Key result
Second-generation accelerometer pacemakers improve rate response over first-generation devices, achieving 124 bpm on stairs.
Why the study?
Second-generation accelerometer controlled pacemakers have not been compared to first-generation vibration controlled pacemakers and sinus rate during stairwalking to assess physiological rate behavior.
Do second-generation accelerometer-controlled pacemakers improve physiological rate response during stairwalking compared to first-generation vibration-controlled pacemakers?
Observational (n=21)
Do second-generation accelerometer-controlled pacemakers improve physiological rate response during stairwalking compared to first-generation vibration-controlled pacemakers?
Absolute Event Rate: 124% vs 97%
p-value: p=<=0.001
Accelerometer-controlled pacemakers provide a more physiological rate response during normal walking speeds compared to first-generation vibration-controlled devices, though this advantage is lost at faster walking speeds.
May enhance physiological rate responses during stairs; hypothesis-generating for clinical outcomes in pacemaker patients.
Activity controlled pacemakers are the most widely used rate adaptive systems. We studied second-generation activity controlled systems (accelerometer) in 21 patients with such an accelerometer controlled system implanted during walking level and stairs. We compared them to the rate of vibration controlled, first-generation activity pacemakers and to the sinus rate of a healthy control group. A metronome directed the speed during walking and climbing stairs at 92, 108, and 120 steps/min. At 92 steps/min, the new accelerometer controlled systems showed a significant (P < or = 0.001) pacing rate increase from 107 +/- 8 beats/min during walking level to 124 +/- 8 beats/min during climbing stairs, and a significant decrease to 105 +/- 12 beats/min during walking downstairs. In contrast, first-generation activity controlled pacemakers showed a less physiological rate behavior with higher pacing rate (113 +/- 7 beats/min) walking downstairs than walking upstairs (97 +/- 9). For everyday activities at normal walking speed, accelerometer controlled pacemakers show a more physiological rate behavior than first-generation pacemakers, but they lose this physiological response with faster walking.
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Matula et al. (1996) conducted an observational in Implanted pacemaker (n=21). Second-generation activity controlled pacemakers (accelerometer) vs. First-generation activity pacemakers (vibration) and healthy controls was evaluated on Pacing rate during climbing stairs at 92 steps/min (p=<=0.001). Second-generation accelerometer pacemakers showed a physiological rate increase to 124 beats/min climbing stairs and decrease to 105 beats/min downstairs, unlike first-generation devices (P<=0.001).
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