Physiological rate adaptation in a child with chronotropic incompetence through closed-loop stimulation using epicardial leads

Pino, Alfredo Di; Caruso, Elio; Censi, Federica; Gaudenti, Gianfranco; Gargaro, Alessio

doi:10.1016/j.hrcr.2015.07.012

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…In clinical trials comparing the effectiveness of CLS and RDR in preventing vasovagal syncope, superior efficacy of CLS devices has been evidenced [ 102 ]. This effect was also observed in patients with an epicardial lead [ 107 ]. Consequently, in the latest European Society of Cardiology (ESC) 2021 pacing guidelines, the implantation of a CLS pacemaker in patients >40 years of age with severe, recurrent, unpredictable reflex syncope caused by asystole was placed in class I indications (recommended) [ 34 , 108 ].…”

Section: Rate Response In Implantable Cardiac Pacemakersmentioning

confidence: 57%

Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications

Świerżyńska

Oręziak

Główczyńska

et al. 2023

Sensors

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Modern cardiac pacemakers are equipped with a function that allows the heart rate to adapt to the current needs of the patient in situations of increased demand related to exercise and stress ("rate-response" function). This function may be based on a variety of mechanisms, such as a built-in accelerometer responding to increased chest movement or algorithms sensing metabolic demand for oxygen, analysis of intrathoracic impedance, and analysis of the heart rhythm (Q-T interval). The latest technologies in the field of rate-response functionality relate to the use of an accelerometer in leadless endocavitary pacemakers; in these devices, the accelerometer enables mapping of the mechanical wave of the heart's work cycle, enabling the pacemaker to correctly sense native impulses and stimulate the ventricles in synchrony with the cycles of atria and heart valves. Another modern system for synchronizing pacing rate with the patient's real-time needs requires a closed-loop system that continuously monitors changes in the dynamics of heart contractions. This article discusses the technical details of various solutions for detecting and responding to situations related to increased oxygen demand (e.g., exercise or stress) in implantable pacemakers, and reviews the results of clinical trials regarding the use of these algorithms.

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Section: Rate Response In Implantable Cardiac Pacemakersmentioning

confidence: 57%

Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications

Świerżyńska

Oręziak

Główczyńska

et al. 2023

Sensors

View full text Add to dashboard Cite

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Effective Pacing Intervention by Closed-loop Stimulation Using a Coronary Vein Lead in a Post-tricuspid Valve Replacement Patient

et al. 2020

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To avoid the negative effects associated with pacing, pacemakers are designed to achieve a pacing cadence as close to physiological pacing as possible. In closed-loop stimulation (CLS; a type of rate-responsive functionality used in pacemakers), the changes in impedance (which correlates with the contractility of the myocardium around the lead tip electrode) are tracked, and the paced heart rate is adjusted accordingly. We herein report a case in which we implanted a pacemaker in a post-tricuspid valve replacement patient. A ventricular lead positioned in the coronary vein exhibited good CLS functionality, and the patient's dizziness and heart failure improved.

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Physiological rate adaptation in a child with chronotropic incompetence through closed-loop stimulation using epicardial leads

Cited by 2 publications

References 7 publications

Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications

Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications

Effective Pacing Intervention by Closed-loop Stimulation Using a Coronary Vein Lead in a Post-tricuspid Valve Replacement Patient

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