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Related Experiment Videos

Chronotropic incompetence: a common and progressive finding in pacemaker patients.

N Gwinn1, R Leman, J Kratz

  • 1Division of Cardiology, Medical University of South Carolina, Charleston 29425.

American Heart Journal
|May 1, 1992
PubMed
Summary

Chronotropic incompetence, the inability to adequately increase heart rate with exercise, affects over half of pacemaker patients. This condition appears to worsen over time after pacemaker implantation.

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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Chronotropic incompetence (CI) is a common issue in pacemaker patients.
  • Understanding CI's progression is crucial for patient management.

Purpose of the Study:

  • To assess the incidence of CI in pacemaker patients.
  • To investigate the relationship between CI and time since pacemaker implantation.

Main Methods:

  • Exercise treadmill tests were performed on 38 patients (ages 40-77) with pacemakers.
  • Chronotropic incompetence was defined as achieving less than 80% of predicted maximum heart rate (% PMHR).
  • Patients were grouped by time since pacemaker implantation (<2 years vs. >4 years).

Main Results:

  • Overall incidence of CI was 58% (22/38 patients).

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  • Patients with pacemakers >4 years old showed lower mean maximum heart rate (MHR) and % PMHR compared to those with pacemakers <2 years old.
  • CI prevalence was higher in patients with pacemakers >4 years (70%) versus <2 years (53%).

    • Conclusions:

    • Chronotropic incompetence appears to worsen over time after pacemaker implantation.
    • This suggests a potential decline in the heart's ability to respond to exertion post-implantation.