Cardiac Pacing pp 271-279 | Cite as

Mixed Venous Oxygen Saturation for Rate Control of an Implantable Pacing System

  • A. Wirtzfeld
  • K. Stangl
  • R. Heinze
  • Th. Bock
  • H. D. Liess
  • E. Alt

Summary

One of the main disadvantages of most pacing systems available today is their inability to increase stimulating rate with exercise. This paper describes the concept of an autoregulating pacing system the rate of which is determined by changes in mixed venous oxygen content. For the realization of this concept an optical sensor mounted on the pacing lead has been developed which allows continuous monitoring of the oxygen saturation in the right ventricular cavity. The advantages of this parameter over other physiologic hemodynamic or metabolic variables are discussed.

Keywords

Ischemia Epoxy Respiration 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Morse D: What’s wrong with pacing? Pace 1982; 5: 455.CrossRefPubMedGoogle Scholar
  2. 2.
    Davidson DM, Braak CA, Preston TA and Judge RD: Effect on long-term survival, congestive heart failure, and subsequent myocardial infarction and stroke. Ann Intern Med 1972; 77: 345.CrossRefPubMedGoogle Scholar
  3. 3.
    Dolder E, Halter J and Nager F: Schrittmacherimplantation bei bradykarder Herzinsuffizienz. Dtsch med Wschr 1975; 100: 2070.CrossRefPubMedGoogle Scholar
  4. 4.
    Segel N, Hudson WA, Harris P and Bishop JM: The circulatory effects of electrically induced changes in ventricular rate at rest and during exercise. J Clin Invest 1964; 43: 1541.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Eimer HH and Witte J: Zur Leistungsbreite bei Patienten mit festfrequentem Herzschrittmacher unter Berücksichtigung von Hämodynamik, arteriovenöser Sauerstoffdifferenz und Lungenfunktion. Z Kardiol 1974; 63: 1099.PubMedGoogle Scholar
  6. 6.
    Goldreyer B: Physiologic pacing: the role of AV synchrony. Pace 1982; 5: 612.CrossRefGoogle Scholar
  7. 7.
    Westermann KW: Hämodynamische Untersuchungen bei Schrittmacherträgern während AV-Block, starrfrequenter und vorhofgesteuerter Stimulation. Intensivmedizin 1972; 9: 360.Google Scholar
  8. 8.
    Karlöf I: Haemodynamic effect of atrial triggered versus fixed rate pacing at rest and during exercise in complete heart block. Acta med Scand 1975; 197: 195.PubMedGoogle Scholar
  9. 9.
    Wirtzfeld A, Himmler FC and Blömer H: Klinische Gesichtspunkte der Schrittmachertherapie bei bradykarden Herzrhythmusstörungen. Verh Dtsch Ges Kreislaufforsch 1981; 47: 98.Google Scholar
  10. 10.
    Kruse I, Arnman K, Conradson TB, and Ryden L: A comparison of the acute and long-term hemodynamic effects of ventricular inhibited and atrial synchronous ventricular inhibited pacing. Circulation 1982; 65: 846.CrossRefPubMedGoogle Scholar
  11. 11.
    Shapland JE, McCarter D, Tockman B and Knudson M: Physiologic benefits of rate responsiveness. Pace 1983; 6: 329.CrossRefPubMedGoogle Scholar
  12. 12.
    Sowton E, Thorburn C and Roy P: Haemodynamic changes during cardiac pacing. In: Thalen H J Th (Ed): Cardiac Pacing. Van Gorcum, Assen 1973.Google Scholar
  13. 13.
    Cammilli L, Alcidi L and Papeschi G: A new pacemaker autoregulating the rate of pacing in relation to metabolic needs. In: Watanabe, Y (Ed): Cardiac Pacing, Excerpta Medica, Amsterdam 1977.Google Scholar
  14. 14.
    Cammilli L, Alcidi L, Shapland E and Obino S: Results, problems and perspectives with the autoregulating pacemaker. Pace 1983; 6: 488.CrossRefPubMedGoogle Scholar
  15. 15.
    Funke HD: Ein Herzschrittmacher mit belastungsabhängiger Frequenzregulation. Biomed. Technik 1975; 20: 225.CrossRefGoogle Scholar
  16. 16.
    Ionescu VL: An „on demand pacemaker” responsive to respiration rate. Pace 1980; 3: 375.Google Scholar
  17. 17.
    Rossi P, Plicchi G, Canducci G, Rognoni G and Aina F: Respiratory rate as a determinant of optimal pacing rate. Pace 1983; 6: 502.CrossRefPubMedGoogle Scholar
  18. 18.
    Weisswange A, Csapo G and Perach W: Frequenzsteuerung von Schrittmachern durch Bluttemperatur. Verh Dtsch Ges Kreislaufforsch 1978; 44: 152.CrossRefGoogle Scholar
  19. 19.
    Griffin JC, Jutzky KR, Claude JP and Knutti JW: Central body temperature as a guide to optimal heart rate. Pace 1983; 6: 498.CrossRefPubMedGoogle Scholar
  20. 20.
    Rickards AF and Norman J: Relation between QT interval and heart rate. New design of physiologically adaptive cardiac pacemaker. Brit Hert J 1981; 45: 56.CrossRefGoogle Scholar
  21. 21.
    Rickards AF, Donaldson RM and Thalen HJTh: The use of QT interval of determine pacing rate: early clinical experience. Pace 1983; 6: 346.CrossRefPubMedGoogle Scholar
  22. 22.
    Wirtzfeld A, Goedel-Meinen L, Bock TH, Heinze R, Liess HD and Munteanu J: Central venous oxygen saturation for the control of automatic rate-responsive pacing. Pace 1982; 5: 829.CrossRefPubMedGoogle Scholar
  23. 23.
    Holmgren A and Linderholm H: Oxygen and carbon dioxyde tensions of arterial blood during heavy and exhaustive exercise. Acta Physiol Scand 1958; 44: 203.CrossRefPubMedGoogle Scholar
  24. 24.
    Wirtzfeld A, Heinze R, Liess HD, Stangl K and Alt E: An active optical sensor for monitoring mixed venous oxygen saturation for an implantable rate-regulating pacing system. Pace 1983; 6: 494.CrossRefPubMedGoogle Scholar
  25. 25.
    Sowton E: Haemodynamic studies in patients with artificial pacemakers. Brit Heart J 1964; 26: 737.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

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

Authors and Affiliations

  • A. Wirtzfeld
    • 1
  • K. Stangl
  • R. Heinze
  • Th. Bock
  • H. D. Liess
  • E. Alt
  1. 1.I. Med. Klinik rechts der Isarder Technischen UniversitätMünchen 80Germany

Personalised recommendations