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Related Experiment Videos

Temperature may be an appropriate sensor for chronotropically incompetent patients with postural syncope

I Singer1, K Ripley, B Johnson

  • 1University of Louisville, Kentucky 40292.

Pacing and Clinical Electrophysiology : PACE
|October 1, 1994
PubMed
Summary

Rate-adaptive pacemakers with temperature sensors improve exercise capacity in chronotropically incompetent patients. These devices also help manage postural syncope by increasing heart rate during head-up tilt tests.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Chronotropic incompetence limits heart rate response during exertion.
  • Postural syncope can persist despite pacemakers due to inadequate sensor response to postural changes.
  • Dual chamber rate-adaptive pacemakers modulate heart rate based on physiological sensors.

Purpose of the Study:

  • To evaluate the efficacy of a temperature-sensing dual chamber pacemaker (Circadia) in chronotropically incompetent patients with postural syncope.
  • To assess pacemaker response during exercise and head-up tilt (HUT).

Main Methods:

  • Seven patients with chronotropic incompetence and postural syncope were studied.
  • Pacemaker modes (DDDR vs. DDI) were compared during exercise and HUT.

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  • Cardiac function was assessed using continuous-wave Doppler and echocardiography.
  • Ventricular temperature and heart rate were monitored.

    • Main Results:

    • Patients exercised longer (168 sec more) in DDDR mode compared to DDI mode (P=0.013).
    • Heart rate increased significantly during exercise in DDDR pacing (71 to 121 bpm) vs. DDI (70 to 103 bpm).
    • During HUT, DDDR pacing increased heart rate (54 to 71 bpm) correlated with a rise in ventricular temperature (P=0.0003).

    Conclusions:

    • The temperature sensor demonstrates a physiological response to both exercise and HUT.
    • Temperature-sensing rate-adaptive dual chamber pacing is a potential solution for chronotropically incompetent patients experiencing posture-related syncope.