Evaluation of a new rate adaptive ventricular pacemaker controlled by double sensors

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Background:

• Pacemakers are crucial for managing bradyarrhythmias.
• Rate-adaptive pacemakers aim to optimize cardiac output during physical activity.
• Current single-sensor pacemakers may not fully replicate physiological heart rate adjustments.

Purpose of the Study:

• To evaluate the efficacy of the LEGEND-PLUS pacemaker in VVIR patients.
• To assess the rate adaptation capabilities of a dual-sensor (activity and minute ventilation) pacemaker.
• To compare the pacemaker's response to physiological demands during exercise.

Main Methods:

• Implantation of the LEGEND-PLUS pacemaker in the right ventricle (VVIR) in 11 patients.
• Initial programming using the Programmer Exercise Protocol (3-minute walk).
• Evaluation through treadmill tests, stair climbing, and Holter recordings.

Main Results:

• The dual-sensor mode demonstrated effective rate adaptation, with acceleration matching activity sensing and deceleration mimicking minute ventilation.
• Significant differences were observed in rate responses between exercise protocol and final programming in minute ventilation sensing mode (P < 0.01).
• Activity sensing mode showed comparable rate responses between protocol and final programming (P = 0.8).

Conclusions:

• Dual-sensor VVIR pacemakers show promise for improving exercise rate adaptation.
• The LEGEND-PLUS pacemaker, with combined activity and minute ventilation sensing, closely mimics physiological heart rate responses to exercise.
• This technology may enhance patient quality of life by providing more natural heart rate regulation.