Advertisement

Cardiac Pacing pp 253-258 | Cite as

Rate Responsive Pacing Using the TX Pacemaker

  • Anthony F. Rickards
  • R. M. Donaldson

Summary

We have evaluated clinically a rate-responsive pacemaker which uses the evoked QT principle as indicator of physiological demand. This pacemaker is microprocessor-based and fully programmable noninvasibly through radiofrequency coupling to an external microcomputer. To date this system has been implanted in 15 patients. With this QT sensing pacemaker the rate response to exercise was smooth and progressive, and gradually returned the basic paced rate after termination of activity. Physiological rate responsive pacing resulted in significant improvement in exercise tolerance and a 40% increase in cardiac output when compared to fixed-rate pacing in 8 patients.

This initial experience confirms the possibility of obtaining a physiological response to exercise using a pacing system dependent only on a unipolar electrode which is independent of the problems of atrial activity and sensing. Rate responsive pacing might prove to be a useful alternative to atrial synchronous systems, particularly advantageous in those patients whose sinoatrial function is abnormal or who suffer from atrial arrhythmias.

Keywords

Cardiac Output Exercise Tolerance Peak Exercise Atrial Arrhythmia Atrial Activity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Samet P, Castillo C, Bernstein WH: Hemodynamic sequelae of atrial ventricular and sequential atrioventricular pacing in cardiac patients. Am Heart J 1966; 72: 725–729.CrossRefPubMedGoogle Scholar
  2. 2.
    Rickards AF, Norman J: Relation between QT interval and heart rate. New design of physiologically adaptive cardiac pacemaker. Br Heart J 1981; 45: 56–61.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Donaldson RM, Fox K, Rickards AF: Initial experience with a physiological, rate responsive pacemaker. Br Med J 1983; 286: 667–671.CrossRefGoogle Scholar
  4. 4.
    Rickards AF, Donaldson RM: The use of the QT to determine pacing rate. Early clinical experience. Pace 1983; 6: (2) 346–354.CrossRefPubMedGoogle Scholar
  5. 5.
    Rickards AF, Donaldson RM: Rate responsive pacing. Clin Progr Pacing & Electrophysiol 1983; 1: 12–19.Google Scholar
  6. 6.
    Knudson MB, Amundson DC, Mosharrafa M: In: Barold S, Mugica J, eds. The Third Decade of Cardiac Pacing. Futura Publishing Co, New York, 1982; 249.Google Scholar
  7. 7.
    Camilli L, Alcidi L, Risani R: Results, problems and perspectives in the autoregulating pacemaker (Abs). Pace 1982; 3: 365.Google Scholar
  8. 8.
    Wirtzfeld A, Goedel-Meinen L, Block T et al: Central venous oxygen saturation for the control of automatic rate responsive pacing. Pace 1982; 5: 829–835.CrossRefPubMedGoogle Scholar
  9. 9.
    Rossi P, Pliccui G, Canducci G et al: Cardiac pacemaker with stimulation rate controlled by breathing frequency. Proceedings 5th International Seminar “La Nuova Frontiera Delle Aritmie”, Trento, Italy. 1982 (In press).Google Scholar
  10. 10.
    MacCarter D, Santini A, Goicoles A et al: Improved exercise tolerance and arrhythmia protection with a new dual chambered rate responsive pacing system (Abs). Circulation 1982; 66 II: 218.Google Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1983

Authors and Affiliations

  • Anthony F. Rickards
    • 1
  • R. M. Donaldson
  1. 1.National Heart HospitalLondonEngland

Personalised recommendations