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Related Experiment Videos

How to program rate responsive pacemakers.

E M Greco1, S Guardini, M Ferrario

  • 1Cardiology Department, Maggiore H., I.R.C.C.S., Milan, Italy.

Pacing and Clinical Electrophysiology : PACE
|March 10, 2000
PubMed
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The Pacing Rate Profile Software (PRPS) accurately predicts optimal pacemaker settings using the oxygen pulse reserve (OPR) method. This software provides a reliable alternative to cardiopulmonary stress testing (CPX) for tailoring rate-responsive pacing, even without specialized equipment.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Exercise Physiology

Background:

  • Oxygen uptake (VO2) increases linearly with heart rate during exercise.
  • The oxygen pulse reserve (OPR) method offers a potential approach for tailoring rate-responsive pacing parameters.
  • Pacing Rate Profile Software (PRPS) was developed to predict exercise pacing rate profiles using the OPR method.

Purpose of the Study:

  • To evaluate the reliability of PRPS in accurately predicting pacing rate profiles.
  • To assess the suitability of activity and metabolic rate-responsive sensors in providing pacing rates comparable to those predicted by cardiopulmonary stress testing (CPX) or PRPS.

Main Methods:

  • Studied 244 patients (NYHA Class I-II) under bicycle and treadmill stress test protocols.
  • Compared PRPS-predicted pacing rates against sinus rhythms or CPX-measured VO2 heart rates (OPR method).

Related Experiment Videos

  • Evaluated 89 patients with activity, metabolic, or dual sensors to assess their pacing rate delivery accuracy.

    • Main Results:

    • PRPS demonstrated high reliability in predicting pacing rates across various protocols (r values ranging from 0.80 to 0.97).
    • Activity, metabolic, and dual sensors provided pacing rates highly correlated with predicted rates (r = 0.93, 0.94, and 0.92, respectively).
    • PRPS proved effective even in NYHA Class III-IV patients (r = 0.92).

    Conclusions:

    • PRPS is a reliable and accurate tool for predicting optimal pacing rate profiles, serving as a viable alternative to CPX when unavailable.
    • The OPR method is a simple physiological approach suitable for tailoring rate-responsive pacing settings.
    • Activity and metabolic sensors can effectively deliver pacing rates close to those predicted by PRPS or CPX.