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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...

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Autores principales: Świerżyńska, Ewa, Oręziak, Artur, Główczyńska, Renata, Rossillo, Antonio, Grabowski, Marcin, Szumowski, Łukasz, Caprioglio, Francesco, Sterliński, Maciej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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