Comparative evaluation of chronotropic responses of QT sensing and activity sensing rate responsive pacemakers

The rate responses of activity sensing (ATS) and QT sensing (QTS) rate responsive pacemakers to different forms and durations of exercises were compared. Nine patients with ATS and five with QTS were studied. All had complete heart block and atrial arrhythmias. At the onset, the pacemakers were programmed to achieve a pacing rate of 100-110 bpm by the end of stage 1 of the Bruce protocol, and to a pacing rate range of 70-150 bpm. With progressive exercise, using a treadmill (Bruce protocol), the maximum pacing rates in the two groups were not significantly different (mean +/- SD: 123 +/- 18 vs 129 +/- 23 bpm, ATS vs QTS). The time taken to return to the baseline pacing rate during recovery was significantly longer with QTS (178 +/- 70 vs 264 +/- 68 s, p less than 0.05). Brief exercise tests on a treadmill were performed for 3 min each with different combinations of treadmill speeds (1.2 and 2.5 mph) and gradients (0, 5, 10 and 15%). In both groups of patients, faster walking speed was associated with a faster pacing rate at each gradient. However, with increasing gradients, at each speed, there was a rise in the maximum pacing rate only in patients with QTS. During brief exercise tests, the maximum rate was achieved by the end of exercise in patients with ATS, but was delayed by 33 +/- 20 s after exercise in patients with QTS.(ABSTRACT TRUNCATED AT 250 WORDS)