Closed Loop Stimulation is Effective in Improving Heart Rate and Blood Pressure Response to Mental Stress: Report of a Single-Chamber Pacemaker Study in Patients with Chronotropic Incompetent Atrial Fibrillation.
In: Pacing & Clinical Electrophysiology, Jg. 35 (2012-08-01), Heft 8, S. 990-998
Online
academicJournal
Zugriff:
Introduction: Closed-loop stimulation (CLS) is a form of rate-adaptive pacing capable of providing an effective pacing rate profile not only during physical exercise but also during mental stress. To test its effectiveness, CLS and accelerometer sensor (AS) rate response were compared intraindividually during a mental stress test (MST). Methods: Thirty-six patients (mean age 78.9 ± 6.4 years) implanted with a pacemaker with the CLS algorithm (Cylos, Biotronik, Berlin, Germany) underwent MSTs in different pacing configurations: nonrate-adaptive mode (VVI), AS mode (VVIR), and CLS mode, respectively. A modified Stroop test was used in order to induce mental stress. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure, and pacing percentage burden were collected for 5 minutes before, during, and 5 minutes after the test. Results: Mean peak-HR during MST was significantly higher in CLS configuration than in VVIR and VVI modes (92.8 ± 12.6 vs 78.9 ± 6.5 vs 77.8 ± 7.5; P ≤ 0.001). The average HR increase during MST was also higher in CLS configuration than in VVIR and VVI modes (22.7 ± 16.7 vs 8.2 ± 8.6 vs 6.6 ± 6.3; P ≤ 0.001). The percentage of pacing beats during MST was higher in CLS configuration than with the other two algorithms (48.4 ± 17.9 vs 27.4 ± 17.5 vs 25.8 ± 17.6; P ≤ 0.001). The average peak-SBP was significantly higher during MST in CLS mode than in VVIR and VVI configurations (172.6 ± 15.5 vs 156.7 ± 12.2 vs 145.5 ± 13.7; P ≤ 0.001). The mean SBP increase showed a similar behavior (51.8 ± 24.7 vs 18.4 ± 13.7 vs 16.4 ± 10.3; P ≤ 0.001). Conclusion: CLS algorithm in a single-chamber device is more effective than AS in detecting an hemodynamic demand due to an emotional stress and supplying a proper HR increase. These results are even more surprising compared to previous data in dual-chamber pacemakers, because they imply that CLS algorithm can provide an appropriate rate-modulation in patients with AF and chronotropic incompetence. (PACE 2012; 35:990-998) [ABSTRACT FROM AUTHOR]
Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Closed Loop Stimulation is Effective in Improving Heart Rate and Blood Pressure Response to Mental Stress: Report of a Single-Chamber Pacemaker Study in Patients with Chronotropic Incompetent Atrial Fibrillation.
|
---|---|
Autor/in / Beteiligte Person: | PROIETTI, RICCARDO ; MANZONI, GIANMAURO ; DI BIASE, LUIGI ; CASTELNUOVO, GIANLUCA ; LOMBARDI, LEONIDA ; FUNDARÒ, CAMILLA ; VEGLIANTE, NADIA ; PIETRABISSA, GIADA ; SANTANGELI, PASQUALE ; CANBY, ROBERT A. ; SAGONE, ANTONIO ; VIECCA, MAURIZIO ; NATALE, ANDREA |
Link: | |
Zeitschrift: | Pacing & Clinical Electrophysiology, Jg. 35 (2012-08-01), Heft 8, S. 990-998 |
Veröffentlichung: | 2012 |
Medientyp: | academicJournal |
ISSN: | 0147-8389 (print) |
DOI: | 10.1111/j.1540-8159.2012.03445.x |
Schlagwort: |
|
Sonstiges: |
|