Rate adaptive pacing in an intracardiac pacemaker
| Autor: | Michael Lloyd, Clemens Steinwender, Gabor Z. Duray, Dwight Reynolds, Kurt Stromberg, Todd J. Sheldon, Wade M. Demmer, J. Harrison Hudnall, Philippe Ritter, John D. Hummel, Lluís Mont, Razali Omar |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Pacemaker Artificial 030204 cardiovascular system & hematology Accelerometer Intracardiac injection Metabolic equivalent Cardiac Catheters 03 medical and health sciences 0302 clinical medicine Heart Rate Physiology (medical) Internal medicine Materials Testing Metabolic Equivalent medicine Humans 030212 general & internal medicine Exertion Treadmill Simulation Aged business.industry Cardiac Pacing Artificial Workload Arrhythmias Cardiac Equipment Design Middle Aged Confidence interval Intracardiac pacemaker Cardiology Exercise Test Female Cardiology and Cardiovascular Medicine business Algorithms |
| Zdroj: | Heart rhythm. 14(2) |
| ISSN: | 1556-3871 |
| Popis: | Background The Micra transcatheter pacemaker was designed to have similar functionality to conventional transvenous VVIR pacing systems. It provides rate adaptive pacing using a programmable 3-axis accelerometer designed to detect patient activity in the presence of cardiac motion. Objective The purpose of this study was to evaluate the system's performance during treadmill tests to maximum exertion in a subset of patients within the Micra Transcatheter Pacing Study. Methods Patients underwent treadmill testing at 3 or 6 months postimplant with algorithm programming at physician discretion. Normalized sensor rate (SenR) relative to the programmed upper sensor rate was modeled as a function of normalized workload in metabolic equivalents (METS) relative to maximum METS achieved during the test. A normalized METS and SenR were determined at the end of each 1-minute treadmill stage. The proportionality of SenR to workload was evaluated by comparing the slope from this relationship to the prospectively defined tolerance margin (0.65–1.35). Results A total of 69 treadmill tests were attempted by 42 patients at 3 and 6 months postimplant. Thirty tests from 20 patients who completed ≥4 stages with an average slope of 0.86 (90% confidence interval 0.77–0.96) confirmed proportionality to workload. On an individual test basis, 25 of 30 point estimates (83.3%) had a normalized slope within the defined tolerance range (range 0.46–1.08). Conclusion Accelerometer-based rate adaptive pacing was proportional to workload, thus confirming rate adaptive pacing commensurate to workload is achievable with an entirely intracardiac pacing system. |
| Databáze: | OpenAIRE |
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