A Comparison of Rate Response Performance in Pacemaker Patients With an Indication of Sinus Node Dysfunction

A Comparison of Rate Response Performance in Pacemaker Patients With an Indication of Sinus Node Dysfunction.

Providing ideal rate response to patients should improve their quality of life and ability to execute activities of daily living.

Medtronic pacemakers provide rate response pacing by utilizing dual zone programming to specify an "activities of daily living" (ADL) response rate and an "exertion" response rate. There is much data to support the target heart rate for an exercise response but the data to support the programming of the ADL rate is lacking.

Medtronic pacemakers provide rate response pacing by utilizing dual zone programming to specify an "activities of daily living" (ADL) response rate and an "exertion" response rate. There is much data to support the target heart rate for an exercise response but the data to support the programming of the ADL rate is lacking.

Unpublished Holter data from our center indicates that the ADL rate for most patients in our practice is between 50-70bpm rather than 95bpm. Moreover, this increased ADL rate may impact diastolic filling times and adversely impact cardiac output.

Inclusion Criteria:

• Diagnosis of hypertension
• Sinus node dysfunction
• New implantation of a dual chamber pacemaker due to symptomatic sinus dysfunction or chronotropic incompetence defined as exercise heart rate less than 100 beats per minute

Exclusion Criteria:

• Second or Third degree AV block
• Age less than 60 or greater than 95 years
• EF less than 45%
• Patients that are not ambulatory
• Persistent atrial fibrillation (atrial fibrillation lasting greater than 7 days)
• Permanent atrial fibrillation (atrial fibrillation lasting great than 1 year)