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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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Improving lung function capacity in patients with chronotropic incompetence using closed loop stimulation: A

Wen-Ling Chen1, Lung-Ching Chen2, Pei-Sung Hsu3

  • 1School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, 24205, Taiwan; Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|October 21, 2024
PubMed
Summary

Pacemaker with closed-loop stimulation (DDD-CLS) pacing significantly improved lung function and exercise capacity in patients with chronotropic incompetence (CI). This advanced pacing enhances heart rate response during exertion, boosting overall cardiopulmonary performance.

Keywords:
Cardiopulmonary exercise testingChronotropic incompetenceClosed-loop stimulationForce vital capacityPeak oxygen uptake

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Area of Science:

  • Cardiology
  • Pulmonology
  • Biomedical Engineering

Background:

  • Chronotropic incompetence (CI) impairs heart rate response, limiting exercise tolerance.
  • Pacemakers are used to manage bradycardia, but some modes may not adequately support exertion.

Purpose of the Study:

  • To compare the effects of pacemaker with closed-loop stimulation (DDD-CLS) pacing versus standard DDD pacing on lung function and cardiopulmonary capacity in patients with CI.

Main Methods:

  • A randomized crossover trial involving 32 patients with CI.
  • Patients were paced with DDD-CLS and DDD modes for 2 months each.
  • Spirometry assessed forced vital capacity (FVC); cardiopulmonary exercise testing (CPET) measured peak oxygen uptake (peak VO2) and peak heart rate.

Main Results:

  • DDD-CLS pacing significantly increased FVC (3.2% improvement) and FEV1 compared to DDD pacing.
  • Peak VO2 was significantly higher with DDD-CLS pacing (14.9 vs 12.2 mlO2/kg/min).
  • Peak heart rate was also significantly higher with DDD-CLS pacing (106.9 vs 98.3 bpm).

Conclusions:

  • DDD-CLS pacing offers physiological chronotropic support, improving cardiopulmonary function during exertion in CI patients.
  • This pacing mode enhances lung capacity and exercise performance compared to standard DDD pacing.