A prospective multicenter study demonstrating clinical benefit with a new accelerometer-based DDDR pacemaker. Dromos...

Area of Science:

• Cardiology
• Biomedical Engineering
• Exercise Physiology

Background:

• Chronotropic incompetence (CI) affects pacemaker patients, limiting heart rate response during exercise.
• Assessing CI requires objective measures of cardiovascular function during physical activity.
• Biotronik Dromos DR and Ergos TC 03 pulse generators utilize accelerometer-based motion sensors.

Purpose of the Study:

• To prospectively evaluate the presence of CI in patients with Biotronik pacemakers.
• To compare the efficacy of DDD versus DDDR pacing modes in patients with CI using metabolic exercise testing.

Main Methods:

• Sixty-three patients with Biotronik Dromos DR or Ergos TC 03 pacemakers were screened for CI using exercise tests.
• Patients diagnosed with CI underwent paired, randomized, double-blind metabolic exercise tests in DDD and DDDR modes.
• Exercise parameters including heart rate, exercise duration, and oxygen consumption (VO2) were analyzed.

Main Results:

• Forty percent (25/63) of patients met the criteria for CI.
• DDDR mode demonstrated statistically significant improvements over DDD mode in all measured endpoints.
• Key improvements included higher heart rate, longer total exercise time, increased maximum VO2, and enhanced VO2 at anaerobic threshold (AT).

Conclusions:

• The accelerometer-based sensor in Biotronik Dromos DR and Ergos TC 03 pulse generators effectively supports DDDR pacing.
• DDDR pacing provides significant clinical benefits for patients with CI, enhancing their exercise capacity and cardiovascular response.
• This study confirms the utility of sensor-driven pacing in managing CI.