Utility of rate histograms in programming and follow-up of a DDDR pacemaker

Dual-chamber, rate-modulated pacing (DDDR) is the newest available pacing mode. To optimize programming of the rate response options for such a pacemaker, the physician must adopt an organized follow-up method, including use of some type of exercise testing to assess the programmed options of the pacemaker. Because the patient may achieve a substantial "training effect" after a rate-modulated pacing device has been implanted, the device probably should be reprogrammed at 1 month or after implantation. Programming and follow-up can be considerably facilitated by the use of pacemaker-generated "rate histograms," which conveniently display the distribution of rate responses to various levels of activity.