PMID: 7885940Dec 1, 1994Paper

Effect of chronotropic response pattern on oxygen kinetics

Pacing and Clinical Electrophysiology : PACE
S M DaileyG N Kay


The sinus node is considered to be the model of chronotropic response for pacemakers that use artificial rate modulating sensors. Maximal metabolic exercise testing with measurement of oxygen consumption (VO2) is frequently used to evaluate chronotropic response. Since activities of daily living are generally transient and involve submaximal effort, maximal exercise testing may not provide the most clinically relevant method of assessing rate modulation. The purpose of this study was to determine if an abrupt increase in heart rate (HR) at the onset of submaximal exercise provides improved oxygen kinetics compared with a linear response. Thirteen patients with complete heart block and permanent rate modulating pacemakers implanted following catheter ablation of the atrioventricular junction for refractory atrial fibrillation were chosen for study. The patients first completed a maximal treadmill exercise test using the chronotropic assessment exercise protocol with breath-by-breath analysis of expired gases. The expected HR at 50% of metabolic reserve was calculated for each patient. Three submaximal constant workload exercise tests were then performed at 50% of each patient's metabolic reserve, with the pacemaker randomly prog...Continue Reading


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