The contribution of rate adaptive pacing with single or dual sensors to health-related quality of life

Hemel, Norbert M. van; Holwerda, Klaas J.; Slegers, Paul C.; Spierenburg, Han A. M.; Timmermans, Alphons A J M; Meeder, Joan G.; Kemp, Peter van der; Kelder, Johannes C.; Stofmeel, Monique A.M.

doi:10.1093/europace/eum021

Cited by 27 publications

(18 citation statements)

References 27 publications

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“…In this study there was no association between Vp and HRQoL after pacemaker implantation. Hemel et al [22] came to similar conclusions in their study, which demonstrated no association between percentage of QRS complexes generated at the preset stimulation rate (DDDR mode) and HRQoL. Interpretation of the results of above clinical trials regarding lack of impact of percentage of Vp on HRQoL is only seemingly straight-forward.…”

Section: Discussionmentioning

confidence: 53%

Czynniki warunkujące jakość życia po implantacji kardiostymulatora

Kostkiewicz

Kostkiewicz²,

Ostafińska-Molik

et al. 2019

Folia Cardiologica

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Introduction. Health-related quality of life (HRQoL) after pacemaker (PM) implantation has been studied according to stimulation mode and indications, however these do not fully explain HRQoL changes. Aim of the study is to evaluate other factors. Materials and methods. Single-center, prospective, observational study on 101 adult PM-recipients, with no periprocedural complications was performed. The study group was surveyed twice: periprocedural and 18 month follow-up (FU). Nottingham Health Profile to evaluate general HRQoL was performed. 83 participants completed full study protocol. Comparative analysis (periprocedural vs. end-of-FU) was performed to measure relationship between HRQoL-change and gender, place of residence, disability level, physical activity, level of care and support, BMI, diet, percentage of atrial and ventricular pacing (Ap&Vp), symptoms associated with rhythm and conduction disorders, severity of coronary heart disease and heart failure. Results. Total HRQoL improvement occurred for the rural residents, obese and Vp > 79%. The study group improved significantly in two HRQoL domains: emotional reactions (E.R.) and sleep disorders (S.D.). Analyzing specific HRQoL domains (energy, pain, E.R.S.D. social alienation, movement limitations) improved patients are: female, self-mobile, high level of care and support, eating habits-changers, without syncope and angina symptoms. Age and body mass index (BMI) were identified as factors changing HRQoL-improving domain. Conclusions. The improvement of HRQoL after PM implantation seems to be mainly related to S.D. and E.R. Important factors influencing HRQoL change are: place of residence, BMI and Vp. This impact of PM implantation on HRQoL requires further study

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Section: Discussionmentioning

confidence: 53%

Czynniki warunkujące jakość życia po implantacji kardiostymulatora

Kostkiewicz

Kostkiewicz²,

Ostafińska-Molik

et al. 2019

Folia Cardiologica

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“…However, there is evidence to suggest that MV sensor driven rate-adaptive pacing may provide a more physiologic heart rate response than accelerometer alone [10]. Whether this improved heart rate profile provided by MV sensor driven pacing translates into a greater functional capacity is ill-defined and previous studies evaluating the benefit of rate-modulated pacing on endpoints such as quality of life have been mixed [8,29,30]. Several issues may contribute to the varied outcomes of previous trials.…”

Section: Discussionmentioning

confidence: 99%

Design and Rationale of the Assessment of Proper Physiologic Response with Rate Adaptive Pacing Driven by Minute Ventilation or Accelerometer (APPROPRIATE) Trial

Gilliam¹,

Giudici

Benn

et al. 2010

J. of Cardiovasc. Trans. Res.

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Rate-adaptive sensors are designed to restore a physiologic heart rate response to activity, in particular for patients that have chronotropic incompetence (CI). Limited data exist comparing two primary types of sensors; an accelerometer (XL) sensor which detects activity or motion and a minute ventilation (MV) sensor, which detects the product of respiration rate and tidal volume. The APPROPRIATE study will evaluate the MV sensor compared with the XL sensor for superiority in improving functional capacity (peak VO(2)) in pacemaker patients that have CI. This study is a double-blind, randomized, two-arm trial that will enroll approximately 1,000 pacemaker patients. Patients will complete a 6-min walk test at the 2-week visit to screen for potential CI. Those projected to have CI will advance to a 1-month visit. At the 1-month visit, final determination of CI will be done by completing a peak exercise treadmill test while the pacemaker is programmed to DDDR with the device sensors set to passive. Patients failing to meet the study criteria for CI will not continue further in the trial. Patients that demonstrate CI will be randomized to program their rate-adaptive sensors to either MV or XL in a 1:1 ratio. The rate-adaptive sensor will be optimized for each patient using a short walk to determine the appropriate response factor. At a 2-month visit, patients will complete a CPX test with the rate-adaptive sensors in their randomized setting.

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“…This pilot study provides information on the patho‐physiological effects of different pacing rates on regional and global MBF in patients with normal left ventricular (LV) function. Insight toward possible rate‐dependent changes of regional MBF is of importance to understand one of the reasons of the variable outcome of rate‐adaptive pacing introduced to increase heart rate corresponding to metabolic demand and level of exercise 9 . To explore rate‐dependent changes of regional MBF, we examined the effects of variation of atrial or ventricular pacing rates on quantitative global and regional MBF in patients with normal LV contraction using H 2 15 O positron emission tomography (PET).…”

Section: Introductionmentioning

confidence: 99%

Effects of Pacing Rates on Global and Regional Myocardial Blood Flow

Cate

Knaapen²,

Lammertsma

et al. 2011

Pacing Clinical Electrophis

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During both acute atrial and RVA pacing, regional and global MBF increases with higher pacing rates. However, the septal to lateral MBF ratio decreases with atrial pacing and increases with RVA pacing in patients with normal LV function. In RVA pacing, these different rate-dependent effects on regional MBF can be considered as a favorable factor that helps to understand why in some long-term paced patients, LV function is preserved.

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The contribution of rate adaptive pacing with single or dual sensors to health-related quality of life

Abstract: 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.

Cited by 27 publications

References 27 publications

Czynniki warunkujące jakość życia po implantacji kardiostymulatora

Czynniki warunkujące jakość życia po implantacji kardiostymulatora

Design and Rationale of the Assessment of Proper Physiologic Response with Rate Adaptive Pacing Driven by Minute Ventilation or Accelerometer (APPROPRIATE) Trial

Effects of Pacing Rates on Global and Regional Myocardial Blood Flow

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