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Related Experiment Videos

Sensor-driven rate smoothing in a DDDR pacemaker.

S T Higano1, D L Hayes, G Eisinger

  • 1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905.

Pacing and Clinical Electrophysiology : PACE
|June 1, 1989
PubMed
Summary
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Dual-chamber pacemakers (DDD) can show rate variations. Sensor-driven rate smoothing in DDDR pacemakers now minimizes these variations, improving patient electrocardiographic displays.

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Dual-chamber pacemakers (DDD) can exhibit significant cycle-to-cycle rate variability at the upper rate limit due to 2:1 or Wenckebach-type block.
  • Rate smoothing was previously implemented to mitigate these variations in DDD devices.

Observation:

  • Modern DDDR pacemakers utilize an activity sensor to achieve a similar effect, termed "sensor-driven rate smoothing."
  • This phenomenon occurs specifically when the activity sensor dictates pacemaker function.

Findings:

  • In a described case, sensor-driven pacing limited RR interval variations to 600-680 msec (13.3%) even when the atrial rate exceeded the maximum tracking rate and triggered Wenckebach-type block.
  • Optimal programming of rate response indicators is crucial for maximizing sensor-driven rate smoothing.

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Implications:

  • Sensor-driven rate smoothing represents a novel mechanism for managing pacemaker rate variability.
  • This electrocardiographic manifestation is expected to become more prevalent with the increasing clinical adoption of DDDR pacemakers.