sensors for rate responsive pacing

Clicks: 222
ID: 249052
2004
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Ranked #24 of 63 articles by views in Medical decision making : an international journal of the Society for Medical Decision Making

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Abstract
Advances in pacemaker technology in the 1980s have generated a wide variety of complex multiprogrammable pacemakers and pacing modes. The aim of the present review is to address the different rate responsive pacing modalities presently available in respect to physiological situations and pathological conditions. Rate adaptive pacing has been shown to improve exercise capacity in patients with chronotropic incompetence. A number of activity and metabolic sensors have been proposed and used for rate control. However, all sensors used to optimize pacing rate metabolic demands show typical limitations. To overcome these weaknesses the use of two sensors has been proposed. Indeed an unspecific but fast reacting sensor is combined with a more specific but slower metabolic one. Clinical studies have demonstrated that this methodology is suitable to reproduce normal sinus behavior during different types and loads of exercise. Sensor combinations require adequate sensor blending and cross checking possibly controlled by automatic algorithms for sensors optimization and simplicity of programming. Assessment and possibly deactivation of some automatic functions should be also possible to maximize benefits from the dual sensor system in particular conditions. This is of special relevance in patient whose myocardial contractility is limited such as in subjects with implantable defibrillators and biventricular pacemakers. The concept of closed loop pacing, implementing a negative feedback relating pacing rate and the control signal, will provide new opportunities to optimize dual-sensors system and deserves further investigation. The integration of rate adaptive pacing into defibrillators is the natural consequence of technical evolution.
Reference Key
dell’orto2004indiansensors Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Simonetta Dell’Orto;Paolo Valli;Enrico Maria Greco
Journal Medical decision making : an international journal of the Society for Medical Decision Making
Year 2004
DOI
DOI not found
URL
http://www.ipej.org/0403/greco.htm
Keywords
physical activity biventricular pacing implantable cardioverter defibrillatordiseases of the circulatory (cardiovascular) system

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