli (r = 0.91 for exercise; r = 0.87 for mental activity). Closed loop rate responsive pacing based on ventricular depolarization gradient analysis showed high correlation with intrinsic P wave during exercise (r = 0.91) and mental activity (r = 0.87).
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