Abstract
The need to adjust pacing rate to changing metabolic conditions has led to the development of different sensing systems that integrate the detection of atrial and ventricular electrical signals in permanent pacemakers [1]. All sensors currently available in the clinical setting assess the patient’s metabolic demand indirectly. This is the case for activity sensors, which generally detect the intensity of body motion by an accelerometer, as well as for physiological sensors, which are sensitive to cardiac or respiratory parameters physiologically correlated to the cardiac rate. The activity sensors usually show good sensitivity and prompt rate-response, but may lack specificity, since they cannot distinguish between active and passive motion. Respiratory sensors are more specific, but they show a slow response, resulting in little sensitivity towards the rapid, small changes in a patient’s activity which normally occur in daily life [2]. Cardiac sensors have to present the best compromise between sentivity and speciaficity, since the different aspects of cardiac function are regulated at the same time by the same controller, the autonomic nervous system (ANS). In patients with chronotropic incompetence, a pacemaker would restore normal rate control on the basis of relative changes in the inotropic, dromotropic, or bathmotropic regulation of the heart [3].
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Occhetta, E., Magnani, A., Bortnik, M., Francalacci, G., Di Gregorio, F., Vassanelli, C. (2004). Hemodynamic Sensors: Their Impact in Clinical Practice. In: Raviele, A. (eds) Cardiac Arrhythmias 2003. Springer, Milano. https://doi.org/10.1007/978-88-470-2137-2_94
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DOI: https://doi.org/10.1007/978-88-470-2137-2_94
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