Key result
Accelerometer-based pacemakers best simulate sinus rate behavior during daily activities versus other sensor types.
Why the study?
A systematic comparison evaluating the relative advantages and disadvantages of different activity-based sensors for rate adaptive pacing had received little study.
How do different activity-based sensors for rate adaptive pacing compare to intrinsic heart rate during exercise and daily activities in healthy volunteers?
How do different activity-based sensors for rate adaptive pacing compare to intrinsic heart rate during exercise and daily activities in healthy volunteers?
Accelerometer-based sensors for rate adaptive pacing most closely parallel intrinsic sinus rate behavior during various physical activities compared to vibration, gravitational, or movement sensors.
Accelerometer-based sensors best approximated sinus rate behavior across activities; leaves open optimal sensor selection for clinical rate-adaptive pacing.
Activity-based sensors for rate adaptive pacing have been available for several years and now include several different types: vibration; acceleration; gravitation; and movement. However, a systematic comparison evaluating the relative advantages and disadvantages of these various sensors has received little study. The purpose of the present study was to compare these sensor subtypes using treadmill testing and an outdoor test circuit, which simulated daily life activities and included both uphill and downhill walking. Pacemakers were strapped on the chest of healthy volunteers and connected to one channel of an ambulatory recording device, which also recorded the subject's intrinsic heart rate. The pacemakers were programmed using an initial treadmill test to standardize the rate responsive parameters for each device. Nine different pacemaker models were studied including 3 vibration-based (Elite, Synchrony, Metros), 4 acceleration-based (Relay, Excel, Ergos, Trilogy), 1 gravitational-based (Swing), and 1 movement-based (Sensorithm) device. All devices demonstrated a prompt rate response with casual walking on flat ground. The vibration-, gravitational-, and movement-based pacemakers showed a pronounced rate decline during more strenuous work, e.g., walking uphill. This phenomenon was absent in the accelerometer-based units. In particular, the vibration- and movement-based units showed a higher rate with walking downhill compared to uphill. An optimally tuned rate behavior on the treadmill usually did not provide an optimal rate behavior during daily activities and there was a tendency to overstimulation during low workload. The development of the two newest sensors (gravitational and movement) did not result in an improved performance of rate response behavior. Overall, the accelerometer-based pacemakers simulated or paralleled sinus rate behavior the most closely.
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CANDINAS et al. (1997) studied Healthy volunteers. Activity-based sensors for rate adaptive pacing (vibration, acceleration, gravitation, movement) vs. Intrinsic heart rate and comparison between sensor subtypes was evaluated on Rate response behavior during treadmill testing and daily life activities. Accelerometer-based pacemakers simulated sinus rate behavior most closely during daily activities, whereas other sensor types showed pronounced rate decline during strenuous work.
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