AIMS: We compared pacing rate adaptation based on closed loop stimulation (CLS) or accelerometer sensor (AS) during acute mental and physical stress in the same patient. METHODS AND RESULTS: One month after Protos (Biotronik, Germany) pacemaker implantation, 131 chronotropically incompetent patients were randomized to AS or CLS for 3 months with crossover. Arithmetic and 6 min walk tests were performed in the non-rate-adaptive mode and AS and CLS rate-adaptive modes, respectively. At the end, patients had to select the individually preferred pacemaker sensor. Heart rate during mental stress was higher (3.0 +/- 9.2 bpm) in the CLS than in the AS mode (P = 0.004). Benefit in the walking distance compared with non-rate-adaptive pacing was similar for the two modes: added 27 +/- 96 m (AS, P = 0.013) and 30 +/- 116 m (CLS, P = 0.025). At the end of the walk, heart rate was higher by 4.8 +/- 21.4 bpm in AS than in CLS (P = 0.049). Twice as many patients preferred CLS over AS (P < 0.01). CONCLUSION: The arithmetic test was associated with a significantly higher heart rate for CLS than for AS, showing a greater sensitivity of CLS-based rate adaptation to mental stress. Performance during physical stress was comparable. Patients preferred CLS.
RCT Entities:
AIMS: We compared pacing rate adaptation based on closed loop stimulation (CLS) or accelerometer sensor (AS) during acute mental and physical stress in the same patient. METHODS AND RESULTS: One month after Protos (Biotronik, Germany) pacemaker implantation, 131 chronotropically incompetent patients were randomized to AS or CLS for 3 months with crossover. Arithmetic and 6 min walk tests were performed in the non-rate-adaptive mode and AS and CLS rate-adaptive modes, respectively. At the end, patients had to select the individually preferred pacemaker sensor. Heart rate during mental stress was higher (3.0 +/- 9.2 bpm) in the CLS than in the AS mode (P = 0.004). Benefit in the walking distance compared with non-rate-adaptive pacing was similar for the two modes: added 27 +/- 96 m (AS, P = 0.013) and 30 +/- 116 m (CLS, P = 0.025). At the end of the walk, heart rate was higher by 4.8 +/- 21.4 bpm in AS than in CLS (P = 0.049). Twice as many patients preferred CLS over AS (P < 0.01). CONCLUSION: The arithmetic test was associated with a significantly higher heart rate for CLS than for AS, showing a greater sensitivity of CLS-based rate adaptation to mental stress. Performance during physical stress was comparable. Patients preferred CLS.
Authors: Yeon Sik Choi; Hyoyoung Jeong; Rose T Yin; Raudel Avila; Anna Pfenniger; Jaeyoung Yoo; Jong Yoon Lee; Andreas Tzavelis; Young Joong Lee; Sheena W Chen; Helen S Knight; Seungyeob Kim; Hak-Young Ahn; Grace Wickerson; Abraham Vázquez-Guardado; Elizabeth Higbee-Dempsey; Bender A Russo; Michael A Napolitano; Timothy J Holleran; Leen Abdul Razzak; Alana N Miniovich; Geumbee Lee; Beth Geist; Brandon Kim; Shuling Han; Jaclyn A Brennan; Kedar Aras; Sung Soo Kwak; Joohee Kim; Emily Alexandria Waters; Xiangxing Yang; Amy Burrell; Keum San Chun; Claire Liu; Changsheng Wu; Alina Y Rwei; Alisha N Spann; Anthony Banks; David Johnson; Zheng Jenny Zhang; Chad R Haney; Sung Hun Jin; Alan Varteres Sahakian; Yonggang Huang; Gregory D Trachiotis; Bradley P Knight; Rishi K Arora; Igor R Efimov; John A Rogers Journal: Science Date: 2022-05-26 Impact factor: 63.714
Authors: Freddy M Abi-Samra; Narendra Singh; Benjamin L Rosin; Jerome V Dwyer; Crystal D Miller Journal: Europace Date: 2013-02-17 Impact factor: 5.214
Authors: Joachim Proff; Béla Merkely; Roland Papp; Corinna Lenz; Peter Nordbeck; Christian Butter; Juergen Meyerhoefer; Michael Doering; Dean J MacCarter; Katharina Ingel; Thomas Thouet; Ulf Landmesser; Mattias J Roser Journal: Europace Date: 2021-11-08 Impact factor: 5.214