Initial clinical experience with a minute ventilation sensing rate modulated pacemaker: improvements in exercise capacity and symptomatology. 1988

C P Lau, and A Antoniou, and D E Ward, and A J Camm
Department of Cardiological Sciences, St. George's Hospital Medical School, London, England.

A minute ventilation sensing rate modulated pacemaker was implanted in nine patients with bradycardia. Minute ventilation is sensed in this pacemaker by means of a standard bipolar pacing electrode. Compared with exercise in the constant rate ventricular pacing (VVI) mode at 1 month after pacemaker implantation, rate responsive pacing resulted in an improvement of exercise capacity of 33 +/- 5% (from 437 +/- 42 s in the VVI mode to 593 +/- 57 s in the rate modulated mode, P less than 0.01, Bruce protocol). This improvement was maintained in the seven patients in whom an exercise test was repeated at 3 months after implantation. The pacing rate was significantly correlated with oxygen consumption (r = 0.84 +/- 0.04) and measured minute ventilation (r = 0.76 +/- 0.06). Symptomatology in these patients was assessed by means of self-assessment questionnaires in a double blind, randomized cross-over study in which the pacemaker was alternatively programmed into the VVI and rate modulated modes. Significant improvements in "shortness of breath" and "energy during daily activities" were documented during rate modulated pacing and "palpitations" and "chest pain" were not worsened. Most patients preferred the rate modulated mode during the study. In conclusion, rate modulated pacing by sensing minute ventilation resulted in better exercise capacity and symptomatology. The pacing rate also showed good correlation with the individual's oxygen requirement.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D010138 Pacemaker, Artificial A device designed to stimulate, by electric impulses, contraction of the heart muscles. It may be temporary (external) or permanent (internal or internal-external). Cardiac Pacemaker, Artificial,Artificial Cardiac Pacemaker,Artificial Cardiac Pacemakers,Artificial Pacemaker,Artificial Pacemakers,Cardiac Pacemakers, Artificial,Pacemaker, Artificial Cardiac,Pacemakers, Artificial,Pacemakers, Artificial Cardiac
D011659 Pulmonary Gas Exchange The exchange of OXYGEN and CARBON DIOXIDE between alveolar air and pulmonary capillary blood that occurs across the BLOOD-AIR BARRIER. Exchange, Pulmonary Gas,Gas Exchange, Pulmonary
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D001919 Bradycardia Cardiac arrhythmias that are characterized by excessively slow HEART RATE, usually below 50 beats per minute in human adults. They can be classified broadly into SINOATRIAL NODE dysfunction and ATRIOVENTRICULAR BLOCK. Bradyarrhythmia,Bradyarrhythmias,Bradycardias
D002304 Cardiac Pacing, Artificial Regulation of the rate of contraction of the heart muscles by an artificial pacemaker. Pacing, Cardiac, Artificial,Artificial Cardiac Pacing,Artificial Cardiac Pacings,Cardiac Pacings, Artificial,Pacing, Artificial Cardiac,Pacings, Artificial Cardiac
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs

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