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Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications
Modern cardiac pacemakers are equipped with a function that allows the heart rate to adapt to the current needs of the patient in situations of increased demand related to exercise and stress ("rate-response" function). This function may be based on a variety of mechanisms, such as a built...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9920425/ https://www.ncbi.nlm.nih.gov/pubmed/36772467 http://dx.doi.org/10.3390/s23031427 |
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author | Świerżyńska, Ewa Oręziak, Artur Główczyńska, Renata Rossillo, Antonio Grabowski, Marcin Szumowski, Łukasz Caprioglio, Francesco Sterliński, Maciej |
author_facet | Świerżyńska, Ewa Oręziak, Artur Główczyńska, Renata Rossillo, Antonio Grabowski, Marcin Szumowski, Łukasz Caprioglio, Francesco Sterliński, Maciej |
author_sort | Świerżyńska, Ewa |
collection | PubMed |
description | Modern cardiac pacemakers are equipped with a function that allows the heart rate to adapt to the current needs of the patient in situations of increased demand related to exercise and stress ("rate-response" function). This function may be based on a variety of mechanisms, such as a built-in accelerometer responding to increased chest movement or algorithms sensing metabolic demand for oxygen, analysis of intrathoracic impedance, and analysis of the heart rhythm (Q-T interval). The latest technologies in the field of rate-response functionality relate to the use of an accelerometer in leadless endocavitary pacemakers; in these devices, the accelerometer enables mapping of the mechanical wave of the heart’s work cycle, enabling the pacemaker to correctly sense native impulses and stimulate the ventricles in synchrony with the cycles of atria and heart valves. Another modern system for synchronizing pacing rate with the patient’s real-time needs requires a closed-loop system that continuously monitors changes in the dynamics of heart contractions. This article discusses the technical details of various solutions for detecting and responding to situations related to increased oxygen demand (e.g., exercise or stress) in implantable pacemakers, and reviews the results of clinical trials regarding the use of these algorithms. |
format | Online Article Text |
id | pubmed-9920425 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99204252023-02-12 Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications Świerżyńska, Ewa Oręziak, Artur Główczyńska, Renata Rossillo, Antonio Grabowski, Marcin Szumowski, Łukasz Caprioglio, Francesco Sterliński, Maciej Sensors (Basel) Review Modern cardiac pacemakers are equipped with a function that allows the heart rate to adapt to the current needs of the patient in situations of increased demand related to exercise and stress ("rate-response" function). This function may be based on a variety of mechanisms, such as a built-in accelerometer responding to increased chest movement or algorithms sensing metabolic demand for oxygen, analysis of intrathoracic impedance, and analysis of the heart rhythm (Q-T interval). The latest technologies in the field of rate-response functionality relate to the use of an accelerometer in leadless endocavitary pacemakers; in these devices, the accelerometer enables mapping of the mechanical wave of the heart’s work cycle, enabling the pacemaker to correctly sense native impulses and stimulate the ventricles in synchrony with the cycles of atria and heart valves. Another modern system for synchronizing pacing rate with the patient’s real-time needs requires a closed-loop system that continuously monitors changes in the dynamics of heart contractions. This article discusses the technical details of various solutions for detecting and responding to situations related to increased oxygen demand (e.g., exercise or stress) in implantable pacemakers, and reviews the results of clinical trials regarding the use of these algorithms. MDPI 2023-01-27 /pmc/articles/PMC9920425/ /pubmed/36772467 http://dx.doi.org/10.3390/s23031427 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Świerżyńska, Ewa Oręziak, Artur Główczyńska, Renata Rossillo, Antonio Grabowski, Marcin Szumowski, Łukasz Caprioglio, Francesco Sterliński, Maciej Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications |
title | Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications |
title_full | Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications |
title_fullStr | Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications |
title_full_unstemmed | Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications |
title_short | Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications |
title_sort | rate-responsive cardiac pacing: technological solutions and their applications |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9920425/ https://www.ncbi.nlm.nih.gov/pubmed/36772467 http://dx.doi.org/10.3390/s23031427 |
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