ABSTRACT
Pacemaker therapy with rate responsive systems becomes increasingly more important. Numerous clinical and experimental trials have been conducted thus far to investigate different sensors of metabolic demands of the body, functioning independently of an atrial electrogram. To transform mechanical energy into electrical energy, activity-triggered systems utilize a piezo-quartz as their sensor. Thirty five patients suffering from pathological bradyarrhythmias and therefore from an inadequate increase of the heart rate during exercise were supplied with a Sensolog 703. Clinical follow-up was first performed with the help of treadmill ergometry, later on by walking on flat ground and climbing steps. The settings due to the first test caused inadequately high stimulation rates. A 24-h-Holter-ECG was necessary to control the programming and the rate profile in the patient's daily life. Using only the histogram and the rateread function, all rate adaptive parameters of the Sensolog 703 could be set by walking on flat ground and climbing steps. We defined a frequency of 75-85 min-1 to be appropriate during walking, respectively "low work." Individual programming ranged from 2-5/8-15/high-low/very fast-medium/fast-medium (slope, threshold, gain, reaction and recovery time). Reprogramming based on 24-h-Holter ECG was only necessary if the pacemaker was formerly adjusted with the help of treadmill ergometry. Besides, we observed an increase of the stimulation rate due to vibrations not related to exercise, e.g., by driving in a car.
