Comparison of two activity-controlled rate-adaptive pacing principles: acceleration versus vibration.
Activity-guided rate-adaptive pacing is currently the most widely used principle for rate adaptation. Broad experience has been gathered from several hundred thousand pacemakers that adjust the pacing rate according to vibrational forces detected by a piezosensor bonded to the inner side of the pacemaker can. A new generation of accelerometer-based pacemakers has been introduced into clinical practice. The vibrational type detects vibration, pressure, and shock waves traveling through the body with physical stress and using the pacemaker can as a resonator. In contrast, the accelerometer is insulated from the pacemaker housing and is incorporated into electronic hybrid circuitry. The forces detected by an accelerometer are motion and acceleration of the body in an anterior-posterior direction. Clinical studies conducted to date have shown that the accelerometer to be superior to the conventional vibration activity pacemakers, as far as the discrimination of different workloads and rejection of unwanted environmental noise are concerned.
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I. Medical Clinic, Rechts der Isar Medical Center, Technical University of Munich, Germany.
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D000054:Acceleration; D000465:Algorithms; D004562:Electrocardiography / Q000295:instrumentation*; D004567:Electrodes, Implanted; D004867:Equipment Design; D006329:Heart Conduction System / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D010138:Pacemaker, Artificial; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D013610:Tachycardia / Q000503:physiopathology; D014732:Vibration