Assessment of Adaptive Rate Response Provided by Accelerometer, Minute Ventilation and Dual Sensor Compared with Normal Sinus Rhythm During Exercise： A Self-controlled Study in Chronotropically Competent Subjects

• Published in: Chinese medical journal Vol. 128; no. 1; pp. 25 - 31
• Main Authors: Cao, Yuanyuan, Zhang, Yiqun, Su, Yangang, Bai, Jin, Wang, Wei, Ge, Junbo
• Format: Journal Article
• Language: English
• Published: China Medknow Publications Pvt Ltd 01.01.2015; Medknow Publications and Media Pvt. Ltd; Lippincott Williams & Wilkins Ovid Technologies; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China%Institute of Advancing Science, Boston Scientific-China, Shanghai 200032, China; Medknow Publications & Media Pvt Ltd; Wolters Kluwer
• Subjects: Accelerometer; Adaptive Rate Pacing; Dual Sensor; Minute Ventilation; Accelerometers; Adult; Aged; Cardiac arrhythmia; Cardiac Pacing, Artificial - methods; Cardiology; Cardiovascular disease; Clinical trials; Comparative analysis; Dosage and administration; Electrocardiography; Exercise - physiology; Exercise Test; Female; Fitness equipment; Heart rate; Humans; Male; Metabolism; Middle Aged; Mortality; Original; Pacemaker, Artificial; Pacemakers; Patients; Physiological aspects; Quality of life; Respiratory system agents; Response rates; Sensors; Sinuses; 主管; 加速度计; 双传感器; 自我控制; 自适应; 评估; 通气量; 速率; China; Accelerometer; Adaptive Rate Pacing; Minute Ventilation; Dual Sensor
• ISSN: 0366-6999; 2542-5641; 2542-5641
• DOI: 10.4103/0366-6999.147798

Background：Dual sensor （DS） for rate adaption was supposed to be more physiological.To evaluate its superiority,the DS （accelerometer [ACC] and minute ventilation [MV]） and normal sinus rate response were compared in a self-controlled way during exercise treadmill testing. Methods：This self-controlled study was performed in atrioventricular block patients with normal sinus function who met the indications of pacemaker implant.Twenty-one patients came to the 1-month follow-up visit.Patients performed a treadmill test 1-month post implant while programmed in DDDR and sensor passive mode.For these patients,sensor response factors were left at default settings （ACC =8,MV =3） and sensor indicated rates （SIRs） for DS,ACC and MV sensor were retrieved from the pacemaker memories,along with measured sinus node （SN） rates from the beginning to 1-minute after the end of the treadmill test,and compared among study groups.Repeated measures analysis of variance and profile analysis,as well as variance analysis of randomized block designs,were used for statistical analysis. Results：Fifteen patients （15/2 l） were determined to be chronotropically competent.The mean differences between DS SIRs and intrinsic sinus rates during treadmill testing were smaller than those for ACC and MV sensor （mean difference between SIR and SN rate：ACC vs.SN,MV vs.SN,DS vs.SN,respectively,34.84,17.60,16.15 beats/min）,though no sensors could mimic sinus rates under the default settings for sensor response factor （ACC vs.SN P-adjusted 〈 0.001; MV vs.SN P-adjusted =0.002; DS vs.SN P-adjusted =0.005）.However,both in the range of 1st minute and first 3 minutes of exercise,only the DS SIR profile did not differ from sinus rates （P-adjusted =0.09,0.90,respectively）. Conclusions：The DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors （ACC or MV sensor）.Further study is needed to determine if individual optimization would further improve adaptive performance of the DS.