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[A heart rate adaptable "physiologic" pacemaker. Is the effort worthwhile?].

M Sigmund, R Uebis

    Fortschritte Der Medizin
    |May 20, 1989
    PubMed
    Summary
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    Dual-chamber pacemakers offer physiologic cardiac action for heart block. Rate-responsive systems show promise but require further research for optimal patient benefit and widespread use.

    Area of Science:

    • Cardiology
    • Biomedical Engineering

    Context:

    • Dual-chamber pacemakers approximate physiologic cardiac function in patients with third-degree atrioventricular block and preserved sinoatrial function.
    • Rate-responsive pacing systems, utilizing parameters like respiration, activity, blood temperature, or QT-interval, represent advancements in pacemaker technology.

    Purpose:

    • To evaluate the clinical experience and current limitations of newly developed rate-responsive pacemaker systems.
    • To identify unresolved issues and potential therapeutic advantages before recommending general use of these advanced pacing systems.

    Summary:

    • Initial clinical data on rate-responsive pacemakers controlled by various physiological parameters are available.
    • Current rate regulation sensitivity, specificity, implantation, and setting efforts are not fully satisfactory.

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  • These systems are primarily implanted based on individual patient needs, highlighting the need for further development.

    • Impact:

    • Further research is needed to address current limitations in sensitivity, specificity, and implantation procedures.
    • Determining the specific therapeutic advantages for different patient groups and underlying conditions is crucial for broader adoption.
    • Resolving these issues will pave the way for more effective and widespread use of advanced pacemaker technology.