Heart rate changes during acute mental stress with closed loop stimulation: report on two single-blinded, pacemaker...

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Background:

• Mental stress impacts cardiac hemodynamics in pacemaker patients.
• Rate-adaptive sensors are crucial for managing mental load-induced heart rate changes.
• Closed Loop Stimulation (CLS) translates cardiac contractility into patient-specific pacing rates.

Purpose of the Study:

• To compare heart rate responses during mental stress using CLS versus accelerometer pacing modes.
• To evaluate the efficacy of CLS in adapting heart rate to acute psychological stress.
• To assess the clinical performance of CLS in pacemaker patients.

Main Methods:

• Patients with BIOTRONIK Protos/CLS pacemakers underwent standardized mental stress tests.
• The stress protocol included relaxation, a color-word test, and an arithmetic challenge.
• The ER2 study employed a randomized design to compare pacing modes.

Main Results:

• CLS demonstrated a statistically significant higher increase in heart rate during stress testing compared to accelerometer mode.
• CLS achieved a statistically significant higher peak heart rate during mental stress.
• Analysis focused on patients with at least 80% sensor-driven pacing during stress.

Conclusions:

• The CLS algorithm provides an appropriate heart rate response to acute mental stress.
• CLS is effective in pacemaker patients with a high percentage of sensor-driven pacing.
• CLS enhances heart rate regulation during psychological challenges.