Validating optimal function of the closed loop stimulation sensor with high right septal ventricular electrode
John Silberbauer1, Paul S G Hong, Rick A Veasey
1Department of Cardiology, Eastbourne General Hospital, East Sussex NHS Trust, Kings Drive, Eastbourne, BN21 2UD, UK. johnsilberbauer@lycos.com
Summary
Closed loop stimulation (CLS) and accelerometer (ACC) sensors are effective for rate-responsive pacing in patients after
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- Persistent atrial fibrillation often requires 'ablate and pace' therapy.
- Rate-responsive pacing aims to optimize heart rate during varying physical and mental demands.
Purpose of the Study:
- To validate closed loop stimulation (CLS) versus accelerometer (ACC) rate-responsive sensors.
- To compare electrode placement in right ventricular high septal (RVHS) versus right ventricular apical (RVA) positions.
- To assess sensor performance in patients post-'ablate and pace' therapy.
Main Methods:
- Randomized, double-blind, crossover study design.
- Comparison of CLS and ACC pacing modes in 'ablate and pace' patients.
- Cardiopulmonary testing (exercise protocols) and daily living activity assessments.
Main Results:
- Heart rate response varied between CLS and ACC modes under different conditions (e.g., sitting up, mental stress, stair descent).
- Peak heart rates during stair descent were lower with CLS.
- No significant differences were observed in key exercise parameters (e.g., peak VO2, total workload) between modes.
- CLS sensor performance was optimal in both RVHS and RVA lead positions.
Conclusions:
- Closed loop stimulation (CLS) rate-adaptive pacing is suitable for 'ablate and pace' patients.
- The CLS sensor demonstrates equal efficacy in both right ventricular apical (RVA) and right ventricular high septal (RVHS) lead positions.
