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Rate adaptive pacing--clinical experience with three different pacing systems.
Pacing and Clinical Electrophysiology : PACE
|November 1, 1986
Summary
Rate-responsive pacemakers adapt heart rate to activity. The Biorate pacemaker functions well but has limited programmability, while the QT-pacemaker (Tx) shows early failures. Activitrax offers satisfactory adaptation.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Physiological stimulation in pacemakers can be achieved through bifocal or rate-responsive pacing.
- Rate-responsive pacemakers adjust heart rate based on biological signals during physical activity.
- Three primary systems for rate-responsive pacing exist: QT-pacemaker (Tx), respiratory biorate pacemaker, and Activitrax.
Purpose of the Study:
- To report on the clinical experiences with three available rate-responsive pacemaker systems.
- To evaluate the performance and reliability of QT-, Biorate-, and Activitrax-pacemakers.
Main Methods:
- Clinical experience with 8 QT, 6 Biorate, and 8 Activitrax pacemakers.
- Survey data from 95 QT and 37 Biorate pacemakers across 11 centers.
- Analysis of pacemaker function, frequency adaptation, and failure modes.
Main Results:
- The Biorate pacemaker demonstrated reliable function, with limited programmability as its main drawback.
- The QT-pacemaker (Tx) exhibited a 26% failure rate in early series, primarily due to electrode tip voltage polarization.
- The Activitrax pacemaker provided satisfactory frequency adaptation, influenced by shoulder and pectoral muscle activity.
Conclusions:
- The Biorate pacemaker is a reliable option despite programmability limitations.
- Early QT-pacemaker models faced challenges with electrode polarization leading to failures.
- Activitrax offers effective rate adaptation, contingent on specific muscle activity.