Activity controlled cardiac pacemakers during stairwalking: a comparison of accelerometer with vibration guided devices and with sinus rate.
Activity controlled pacemakers are the most widely used rate adaptive systems. We studied second-generation activity controlled systems (accelerometer) in 21 patients with such an accelerometer controlled system implanted during walking level and stairs. We compared them to the rate of vibration controlled, first-generation activity pacemakers and to the sinus rate of a healthy control group. A metronome directed the speed during walking and climbing stairs at 92, 108, and 120 steps/min. At 92 steps/min, the new accelerometer controlled systems showed a significant (P < or = 0.001) pacing rate increase from 107 +/- 8 beats/min during walking level to 124 +/- 8 beats/min during climbing stairs, and a significant decrease to 105 +/- 12 beats/min during walking downstairs. In contrast, first-generation activity controlled pacemakers showed a less physiological rate behavior with higher pacing rate (113 +/- 7 beats/min) walking downstairs than walking upstairs (97 +/- 9). For everyday activities at normal walking speed, accelerometer controlled pacemakers show a more physiological rate behavior than first-generation pacemakers, but they lose this physiological response with faster walking.
Matula
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I. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Germany.
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D002304:Cardiac Pacing, Artificial / Q000379:methods*; D016022:Case-Control Studies; D004867:Equipment Design; D015444:Exercise / Q000502:physiology; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012984:Software; D014732:Vibration; D016138:Walking / Q000502:physiology*