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Assessment of adaptive rate response provided by accelerometer, minute ventilation and dual sensor compared with normal sinus rhythm during exercise: a self-controlled study in chronotropically competent subjects.

Cao Y, Zhang Y, Su Y, Bai J, Wang W, Ge J - Chin. Med. J. (2015)

Bottom Line: For these patients, sensor response factors were left at default settings (ACC = 8, MV = 3) and sensor indicated rates (SIRs) for DS, ACC and MV sensor were retrieved from the pacemaker memories, along with measured sinus node (SN) rates from the beginning to 1-minute after the end of the treadmill test, and compared among study groups.The DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors (ACC or MV sensor).Further study is needed to determine if individual optimization would further improve adaptive performance of the DS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.

ABSTRACT

Background: Dual sensor (DS) for rate adaption was supposed to be more physiological. To evaluate its superiority, the DS (accelerometer [ACC] and minute ventilation [MV]) and normal sinus rate response were compared in a self-controlled way during exercise treadmill testing.

Methods: This self-controlled study was performed in atrioventricular block patients with normal sinus function who met the indications of pacemaker implant. Twenty-one patients came to the 1-month follow-up visit. Patients performed a treadmill test 1-month post implant while programmed in DDDR and sensor passive mode. For these patients, sensor response factors were left at default settings (ACC = 8, MV = 3) and sensor indicated rates (SIRs) for DS, ACC and MV sensor were retrieved from the pacemaker memories, along with measured sinus node (SN) rates from the beginning to 1-minute after the end of the treadmill test, and compared among study groups. Repeated measures analysis of variance and profile analysis, as well as variance analysis of randomized block designs, were used for statistical analysis.

Results: Fifteen patients (15/21) were determined to be chronotropically competent. The mean differences between DS SIRs and intrinsic sinus rates during treadmill testing were smaller than those for ACC and MV sensor (mean difference between SIR and SN rate: ACC vs. SN, MV vs. SN, DS vs. SN, respectively, 34.84, 17.60, 16.15 beats/min), though no sensors could mimic sinus rates under the default settings for sensor response factor (ACC vs. SN P-adjusted < 0.001; MV vs. SN P-adjusted = 0.002; DS vs. SN P-adjusted = 0.005). However, both in the range of 1 st minute and first 3 minutes of exercise, only the DS SIR profile did not differ from sinus rates (P-adjusted = 0.09, 0.90, respectively).

Conclusions: The DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors (ACC or MV sensor). Further study is needed to determine if individual optimization would further improve adaptive performance of the DS.

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Related in: MedlinePlus

Profile analysis of the heart rate variations of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates measured at discrete time points during treadmill test: Onset, the onset of treadmill test; 1 min, 1 minute after test began; 2 min, 2 minutes after test began; 3 min, 3 minutes after test began; peak time, the time point to peak sinus rate; end, the end of the treadmill test; 1 minute after, 1 min after the end of test.
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Figure 1: Profile analysis of the heart rate variations of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates measured at discrete time points during treadmill test: Onset, the onset of treadmill test; 1 min, 1 minute after test began; 2 min, 2 minutes after test began; 3 min, 3 minutes after test began; peak time, the time point to peak sinus rate; end, the end of the treadmill test; 1 minute after, 1 min after the end of test.

Mentions: Figure 1 shows profiles of ACC, MV and DS SIRs and the corresponding intrinsic sinus rates during the treadmill testing, averaged across the patient pool at seven fixed time points as follows: At onset of the treadmill testing, then 1, 2, and 3 minutes after onset, the time of peak sinus rate, the end of the treadmill testing, and 1 minute after the test. None of the three SIR profiles was statistically similar to intrinsic rate profile (ACC vs. SN P-adjusted < 0.001; MV vs. SN P-adjusted = 0.002; DS vs. SN P-adjusted = 0.005; Table 2), but the mean difference between the DS and sinus rate profiles was smaller (mean difference between SIR and SN rate: ACC vs. SN, MV vs. SN, DS vs. SN, respectively, 34.84, 17.60, 16.15 beats/min; Table 2). SIR profiles for ACC and DS were significantly different while SIR profiles for MV and DS were similar (ACC vs. DS P-adjusted = 0.001, MV vs. DS P-adjusted > 0.99; Table 2). In the first 3 min of the test, there were no significant differences between SIRs for DS and MV vs. intrinsic sinus rates (DS vs. SN, P-adjusted = 0.90; MV vs. SN, P-adjusted = 0.33; Table 3). On the contrary, significant differences were observed between ACC SIRs and intrinsic sinus rates (ACC vs. SN, P-adjusted = 0.005; Table 3).


Assessment of adaptive rate response provided by accelerometer, minute ventilation and dual sensor compared with normal sinus rhythm during exercise: a self-controlled study in chronotropically competent subjects.

Cao Y, Zhang Y, Su Y, Bai J, Wang W, Ge J - Chin. Med. J. (2015)

Profile analysis of the heart rate variations of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates measured at discrete time points during treadmill test: Onset, the onset of treadmill test; 1 min, 1 minute after test began; 2 min, 2 minutes after test began; 3 min, 3 minutes after test began; peak time, the time point to peak sinus rate; end, the end of the treadmill test; 1 minute after, 1 min after the end of test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837815&req=5

Figure 1: Profile analysis of the heart rate variations of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates measured at discrete time points during treadmill test: Onset, the onset of treadmill test; 1 min, 1 minute after test began; 2 min, 2 minutes after test began; 3 min, 3 minutes after test began; peak time, the time point to peak sinus rate; end, the end of the treadmill test; 1 minute after, 1 min after the end of test.
Mentions: Figure 1 shows profiles of ACC, MV and DS SIRs and the corresponding intrinsic sinus rates during the treadmill testing, averaged across the patient pool at seven fixed time points as follows: At onset of the treadmill testing, then 1, 2, and 3 minutes after onset, the time of peak sinus rate, the end of the treadmill testing, and 1 minute after the test. None of the three SIR profiles was statistically similar to intrinsic rate profile (ACC vs. SN P-adjusted < 0.001; MV vs. SN P-adjusted = 0.002; DS vs. SN P-adjusted = 0.005; Table 2), but the mean difference between the DS and sinus rate profiles was smaller (mean difference between SIR and SN rate: ACC vs. SN, MV vs. SN, DS vs. SN, respectively, 34.84, 17.60, 16.15 beats/min; Table 2). SIR profiles for ACC and DS were significantly different while SIR profiles for MV and DS were similar (ACC vs. DS P-adjusted = 0.001, MV vs. DS P-adjusted > 0.99; Table 2). In the first 3 min of the test, there were no significant differences between SIRs for DS and MV vs. intrinsic sinus rates (DS vs. SN, P-adjusted = 0.90; MV vs. SN, P-adjusted = 0.33; Table 3). On the contrary, significant differences were observed between ACC SIRs and intrinsic sinus rates (ACC vs. SN, P-adjusted = 0.005; Table 3).

Bottom Line: For these patients, sensor response factors were left at default settings (ACC = 8, MV = 3) and sensor indicated rates (SIRs) for DS, ACC and MV sensor were retrieved from the pacemaker memories, along with measured sinus node (SN) rates from the beginning to 1-minute after the end of the treadmill test, and compared among study groups.The DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors (ACC or MV sensor).Further study is needed to determine if individual optimization would further improve adaptive performance of the DS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.

ABSTRACT

Background: Dual sensor (DS) for rate adaption was supposed to be more physiological. To evaluate its superiority, the DS (accelerometer [ACC] and minute ventilation [MV]) and normal sinus rate response were compared in a self-controlled way during exercise treadmill testing.

Methods: This self-controlled study was performed in atrioventricular block patients with normal sinus function who met the indications of pacemaker implant. Twenty-one patients came to the 1-month follow-up visit. Patients performed a treadmill test 1-month post implant while programmed in DDDR and sensor passive mode. For these patients, sensor response factors were left at default settings (ACC = 8, MV = 3) and sensor indicated rates (SIRs) for DS, ACC and MV sensor were retrieved from the pacemaker memories, along with measured sinus node (SN) rates from the beginning to 1-minute after the end of the treadmill test, and compared among study groups. Repeated measures analysis of variance and profile analysis, as well as variance analysis of randomized block designs, were used for statistical analysis.

Results: Fifteen patients (15/21) were determined to be chronotropically competent. The mean differences between DS SIRs and intrinsic sinus rates during treadmill testing were smaller than those for ACC and MV sensor (mean difference between SIR and SN rate: ACC vs. SN, MV vs. SN, DS vs. SN, respectively, 34.84, 17.60, 16.15 beats/min), though no sensors could mimic sinus rates under the default settings for sensor response factor (ACC vs. SN P-adjusted < 0.001; MV vs. SN P-adjusted = 0.002; DS vs. SN P-adjusted = 0.005). However, both in the range of 1 st minute and first 3 minutes of exercise, only the DS SIR profile did not differ from sinus rates (P-adjusted = 0.09, 0.90, respectively).

Conclusions: The DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors (ACC or MV sensor). Further study is needed to determine if individual optimization would further improve adaptive performance of the DS.

Show MeSH
Related in: MedlinePlus