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Updated: Jul 7, 2026
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Home-Based Monitor for Gait and Activity Analysis
Published on: August 8, 2019
Closed loop stimulation and accelerometer-based rate adaptation: results of the PROVIDE study
Martin Coenen1, Klaus Malinowski, Wilhelm Spitzer
1Department of Cardiology, University Hospital, Petersgraben 4, 4031 Basel, Switzerland. mcoenen@uhbs.ch
Summary
Closed loop stimulation (CLS) demonstrated greater sensitivity to mental stress compared to accelerometer sensor (AS) pacing rate adaptation. Patients preferred CLS, though physical performance was similar between the two pacemaker sensor modes.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Pacemaker rate adaptation aims to optimize heart rate response to physiological demands.
- Assessing the efficacy of different rate-adaptive pacing modes during stress is crucial for patient management.
Purpose of the Study:
- To compare closed loop stimulation (CLS) and accelerometer sensor (AS) for pacemaker rate adaptation during acute mental and physical stress.
- To evaluate patient preference between CLS and AS pacing modes.
Main Methods:
- A randomized crossover study involving 131 chronotropically incompetent patients.
- Comparison of AS and CLS modes against a non-rate-adaptive mode during arithmetic and 6-minute walk tests.
- Patient preference assessment post-intervention.
Main Results:
- CLS pacing showed a significantly higher heart rate response during mental stress compared to AS (P = 0.004).
- Both AS and CLS provided similar improvements in walking distance compared to non-rate-adaptive pacing.
- Patients showed a significant preference for CLS over AS (P < 0.01).
Conclusions:
- CLS offers superior rate adaptation to mental stress, indicating greater sensitivity.
- Pacemaker performance during physical exertion is comparable between CLS and AS.
- Patient preference favors CLS, suggesting potential benefits in perceived comfort or effectiveness.
