The use of biosensors in pacemaker technology: experience with a ventricular rate responsive pacemaker

Area of Science:

• Cardiology
• Biomedical Engineering

Background:

• Severe conduction abnormalities can impair cardiac function and exercise tolerance.
• Elderly patients often experience decreased cardiac reserve, necessitating effective interventions.

Purpose of the Study:

• To evaluate the impact of a ventricular rate-responsive pulse generator on left ventricular function and exercise capacity in elderly patients.
• To assess echocardiographic parameters and patient-reported outcomes after pacemaker implantation.

Main Methods:

• Ten elderly patients with severe conduction abnormalities received a rate-responsive pacemaker (Activitrax).
• Echocardiography was performed at rest and during maximal pacing (125 ppm) to measure end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), and peak systolic pressure/end-systolic volume (PSP/ESV).

Main Results:

• Significant increases in EDV (p < .05) and EF (p < .05) were observed.
• Significant decreases in ESV (p < .005) and increases in PSP/ESV ratio (p = .10) were noted.
• All patients remained asymptomatic with improved exercise capacity; paradoxical septal motion occurred at maximal pacing.

Conclusions:

• Ventricular rate-responsive pacing effectively enhances left ventricular function during exercise in elderly patients.
• Heart rate modulation appears to be a more significant factor than AV synchrony in improving ventricular function during maximal pacing.