Rate-responsive cardiac pacemakers

Pacemaker technology continues to advance in the direction of restoring a normal hemodynamic response under varying physiologic conditions. Rate-responsive pacemakers meet this challenge by adjusting the pacing rate in response to a sensed physiologic variable other than sinus node activity. In an effort to design the ideal rate-responsive system, various physiologic cues have been tested. To translate shifts in the sensed physiologic indicator into an appropriate pacing rate, specialized sensor systems also have been developed and include mechanical, chemical, thermal, and electrical sensors. Although each sensor system offers advantages and disadvantages, continued research and clinical experience will determine the future of this exciting new form of cardiac pacing.