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Indications for Implanting Rate-Adaptive Cardiac Pacemakers

  • Conference paper
Rate Adaptive Cardiac Pacing

Abstract

Pacemaker therapy has developed into one of the most successful treatment methods in the field of cardiology. Initially implanted mainly to prevent Adams-Stokes attacks and to decrease the mortality of life-threatening bradycardias, pacemakers are increasingly implanted today for hemodynamic reasons, i.e. to improve the quality of life. The purpose is often not only to alleviate congestive heart failure at rest but alsoto enhance physical performance by improving cardiac output on exertion [1]. Other aims of rate-adaptive pacing are to provide an adequate rate response for different forms and levels of exercise, a rate adaptation under changing metabolic or circulatory conditions not due to exercise, a rate adaptation in terms of biorhythmics, a rate reaction in the case of emotional responses and to prevent the occurrence of especially atrial rhythm disorders.

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References

  1. Alt E, Stangl K, Blömer H (1986) Therapie mit frequenzadaptiven Herzschrittmachern. Herz Kreisl 18: 556

    Google Scholar 

  2. Alt E (1988) Cardiac and pulmonary response during physical activity in normal patients. In: Santini M, Pistolese M, Alliegro A (eds) Progress in clinical pacing. Excerpta Medica, Amsterdam, pp 7–12

    Google Scholar 

  3. Nordlander R, Hedman A, Pehrsson SK (1989) Rate-responsive pacing and exercise capacity a comment. PACE 12: 749–751

    Article  PubMed  CAS  Google Scholar 

  4. Alt E, Völker R, Högl B, MacCarter D (1988) First clinical results with a new temperature controlled rate responsive pacemaker. Circulation 78; 111: 116–124

    Google Scholar 

  5. Alt E, Krieg HJ, Wirtzfeld A (1983) Verlauf bei 127 Patienten mit physiologischen Schrittmachersystemen. Z Kardiol 59: 131

    Google Scholar 

  6. Alt. E, Zitzmann E, Heinz M, Gastmann U, Matula M, Lehmann M (1990) The effect of rateresponsive pacing on exercise capacity, serum catecholamines and other metabolic parameters. PACE 13: 531

    Google Scholar 

  7. Pehrsson SK, Hjemdahl P, Nordlander R (1988) A comparison of sympathoadrenal activity and cardiac performance at rest and during exercise in patients with ventricular demand or atrial synchronous pacing. Br Heart J 60: 212–220

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  8. Hatano K, Kato R, Hayashi H, Nöda S, Sotobata I, Murase M (1989) Usefulness of rateresponsive atrial pacing in patients with sick sinus syndrome. PACE 12: 16–24

    PubMed  CAS  Google Scholar 

  9. Heinz M, Zitzmann E, Coenen M, Alt E (1990) Malfunctioning of DDD pacemakers despite correct functioning at routine pacemaker controls. PACE 13: 560

    Google Scholar 

  10. Wilkoff BL, Corey J, Blackburn G (1989) A mathematical model of the cardiac chronotropic response to exercise J Electrophysiol(1989) 3 /3: 176

    Google Scholar 

  11. Heinz H, Wörl HH, Alt E, Theres H, Blömer H (1988) Which patient is most likely to benefit from a rate-responsive pacemaker? PACE 11: 1834–1839

    Article  PubMed  CAS  Google Scholar 

  12. McBride JW, Reyes WJ, Medellin L, Lauer NY (1990) What is the need for rate-modulated pacemakers? PACE 13: 504

    Google Scholar 

  13. Simonsen E (1987) Assessment of the need for a rate-responsive pacing in patients with sinus node dysfunction. A prospective study of heart-rate response during daily activities and exercise testing. PACE 10: 418

    Google Scholar 

  14. Prior M, Masterson M, Morant VA, Castle LW, Maloney JD (1987) Do patients with sinus node dysfunction and permanent pacemakers require an additional chronotropic sensor? PACE 10: 418

    Google Scholar 

  15. Corbelli R, Masterson M, Wilkoff BL (1990) Chronotropic response to exercise in patients with atrial fibrillation. PACE 13: 179–187

    Article  PubMed  CAS  Google Scholar 

  16. Lau CHP, Wong CHH, Cheng CHH, Leung WH (1990) Importance of heart rate modulation on the cardiac hemodynamics during postexercise recovery. PACE 13: 1277–1285

    Article  PubMed  CAS  Google Scholar 

  17. Sulke N, Pipilis A, Bucknall C, Sowton E (1990) Quantitative analysis of contribution of rate response in three different ventricular rate-responsive pacemakers during out of hospital activity. PACE 13: 37–44

    Article  PubMed  CAS  Google Scholar 

  18. Seitz K, Stangl K, Wirtzfeld A, Delius W, Laule M (1990) Erlaubt die Sinusknotenerholungszeit Rückschlüsse auf die Belastungsadaptation im weiteren Verlauf? Herzschr Elektrophys 1: 63, A37

    Google Scholar 

  19. Benchimol A, Ligett MS (1966) Cardiac hemodynamics during stimulation at the right atrium, right ventricle, and left ventricle in normal and abnormal hearts. Circulation 33: 933

    Article  PubMed  CAS  Google Scholar 

  20. Cock CC, Fisser FC, Stockei L, Roos JP (1990) Rate-responsive pacing in patients after myocardial infarction and angina pectoris. PACE 13: 1192

    Google Scholar 

  21. Kruse M (1988) Long-term improvements in functional capacity by AAI rate-responsive pacing. In: Santini M, Pistolese M, Alliegro A (eds) Progress in clinical pacing. Excerpta Medica, Amsterdam, pp 25–29

    Google Scholar 

  22. Griffin J (1991) The optimal pacing mode for the individual patient: the role of DDDR. In: Barold SS, Mugica J (eds) New perspectives in cardiac pacing, vol. 2. Futura, Mount Kisco, NY, pp 325–338

    Google Scholar 

  23. Rosenquist M, Brandt J, Schüller H (1988) Long-term pacing in sinus node disease. Effects of stimulation mode on cardiovascular morbidity and mortality. Am Heart J 116: 16–22

    Article  Google Scholar 

  24. Sutton R, Kenny RA (1986) The natural history of sick sinus syndrome. PACE 9: 1110–1114

    Article  PubMed  CAS  Google Scholar 

  25. Kannel WB, Abbott RD, Savage DD (1978) Epidemiological features of chronic atrial fibrillation: the Framingham study. N Engl J Med 306: 1018–1022

    Article  Google Scholar 

  26. Wolf PA, Kannel WB, McGee DL (1983) Duration of atrial fibrillation and imminence of stroke: the Framingham study. Stroke 14: 664–667

    Article  PubMed  CAS  Google Scholar 

  27. Perersen P, Madsen EB, Brun B (1987) Silent cerebral infarction in chronic atrial fibrillation. Stroke 18: 1098–1100

    Article  Google Scholar 

  28. Bathen JS, Rokseth R (1978) Embolism in sinoatrial disease. Acta Med Scand 203: 7–11

    Article  PubMed  CAS  Google Scholar 

  29. Baller D, Wolpers H, Zipfel J (1988) Comparison of the effects of right atrial, right ventricular apex and atrioventricular sequential pacing on myocardial oxygen consumption and cardiac efficiency: a laboratory investigation. PACE 11: 394–403

    Article  PubMed  CAS  Google Scholar 

  30. Edelstam C, Hjemdahl P, Pehrsson K, Aström H, Nordlander R (1990) Is DDD-pacing superior to WI-R? Effects on myocardial sympathetic activity and oxygen consumption. PACE 13: 1193

    Google Scholar 

  31. Kato R, Terasawa T, Gotoh T, Suzuki M (1988) Antiarrhythmic efficacy of atrial demand (AAI) and rate-responsive atrial pacing. In: Santini M, Pistolese M, Alliegro A (eds) Progress in clinical pacing. Excerpta Medica, Amsterdam, pp 15–24

    Google Scholar 

  32. Fairfax AJ, Lambert CD, Leatham A (1976) Systemic embolism in chronic sinoatrial disorder. N Engl J Med 295: 190–192

    Article  PubMed  CAS  Google Scholar 

  33. Ezekowitz M, Bridgers S, James K (1991) Interim analysis of the VA Cooperative study of stroke prevention in non rheumatic atrial fibrillation. Circulation 84/4 [Suppl II]: 450

    Google Scholar 

  34. The Boston area anticoagulation trial for atrial fibrillation investigators: the effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med 323:1505–1511

    Google Scholar 

  35. Rosenquist M, Obel IWP (1989) Atrial pacing and the risk vor AV block: is there a time for change in attitude? PACE 12: 97–101

    Google Scholar 

  36. Camm AJ, Katritsis D (1990) Ventricular pacing for sick sinus syndrome - a risky business? PACE 13: 695–699

    Article  PubMed  CAS  Google Scholar 

  37. Vardas P, Travill C, Wilhams M, Ingram A, Lightman S, Sutton R (1987) Atrial natriuretic peptide in complete atrioventricular block untreated and after VYI and DDD pacing. PACE 10: 990

    Google Scholar 

  38. Hull RW, Snow F, Herre J, Ellenbogen KA (1990) The plasma catecholamine responses to ventricular pacing: implications for rate-responsive pacing. PACE 13: 1408–1415

    Article  PubMed  CAS  Google Scholar 

  39. Edelstam C, Nordlander R, Wallgren E, Rosenquist M (1990) AAI-R pacing and exercise — what happens to AV conduction? PACE 13: 1193

    Google Scholar 

  40. Alt E, Völker R, Wirtzfeld A, Ulm K (1985) Survival and follow-up after pacemaker implantation: a comparison of patients with sick sinus syndrome, complete heart block and atrial fibrillation. PACE 8: 849–855

    Article  PubMed  CAS  Google Scholar 

  41. Stangl K, Wirtzfeld A, Alt E, Blömer H (1990) 30 Jahre Herzschrittmachertherapie: Eine Standortbestimmung. Z Kardiol 79: 383–395

    PubMed  CAS  Google Scholar 

  42. Kappenberger L, Hepes L (1986) Rate-responsive dual-chamber pacing. PACE 9: 1110

    Article  Google Scholar 

  43. Klementowicz P, Oseroff O, Anrews C, Furman S (1987) An analysis of DDD-pacing mode survival: the first 5 years. PACE 10: 409

    Google Scholar 

  44. Relay technical manual (1991) Intermedics Inc Freeport TX, USA

    Google Scholar 

  45. Ilvento J, Fee J, Shewmaker S (1990) Automatic mode switching from DDDR to WIR; a management algorithm for atrial arrhythmias in patients with dual-chamber pacemakers. Cardiostimulazione 8 /4: 256

    Google Scholar 

  46. Mugica J, Barold S, Ripart A (1991) The smart pacemaker. In: Barold SS, Mugica J (eds) New perspectives in cardiac pacing, vol 2. Futura, Mount Kisco, NY, p 545

    Google Scholar 

  47. Higano S, Hayes D, Eisinger G (1989) Sensor-driven rate smoothing in a DDD-R pacemaker. PACE 12: 922–929

    Article  PubMed  CAS  Google Scholar 

  48. Hayes D, Higano S, Eisinger G (1989) Electrocardiographic manifestations of a dualchamber, rate-modulated (DDDR) pacemaker. PACE 12: 555–561

    Article  PubMed  CAS  Google Scholar 

  49. Vogt P, Goy J, Kuh M (1988) Single- versus double-chamber rate-responsive cardiac pacing: comparison by cardiopulmonary noninvasive exercise testing. PACE 11: 1896–1901

    Article  PubMed  CAS  Google Scholar 

  50. Feuer J, Shandling A, Ellestad M (1990) Sensor-modulated dual-chamber pacing: too much of a good thing too fast? PACE 13: 816–818

    Article  PubMed  CAS  Google Scholar 

  51. Lau CP, Tai YT, Fong PC, Li JPS, Leung SK, Chung FLW, Song S: Clinical experience with an activity sensing DDDR pacemaker using an accelerometer sensor. PACE 15: 334–343 (1992)

    Article  PubMed  CAS  Google Scholar 

  52. Lau CP, Tai YT, Fong PC, Li JPS, Chung FLW, Song S: The use of implantable sensors for the control of pacemaker mediated tachycardias: a comparative evaluation between minute ventilation sensing and acceleration sensing dual chamber rate adaptive pacemakers. PACE 15: 34–44 (1992)

    Article  PubMed  CAS  Google Scholar 

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© 1993 Springer Verlag, Berlin Heidelberg

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Alt, E., Matula, M., Heinz, M. (1993). Indications for Implanting Rate-Adaptive Cardiac Pacemakers. In: Alt, E., Barold, S.S., Stangl, K. (eds) Rate Adaptive Cardiac Pacing. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76649-7_6

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  • DOI: https://doi.org/10.1007/978-3-642-76649-7_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-76651-0

  • Online ISBN: 978-3-642-76649-7

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