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Related Experiment Videos

Rate responsive pacemakers: a rapid assessment protocol.

Justin D Shaber1, John D Fisher, Indiresha Ramachandra

  • 1Department of Medicine, Cardiology Division, Arrhythmia Service, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.

Pacing and Clinical Electrophysiology : PACE
|February 1, 2008
PubMed
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A quick treadmill test can efficiently assess rate-responsive (RR) pacemaker settings. This method helps optimize RR pacemakers, as factory settings may be suboptimal for many patients.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Exercise Physiology

Background:

  • Rate-responsive (RR) pacemakers are often implanted with conservative, factory-set parameters.
  • Established protocols for assessing RR pacemaker responsiveness are time-consuming.
  • There is a need for efficient methods to evaluate RR pacemaker settings.

Purpose of the Study:

  • To develop and validate a brief exercise test for assessing heart rate (HR) response in patients with pacemakers.
  • To compare the effectiveness of a novel, rapid assessment protocol with traditional methods.

Main Methods:

  • A non-motorized treadmill exercise test was employed, involving a 30-second walk and a 15-second brisk exertion.
  • Heart rate was measured at rest, during casual walking, during brisk exertion, and during recovery.

Related Experiment Videos

  • The study included 110 subjects: 26 with RR pacemakers, 22 with non-RR pacemakers, 27 non-paced "sick" controls, and 35 healthy controls.

    • Main Results:

    • RR pacemaker patients showed a 27% increase in HR during the test.
    • Non-RR pacemaker patients had a similar HR increase (24.3%).
    • Both control groups (sick and healthy) exhibited significantly higher HR increases (51.9% and 47%, respectively) compared to paced groups, indicating suboptimal RR settings in many paced patients.

    Conclusions:

    • The brief, non-motorized treadmill test provides a quick, inexpensive, and effective method for assessing RR pacemaker function.
    • Nominal RR pacemaker settings may not adequately meet the physiological demands of many patients.
    • This efficient assessment has the potential to improve RR pacemaker programming and patient outcomes.