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Experience with activity sensing rate responsive ventricular pacing. A study based upon assessment of exercise
Summary
Rate responsive pacing (RRP) significantly improved exercise tolerance in patients with VVI pacemakers, increasing maximum treadmill time by 25.4% compared to fixed-rate VVI pacing. This enhancement was observed across different pacing rhythms.
Area of Science:
- Cardiology
- Biomedical Engineering
- Exercise Physiology
Background:
- VVI pacemakers offer fixed-rate pacing, which may limit exercise capacity.
- Rate-responsive pacing (RRP) aims to optimize heart rate during activity.
- Evaluating RRP's impact on exercise tolerance is crucial for pacemaker patient management.
Purpose of the Study:
- To assess the relationship between rate response and exercise tolerance in patients with VVI pacemakers.
- To compare exercise capacity using fixed-rate VVI pacing versus VVI with activity mode pacing (RRP).
Main Methods:
- Fourteen patients with VVI pacemakers underwent treadmill testing under two pacing modes: fixed-rate VVI and VVI + RRP.
- Maximum treadmill time (MTT) was the primary measure of exercise tolerance.
- Holter monitoring confirmed proper RRP function.
Main Results:
- Patients achieved 25.4% longer MTT with RRP compared to VVI pacing (11.4 vs. 8.5 minutes, p < 0.01).
- Patients with paced-only rhythms showed a 31.4% increase in MTT with RRP.
- A significant positive correlation was found between MTT and heart rate increase during RRP (r = 0.85, p < 0.001).
Conclusions:
- Rate-responsive pacing significantly enhances exercise tolerance in patients with VVI pacemakers.
- RRP effectively adjusts heart rate to improve functional capacity during physical activity.
- Activity-sensing pacemakers represent an advancement in managing pacemaker patients' exercise limitations.