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Validation by serial standardized testing of a new rate-responsive pacemaker sensor based on variations in myocardial
J Clémenty1, A Kobeissi, S Garrigue
1H pital Cardiologique du Haut-Lévêque, Département d'Electrophysiologie et Stimulation Cardiaque, Pessac, France. jacques.clementy@pu.u-bordeaux2.fr
Summary
This study demonstrates that peak endocardial acceleration (PEA) effectively restores heart rate response in patients with chronotropic incompetence. The PEA sensor accurately adjusts pacemaker rate, mimicking normal sinus rhythm during various activities and exercise.
Area of Science:
- Cardiology
- Biomedical Engineering
- Physiology
Background:
- Preliminary studies indicate peak endocardial acceleration (PEA) correlates with left ventricular contractility and sinus node rate changes.
- PEA has been utilized to drive rate-responsive DDD pacemakers.
Purpose of the Study:
- To compare the chronotropic performance of PEA-driven pacemakers in patients with chronotropic incompetence against control subjects in normal sinus rhythm.
Main Methods:
- Fourteen patients with chronotropic incompetence and 18 control subjects underwent standardized daily activities and exercise protocols.
- Pacemakers were programmed individually, and correlation coefficients were calculated between PEA, paced rate, and heart rate variations.
Main Results:
- Paced heart rate variations closely correlated with normal sinus rhythm, demonstrating sensitivity, specificity, and rapidity.
- The PEA sensor effectively modulated heart rate, mirroring normal sinus rhythm after optimal programming.
Conclusions:
- A single PEA sensor successfully restored chronotropic response in patients with severe chronotropic incompetence.
- PEA monitoring enables beat-to-beat heart rate adjustments, with accurate pacemaker programming achievable via a single exercise test.