creators_name: Dell’Orto, Simonetta creators_name: Valli, Paolo creators_name: Greco, Enrico Maria editors_name: Singh, Balbir editors_name: Lokhandwala, Yash editors_name: Francis, Johnson editors_name: Gupta, Anup type: journalp datestamp: 2005-04-12 lastmod: 2011-03-11 08:55:54 metadata_visibility: show title: Sensors for Rate Responsive Pacing ispublished: pub subjects: ipej full_text_status: public keywords: rate responsive pacing, activity sensors, metabolic sensors, physical activity, biventricular pacing, implantable cardioverter defibrillator abstract: Advances in pacemaker technology in the 1980s have generated a wide variety of complex multiprogrammable pacemakers and pacing modes. The aim of the present review is to address the different rate responsive pacing modalities presently available in respect to physiological situations and pathological conditions. Rate adaptive pacing has been shown to improve exercise capacity in patients with chronotropic incompetence. A number of activity and metabolic sensors have been proposed and used for rate control. However, all sensors used to optimize pacing rate metabolic demands show typical limitations. To overcome these weaknesses the use of two sensors has been proposed. Indeed an unspecific but fast reacting sensor is combined with a more specific but slower metabolic one. Clinical studies have demonstrated that this methodology is suitable to reproduce normal sinus behavior during different types and loads of exercise. Sensor combinations require adequate sensor blending and cross checking possibly controlled by automatic algorithms for sensors optimization and simplicity of programming. Assessment and possibly deactivation of some automatic functions should be also possible to maximize benefits from the dual sensor system in particular conditions. This is of special relevance in patient whose myocardial contractility is limited such as in subjects with implantable defibrillators and biventricular pacemakers. The concept of closed loop pacing, implementing a negative feedback relating pacing rate and the control signal, will provide new opportunities to optimize dual-sensors system and deserves further investigation. The integration of rate adaptive pacing into defibrillators is the natural consequence of technical evolution. date: 2004-07 date_type: published publication: Indian Pacing and Electrophysiology Journal volume: 4 number: 3 publisher: Indian Pacing and Electrophysiology Group pagerange: 137-145 refereed: TRUE referencetext: 1. Fananapazir L, Bennett DH, Monks P. Contribution of the chronotropic responce to improved exercise performance. Pace 1983; 6:601-608. 2. Rossi P, Rognoni G, Ochetta E, et al. Respiration-dependent ventricular pacing compared with fixed ventricular and atrial-ventricular synchronous pacing. 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Pace 1998; 21:568-575. citation: Dell’Orto, Simonetta and Valli, Paolo and Greco, Enrico Maria (2004) Sensors for Rate Responsive Pacing. [Journal (Paginated)] document_url: http://cogprints.org/4194/1/greco.htm document_url: http://cogprints.org/4194/2/greco.pdf