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Accelerometer-based adaptive-rate pacing: a multicenter study. European EXCEL Study Group

R G Charles¹, J P Heemels, B L Westrum

¹Cardiothoracic Centre-Liverpool, United Kingdom.

Pacing and Clinical Electrophysiology : PACE

|March 1, 1993

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This study evaluated an adaptive rate pacemaker that uses motion detection to adjust heart rate. Results show appropriate rate modulation during exercise, confirming effective optimization through a simple walking test.

Area of Science:

Cardiology
Biomedical Engineering

Background:

Adaptive rate pacemakers aim to match heart rate with metabolic demand.
Previous methods for optimization could be cumbersome, requiring ECG monitoring.

Purpose of the Study:

To evaluate a new adaptive rate pacemaker (EXCEL VR) utilizing accelerometer-based motion detection.
To assess the efficacy of a simple walking test for optimizing pacemaker settings.

Main Methods:

Multi-center trial involving 55 patients implanted with the EXCEL VR pacemaker.
Optimization of pacing response using an "exercise test" feature, eliminating ECG monitoring.
Symptom-limited treadmill testing (Chronotropic Assessment Exercise Protocol) to assess rate modulation.

Main Results:

Related Experiment Videos

Pacemaker rate increased significantly during slow (29 ppm) and brisk (44 ppm) walking tests.
Mean pacing rate increased from 74.5 ppm at rest to 118.6 ppm at 3 mph/6% grade and 143.5 ppm at 3.8 mph/8% grade.
Individual patient responses were proportional to physical exertion.

Conclusions:

The adaptive rate pacemaker demonstrated appropriate rate modulation based on physical exertion.
A simple walking test effectively optimizes pacemaker settings for individual patients.
The accelerometer-based system provides a practical method for enhancing pacemaker function.