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Published on: February 17, 2018
Induction of oscillatory ventilation pattern using dynamic modulation of heart rate through a pacemaker
Charlotte H Manisty1, Keith Willson, Justin E R Davies
1International Centre for Circulatory Health, St. Mary's Hospital and Imperial College, London, United Kingdom. cmanisty@ic.ac.uk
Summary
Altering heart rate with a pacemaker can create breathing oscillations. This cardiorespiratory mechanism may be used to develop therapies for breathing disorders like sleep apnea.
Area of Science:
- Cardiorespiratory physiology
- Medical engineering
Background:
- Oscillatory ventilation characterizes certain disease states, necessitating dynamic therapies.
- Modulating respiratory gas transport via circulation presents a potential therapeutic avenue.
Purpose of the Study:
- To investigate if repetitive heart rate alternations can induce respiratory oscillations.
- To explore the therapeutic potential of this cardiorespiratory interaction.
Main Methods:
- Integrated mathematical modeling of cardiac output manipulations.
- Studied 22 subjects with pacemakers undergoing heart rate alternations (30 bpm, 60s periodicity).
- Monitored cardiac output, respiratory gases (end-tidal CO2), and ventilation.
Main Results:
- Consistent oscillations in end-tidal CO2 (8.4%) and ventilation (24.4%) were observed.
- Oscillations occurred with a 60s period, matching heart rate alternations.
- Oscillation amplitude correlated with cardiac output changes (r=0.59, P=0.001).
Conclusions:
- Repetitive heart rate alternations reliably induce oscillations in end-tidal CO2 and ventilation.
- The magnitude of these oscillations is dependent on the cardiac output response.
- This mechanism could be harnessed for dynamic responsive pacing to counteract disorders like apneic breathing.
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