Right Ventricular Blood Temperature Profiles for Rate Responsive Pacing

To establish the efficacy of a temperature-based pacemaker control algorithm, right ventricular temperature and heart rate were measured for 12-70 hours in eight patients (51 +/- 17 years) and in one normal volunteer (28 years) during a variety of activities including exercise, rest, sleeping, eating, drinking, and bathing. A diurnal variation in heart rate and temperature was observed. Drinking caused transient temperature changes (less than one minute); during eating, increases of 0.07-0.36 degrees C over 3-12 minutes were observed. An increase of 0.24 degrees C over 8.5 minutes was observed in one patient during bathing. An abrupt drop in temperature was typically observed at the onset of exercise, followed by a steady temperature rise. During treadmill exercise, after a drop (0.13-0.48 degrees C, Bruce n = 4; 0.16-0.34 degrees C, Naughton, n = 3) during the first 1-2 minutes, temperature rose steadily through the end of peak exercise (0.45-1.01 degrees C, Bruce; 0.28-0.47 degrees C, Naughton). A temperature dip was also observed when a patient was told exercise would start but the treadmill failed to turn on. The dip is probably secondary to changes in blood flow from the peripheral circulation to the central system at the onset of exercise. Repeated exercise separated by short rests caused progressive blunting of the initial dip. Right ventricular temperature changes in a predictable manner with daily activity, allowing a temperature algorithm to detect rest and exercise.