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Related Experiment Videos

Dual sensor VVIR mode pacing: is it worth it?

N Sulke1, K Tan, K Kamalvand

  • 1Department of Cardiology, Guy's Hospital, London, United Kingdom.

Pacing and Clinical Electrophysiology : PACE
|November 1, 1996
PubMed
Summary

Dual sensor VVIR pacing offers no significant advantage over single sensor VVIR pacing for pacemaker patients. Activity sensing VVIR mode was preferred, with dual sensor pacing showing no added clinical benefits but increased complexity and cost.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Rate-responsive pacemakers adjust pacing to meet physiological demand.
  • Dual-sensor technology aims to improve upon single-sensor systems for more accurate rate adaptation.

Purpose of the Study:

  • To compare dual-sensor VVIR pacing with single-sensor VVIR pacing in patients with high-grade AV block and atrial fibrillation.
  • To assess the clinical advantages and disadvantages of dual-sensor VVIR pacemaker technology.

Main Methods:

  • A randomized, double-blind, crossover study involving ten patients with Medtronic Legend Plus dual-sensor VVIR pacemakers.
  • Patients underwent assessment in VVIR mode (minute ventilation sensing), VVIR mode (activity sensing), VVIR mode (dual sensor), and VVI mode (no rate response).

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  • Evaluations included subjective preference, objective exercise testing (treadmill), and daily activity monitoring.

    • Main Results:

    • All VVIR modes showed significantly better subjective exercise capacity and functional status compared to VVI mode.
    • Objective exercise tolerance was significantly lower in VVI mode compared to all VVIR modes.
    • While dual-sensor pacing showed the best chronotropic response in some daily activities, no marked clinical advantage over activity-sensing VVIR pacing was observed.

    Conclusions:

    • Dual-sensor VVIR pacing does not provide a significant clinical advantage over current activity-sensing VVIR pacemakers.
    • The adoption of dual-sensor devices may be limited by increased size, complexity, cost, and potentially decreased longevity.