Limits...
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.

Show MeSH

Related in: MedlinePlus

Average rates of change of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates in different stages of exercise: Onset -1 min, in 1st minute after the onset of treadmill test; 1–2 min, in 2nd minute after onset of test; 2–3 min, in 3rd minute after the onset of treadmill test; 3 min-peak, the time ranging from the 3rd minute to the time of peak sinus rate; end -1 min after, in 1st minute after the end of test (*P < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4837815&req=5

Figure 2: Average rates of change of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates in different stages of exercise: Onset -1 min, in 1st minute after the onset of treadmill test; 1–2 min, in 2nd minute after onset of test; 2–3 min, in 3rd minute after the onset of treadmill test; 3 min-peak, the time ranging from the 3rd minute to the time of peak sinus rate; end -1 min after, in 1st minute after the end of test (*P < 0.05).

Mentions: Average rates of change of ACC, MV, DS SIRs and the intrinsic sinus rate in the 1st, 2nd, and 3rd minute of the treadmill testing, between the 3rd minute and the time of peak sinus rate, and in the 1st minute after the test were calculated and shown in Tables 4, 5 and Figure 2. Sinus rates, in the 1st minute of the exercise, increased rapidly with an average increment of (26 ± 10) beats/min. The subsequent average increments became smaller and smaller, (12 ± 12) beats/min in the 2nd min, (6 ± 4) beats/min in the 3rd min. Sinus rates were still increasing after the 3rd min and before the peak time with an average change of (9 ± 5) beats/min. In the 1st minute after the end of exercise, the sinus rates decreased with an average value of (37 ± 7) beats/min. In the 1st minute of the exercise, the ACC SIRs increased to a similar extent as the sinus rates ([21 ± 18] vs. [26 ± 10] beats/min; P-adjusted = 0.474). After that, the rates of change of ACC sensor and SN diverged. MV SIRs increased to a similar extent as sinus rates during the 2nd and 3rd minute of the exercise (both P-adjusted > 0.99) but exhibited a significantly less pronounced increase than sinus rates in the 1st minute (P-adjusted = 0.002). No significant differences of rate increase in the first 3 minute of exercise were observed between DS and SN (P-adjusted one by one in the 1st, 2nd, 3rd minute: 0.09, >0.99, >0.99). The average rates of change of MV and DS SIRs after the 3rd minute were significant different from sinus rates, including the 1st minute after the end of the test (all P-adjusted < 0.001).


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)

Average rates of change of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates in different stages of exercise: Onset -1 min, in 1st minute after the onset of treadmill test; 1–2 min, in 2nd minute after onset of test; 2–3 min, in 3rd minute after the onset of treadmill test; 3 min-peak, the time ranging from the 3rd minute to the time of peak sinus rate; end -1 min after, in 1st minute after the end of test (*P < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Average rates of change of accelerometer, minute ventilation and dual sensor sensor indicated rate, and intrinsic sinus rates in different stages of exercise: Onset -1 min, in 1st minute after the onset of treadmill test; 1–2 min, in 2nd minute after onset of test; 2–3 min, in 3rd minute after the onset of treadmill test; 3 min-peak, the time ranging from the 3rd minute to the time of peak sinus rate; end -1 min after, in 1st minute after the end of test (*P < 0.05).
Mentions: Average rates of change of ACC, MV, DS SIRs and the intrinsic sinus rate in the 1st, 2nd, and 3rd minute of the treadmill testing, between the 3rd minute and the time of peak sinus rate, and in the 1st minute after the test were calculated and shown in Tables 4, 5 and Figure 2. Sinus rates, in the 1st minute of the exercise, increased rapidly with an average increment of (26 ± 10) beats/min. The subsequent average increments became smaller and smaller, (12 ± 12) beats/min in the 2nd min, (6 ± 4) beats/min in the 3rd min. Sinus rates were still increasing after the 3rd min and before the peak time with an average change of (9 ± 5) beats/min. In the 1st minute after the end of exercise, the sinus rates decreased with an average value of (37 ± 7) beats/min. In the 1st minute of the exercise, the ACC SIRs increased to a similar extent as the sinus rates ([21 ± 18] vs. [26 ± 10] beats/min; P-adjusted = 0.474). After that, the rates of change of ACC sensor and SN diverged. MV SIRs increased to a similar extent as sinus rates during the 2nd and 3rd minute of the exercise (both P-adjusted > 0.99) but exhibited a significantly less pronounced increase than sinus rates in the 1st minute (P-adjusted = 0.002). No significant differences of rate increase in the first 3 minute of exercise were observed between DS and SN (P-adjusted one by one in the 1st, 2nd, 3rd minute: 0.09, >0.99, >0.99). The average rates of change of MV and DS SIRs after the 3rd minute were significant different from sinus rates, including the 1st minute after the end of the test (all P-adjusted < 0.001).

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