Key result
Closed Loop Stimulation drives greater heart rate increases during mental stress testing versus accelerometer pacing.
Why the study?
Mental stress affects hemodynamic properties in pacemaker patients, necessitating a rate-adaptive sensor responsive to mental loads such as Closed Loop Stimulation (CLS).
Does Closed Loop Stimulation (CLS) pacing mode improve heart rate response during acute mental stress compared to accelerometer pacing mode in pacemaker patients?
Population
Patients implanted with BIOTRONIK Protos/CLS pacemaker exhibiting at least 80% sensor-driven heart rates during stress testing
Comparison
Closed Loop Stimulation pacing mode vs accelerometer pacing mode
Design
Two single-blinded studies including one randomized study (ER2) with randomized pacing mode testing order
Follow-up
Acute during mental stress test
Authors
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CLS may better mimic physiologic HR response to mental stress than accelerometer pacing; leaves open whether this improves outcomes in pacemaker patients.
RCT
Single-blind
randomized
Does Closed Loop Stimulation (CLS) pacing mode improve heart rate response during acute mental stress compared to accelerometer pacing mode in pacemaker patients?
Closed Loop Stimulation provides a more appropriate and significantly higher heart rate response to acute mental stress compared to standard accelerometer-based pacing in pacemaker patients.
CHANDIRAMANI et al. (2007) conducted an RCT in patients indicated for a pacemaker. Closed Loop Stimulation (CLS) pacing mode vs. accelerometer pacing mode was evaluated on heart rate changes during a mental stress test. Closed Loop Stimulation provided a statistically significant higher increase in heart rate and higher peak heart rate during acute mental stress testing compared with an accelerometer pacing mode.
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