Rate-Adaptive Cardiac Pacing in Children Using a Minute Ventilation Biosensor

• Published in: Pacing and clinical electrophysiology 1990-12, Vol.13 (12), p.2108-2112
• Main Authors: YABEK, STEVEN M., WERNLY, JORGE, CHICK, THOMAS W., BERMAN JR, WILLIAM, McWILLIAMS, BENNIE
• Format: Article
• Language: English
• Subjects: Adult; Bradycardia - therapy; Cardiac Pacing, Artificial - methods; Child; Electric Conductivity; Electrodes, Implanted; Equipment Design; Female; Heart Rate - physiology; Humans; Male; minute ventilation; Oxygen Consumption - physiology; Pacemaker, Artificial; pediatric pacing; Physical Exertion - physiology; rate-adaptive pacing; Respiration - physiology; Tidal Volume - physiology; Time Factors
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.1990.tb06952.x

YABEK, S.M., ET AL.: Rate‐Adaptive Cardiac Pacing in Children Using a Minute Ventilation Biosensor.Chronotropic integrity is required for a normal cardiac output response to exercise. We evaluated a rate‐adaptive ventricular demand pacemaker (Telectronics, META‐MV) which uses minute ventilation as the sensed physiological variable for adjusting pacing rate, in seven young patients with a mean age of 11.4 years. All patients had clinically significant bradycardia related to complete heart block (n = 4) or sinus node dysfunction (n = 3). For the entire group, paced heart rates increased from 70 ± 10 beats/min to 151 ± 19 beats/min with exercise testing. The onset of rate adaptation took < 30 seconds. Changes in paced rate were linearly related to workload, VO2 (5.9 to 20.7 mL/min/kg) and minute ventilation (8–65 L/min). The decline in pacing rate after exercise was related directly to the gradual decrease in minute ventilation and VO2. Our data show that minute ventilation closely and accurately reflects the metabolic demands of varying workloads in children and can be used to achieve physiological, rate‐adaptive pacing.