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Translational Rabbit Model of Chronic Cardiac Pacing
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Temperature-based rate response in a leadless pacemaker system.

Mayer Y Rashtian1, James E Ip2, Derek V Exner3

  • 1Huntington Memorial Hospital, Pasadena, California.

Heart Rhythm
|November 24, 2024
PubMed
Summary
This summary is machine-generated.

The dual-chamber leadless pacemaker system effectively uses a temperature-based sensor to adjust pacing rates during exercise. This rate-responsive pacing accurately matches metabolic demand in both ventricular and atrial devices.

Keywords:
AveirCAEPDual chamberLeadless pacemakerRate response

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • A novel dual-chamber leadless pacemaker (DR-LP) system utilizes a temperature-based rate-response sensor.
  • Effectiveness of rate response during exercise for ventricular (VR-LP) and atrial (AR-LP) devices requires evaluation.

Purpose of the Study:

  • To determine if temperature-based rate-responsive pacing is proportional to metabolic workload in a leadless pacemaker system.
  • Assess the efficacy of rate modulation in response to exercise-induced metabolic demand.

Main Methods:

  • Treadmill exercise protocol administered to participants in LEADLESS II-Phase 2 and Aveir DR i2i studies.
  • Evaluated ventricular and atrial rate-response sensors using programmed settings optimized post-walk test.
  • Aggregated normalized slopes of sensor-indicated rate vs. metabolic workload; acceptance range defined by 95% CI between 0.65 and 1.35.

Main Results:

  • Mean ventricular rate-response slope was 0.93 (CI, 0.78-1.08), within acceptance criteria (P = .001).
  • Mean atrial rate-response slope was 0.91 (CI, 0.78-1.05), also within acceptance criteria (P < .001).

Conclusions:

  • The temperature-based sensor in the DR-LP system effectively modulates pacing rate with increased metabolic demand.
  • Demonstrated proportionality between pacing rate and metabolic workload for both ventricular and atrial leadless pacing devices.