The contribution of rate adaptive pacing with single or dual sensors to health-related quality of life.
OBJECTIVE
The characteristics of sensors to perform rate adaptive pacing are well established but whether their contribution improves health-related quality of life (QoL) remains disputable. To compare the effects on QoL with an integrated dual sensor [minute ventilation (MV) and acceleration, TT sensor] with a single MV sensor, and with no rate adaptive pacing.


RESULTS
This Dutch multi centre, prospective, single- (patient) blind study was performed in patients after first pacemaker (PM) implant for sick sinus syndrome or AV block. After a 3-month 'sensor off'-period following DDD PM implantation, where the latter 2 months permitted the MV sensor to learn the intrinsic rhythm, a 2-month period of DDDR with TT sensor or 2 months of DDDR with MV sensor, subsequently the two modes were crossed over. Quality of life was determined with Aquarel, the disease-specific instrument for PM patients. Heart rate, percentages of sensor driven and intrinsic rhythm were retrieved from PM memories. Sixty-four patients completed the 7-month study. In sick sinus patients, percentages of sensor-driven pacing occurred significantly more frequently than in AV block patients After implant QoL improved significantly: before 71.3 and after 83.5% (P < 0.001) measured with Aquarel and in 3 of 9 SF-36 scales, but no significant additive QoL benefit with dual or MV sensor pacing was observed. Pacing diagnosis, percentages of rate adaptive pacing, and heart rate influencing medication did not influence this result.


CONCLUSIONS
Pacemaker implantation strongly improves QoL, but neither single- nor dual- sensor-driven pacing offered additional improvement in QoL during the initial 8 months after the first PM implant.
van Hemel
Norbert M
NM
Rodger Crowson Foundation for Cardiac Arrhythmias Studies, 3984 PC Odijk, The Netherlands. n.m.vanhemel@hetnet.nl
Holwerda
Klaas J
KJ
Slegers
Paul C
PC
Spierenburg
Han A M
HA
Timmermans
Alphons A J M
AA
Meeder
Joan G
JG
van der Kemp
Peter
P
Kelder
Johannes C
JC
Stofmeel
Monique A M
MA
D000328:Adult; D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000706:statistics & numerical data*; D005260:Female; D006327:Heart Block / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000379:methods; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012804:Sick Sinus Syndrome / Q000453:epidemiology* / Q000517:prevention & control*; D016037:Single-Blind Method; D016896:Treatment Outcome