Clinical Performance of Automatic Closed‐Loop Stimulation Systems
Identifieur interne : 001366 ( Istex/Corpus ); précédent : 001365; suivant : 001367Clinical Performance of Automatic Closed‐Loop Stimulation Systems
Auteurs : Lothar Griesbach ; Brigitta Gestrich ; Dariusz Wojciechowski ; Georg Weyers ; Jürgen Tönges ; Matthias Schier ; Dejan DanilovicSource :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 2003-07.
English descriptors
Abstract
Inos pacemakers use contraction dynamics to regulate the pacing rate according to the Closed‐Loop Stimulation (CLS) principle. The physician can program only the lower and upper rate limits, while the internal rate responsive parameters are continually adjusted to changing patient conditions. Seventy‐two patients with sinus node disease were enrolled in the multicenter Rate Behavior of the Pacing System Inos2 CLS during Daily Life (RAPID) study to evaluate the appropriateness of CLS rates during daily activities and the long‐term stability of the system. The pacemakers clearly differentiated between climbing stairs, descending stairs, and slow walking, with the corresponding peak rates of 104 ± 18, 95 ± 15 , and 88 ± 11 beats/min , respectively ( P < 0.001 for any pair of activities). The peak CLS rate during the color‐word test was significantly higher than that at rest ( 80 ± 8 vs 67 ± 7 beats/min, P = 0.002 ). The 24‐hour heart rate trends retrieved from the pacemaker memory at 3, 6, and 12 months after implantation appeared appropriate in all patients except for two whose pacing rates were occasionally too fast during the night. Mean diurnal and nocturnal rates determined at 3‐month, 6‐month, and 12‐month examinations fluctuated only slightly, from 74.6–75.3 beats/min (diurnal, P = NS ) and from 67.0–68.1 beats/min (nocturnal, P = NS ), indicating a satisfactory long‐term stability of the system. The incidence of atrial pacing events during the entire follow‐up was 82 ± 18% . A 6.5–8.3 beats/min difference, on average, between day and night (P < 0.001) and distinction between different daily activities seem to evidence sensitivity of the automatic CLS‐driven pacemakers to physiological demands despite minimum programming requirements. (PACE 2003; 26[Pt. I]:1432–1437)
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DOI: 10.1046/j.1460-9592.2003.t01-1-00207.x
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ISTEX:1583C3778EB547778540C8BBB5D1700C3A115D5CLe document en format XML
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Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Futura Publishing, Inc.</publisher><pubPlace>350 Main Street , Malden , MA 02148‐5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK .</pubPlace><date type="published" when="2003-07">2003-07</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">7p1</biblScope><biblScope unit="page" from="1432">1432</biblScope><biblScope unit="page" to="1437">1437</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">1583C3778EB547778540C8BBB5D1700C3A115D5C</idno><idno type="DOI">10.1046/j.1460-9592.2003.t01-1-00207.x</idno><idno type="ArticleID">PACE207</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>closed‐loop stimulation</term><term>contraction dynamics</term><term>impedance cardiography</term><term>rate adaptive pacing</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Inos pacemakers use contraction dynamics to regulate the pacing rate according to the Closed‐Loop Stimulation (CLS) principle. The physician can program only the lower and upper rate limits, while the internal rate responsive parameters are continually adjusted to changing patient conditions. Seventy‐two patients with sinus node disease were enrolled in the multicenter Rate Behavior of the Pacing System Inos2 CLS during Daily Life (RAPID) study to evaluate the appropriateness of CLS rates during daily activities and the long‐term stability of the system. The pacemakers clearly differentiated between climbing stairs, descending stairs, and slow walking, with the corresponding peak rates of 104 ± 18, 95 ± 15 , and 88 ± 11 beats/min , respectively ( P < 0.001 for any pair of activities). The peak CLS rate during the color‐word test was significantly higher than that at rest ( 80 ± 8 vs 67 ± 7 beats/min, P = 0.002 ). The 24‐hour heart rate trends retrieved from the pacemaker memory at 3, 6, and 12 months after implantation appeared appropriate in all patients except for two whose pacing rates were occasionally too fast during the night. Mean diurnal and nocturnal rates determined at 3‐month, 6‐month, and 12‐month examinations fluctuated only slightly, from 74.6–75.3 beats/min (diurnal, P = NS ) and from 67.0–68.1 beats/min (nocturnal, P = NS ), indicating a satisfactory long‐term stability of the system. The incidence of atrial pacing events during the entire follow‐up was 82 ± 18% . A 6.5–8.3 beats/min difference, on average, between day and night (P < 0.001) and distinction between different daily activities seem to evidence sensitivity of the automatic CLS‐driven pacemakers to physiological demands despite minimum programming requirements. (PACE 2003; 26[Pt. I]:1432–1437)</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>LOTHAR GRIESBACH</name><affiliations><json:string>Department of Internal Medicine, District General Hospital, Kirchberg</json:string></affiliations></json:item><json:item><name>BRIGITTA GESTRICH</name><affiliations><json:string>Department of Cardiology, Brothers of Charity Hospital, Trier, Germany</json:string></affiliations></json:item><json:item><name>DARIUSZ WOJCIECHOWSKI</name><affiliations><json:string>Bioengineering Department of the Wolski Hospital and Institute of Biocybernetics and Bioengineering, Polish Academy of Sciences, Warsaw, Poland</json:string></affiliations></json:item><json:item><name>GEORG WEYERS</name><affiliations><json:string>Department of Internal Medicine, Evangelic Hospital, Bergisch Gladbach</json:string></affiliations></json:item><json:item><name>JÜRGEN TÖNGES</name><affiliations><json:string>Department of Internal Medicine, Cusanus Hospital, Bernkastel‐Kues</json:string></affiliations></json:item><json:item><name>MATTHIAS SCHIER</name><affiliations><json:string>Department of Biomedical Engineering, Friedrich‐Alexander University, Erlangen‐Nuremberg</json:string></affiliations></json:item><json:item><name>DEJAN DANILOVIC</name><affiliations><json:string>Department of Scientific and Technical Marketing, Biotronik, Erlangen, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>rate adaptive pacing</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>contraction dynamics</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>closed‐loop stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>impedance cardiography</value></json:item></subject><articleId><json:string>PACE207</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Inos pacemakers use contraction dynamics to regulate the pacing rate according to the Closed‐Loop Stimulation (CLS) principle. The physician can program only the lower and upper rate limits, while the internal rate responsive parameters are continually adjusted to changing patient conditions. Seventy‐two patients with sinus node disease were enrolled in the multicenter Rate Behavior of the Pacing System Inos2 CLS during Daily Life (RAPID) study to evaluate the appropriateness of CLS rates during daily activities and the long‐term stability of the system. The pacemakers clearly differentiated between climbing stairs, descending stairs, and slow walking, with the corresponding peak rates of 104 ± 18, 95 ± 15 , and 88 ± 11 beats/min , respectively ( P > 0.001 for any pair of activities). The peak CLS rate during the color‐word test was significantly higher than that at rest ( 80 ± 8 vs 67 ± 7 beats/min, P = 0.002 ). The 24‐hour heart rate trends retrieved from the pacemaker memory at 3, 6, and 12 months after implantation appeared appropriate in all patients except for two whose pacing rates were occasionally too fast during the night. Mean diurnal and nocturnal rates determined at 3‐month, 6‐month, and 12‐month examinations fluctuated only slightly, from 74.6–75.3 beats/min (diurnal, P = NS ) and from 67.0–68.1 beats/min (nocturnal, P = NS ), indicating a satisfactory long‐term stability of the system. The incidence of atrial pacing events during the entire follow‐up was 82 ± 18% . A 6.5–8.3 beats/min difference, on average, between day and night (P > 0.001) and distinction between different daily activities seem to evidence sensitivity of the automatic CLS‐driven pacemakers to physiological demands despite minimum programming requirements. (PACE 2003; 26[Pt. 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Res</title></host><title>Influence of closed‐loop pacemaker implantation on patient's quality of life: RAPID study findings</title></json:item></refBibs><genre><json:string>article</json:string></genre><host><volume>26</volume><publisherId><json:string>PACE</json:string></publisherId><pages><total>6</total><last>1437</last><first>1432</first></pages><issn><json:string>0147-8389</json:string></issn><issue>7p1</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1540-8159</json:string></eissn><title>Pacing and Clinical Electrophysiology</title><doi><json:string>10.1111/(ISSN)1540-8159</json:string></doi></host><categories><wos><json:string>science</json:string><json:string>engineering, biomedical</json:string><json:string>cardiac & cardiovascular systems</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>cardiovascular system & 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xml:id="author-7"><persName><forename type="first">DEJAN</forename><surname>DANILOVIC</surname></persName><affiliation>Department of Scientific and Technical Marketing, Biotronik, Erlangen, Germany</affiliation></author></analytic><monogr><title level="j">Pacing and Clinical Electrophysiology</title><idno type="pISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><idno type="DOI">10.1111/(ISSN)1540-8159</idno><imprint><publisher>Blackwell Futura Publishing, Inc.</publisher><pubPlace>350 Main Street , Malden , MA 02148‐5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK .</pubPlace><date type="published" when="2003-07"></date><biblScope unit="volume">26</biblScope><biblScope unit="issue">7p1</biblScope><biblScope unit="page" from="1432">1432</biblScope><biblScope unit="page" to="1437">1437</biblScope></imprint></monogr><idno type="istex">1583C3778EB547778540C8BBB5D1700C3A115D5C</idno><idno type="DOI">10.1046/j.1460-9592.2003.t01-1-00207.x</idno><idno type="ArticleID">PACE207</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2003</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Inos pacemakers use contraction dynamics to regulate the pacing rate according to the Closed‐Loop Stimulation (CLS) principle. The physician can program only the lower and upper rate limits, while the internal rate responsive parameters are continually adjusted to changing patient conditions. Seventy‐two patients with sinus node disease were enrolled in the multicenter Rate Behavior of the Pacing System Inos2 CLS during Daily Life (RAPID) study to evaluate the appropriateness of CLS rates during daily activities and the long‐term stability of the system. The pacemakers clearly differentiated between climbing stairs, descending stairs, and slow walking, with the corresponding peak rates of 104 ± 18, 95 ± 15 , and 88 ± 11 beats/min , respectively ( P < 0.001 for any pair of activities). The peak CLS rate during the color‐word test was significantly higher than that at rest ( 80 ± 8 vs 67 ± 7 beats/min, P = 0.002 ). The 24‐hour heart rate trends retrieved from the pacemaker memory at 3, 6, and 12 months after implantation appeared appropriate in all patients except for two whose pacing rates were occasionally too fast during the night. Mean diurnal and nocturnal rates determined at 3‐month, 6‐month, and 12‐month examinations fluctuated only slightly, from 74.6–75.3 beats/min (diurnal, P = NS ) and from 67.0–68.1 beats/min (nocturnal, P = NS ), indicating a satisfactory long‐term stability of the system. The incidence of atrial pacing events during the entire follow‐up was 82 ± 18% . A 6.5–8.3 beats/min difference, on average, between day and night (P < 0.001) and distinction between different daily activities seem to evidence sensitivity of the automatic CLS‐driven pacemakers to physiological demands despite minimum programming requirements. (PACE 2003; 26[Pt. I]:1432–1437)</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>rate adaptive pacing</term></item><item><term>contraction dynamics</term></item><item><term>closed‐loop stimulation</term></item><item><term>impedance cardiography</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2003-07">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/1583C3778EB547778540C8BBB5D1700C3A115D5C/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Futura Publishing, Inc.</publisherName><publisherLoc> 350 Main Street , Malden , MA 02148‐5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . </publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8159</doi><issn type="print">0147-8389</issn><issn type="electronic">1540-8159</issn><idGroup><id type="product" value="PACE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="PACING CLINICAL ELECTROPHYSIOLOGY">Pacing and Clinical Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="07000"><doi origin="wiley">10.1111/pace.2003.26.issue-7p1</doi><numberingGroup><numbering type="journalVolume" number="26">26</numbering><numbering type="journalIssue">7p1</numbering></numberingGroup><coverDate startDate="2003-07">July 2003</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="2" status="forIssue"><doi origin="wiley">10.1046/j.1460-9592.2003.t01-1-00207.x</doi><idGroup><id type="unit" value="PACE207"></id><id type="supplier" value="pace207"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="tocHeading1"><i>ORIGINAL ARTICLES</i></title></titleGroup><eventGroup><event type="firstOnline" date="2003-06-30"></event><event type="publishedOnlineFinalForm" date="2003-06-30"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.5 mode:FullText source:FullText result:FullText" date="2010-04-06"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-06"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-03"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="1432">1432</numbering><numbering type="pageLast" number="1437">1437</numbering></numberingGroup><correspondenceTo>Address for reprints: Lothar Griesbach, M.D., Innere Medizin, Kreiskrankenhaus Kirchberg, Schneebergerstr. 36, D‐08107 Kirchberg, Germany. Fax: +49‐37602‐8‐1304; e‐mail: <email normalForm="edv@kkh-kirchberg.de">edv@kkh‐kirchberg.de</email></correspondenceTo><objectNameGroup><objectName elementName="appendix">Appendix</objectName></objectNameGroup><linkGroup><link type="toTypesetVersion" href="file:PACE.PACE207.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="2"></count><count type="formulaTotal" number="43"></count><count type="referenceTotal" number="20"></count><count type="linksCrossRef" number="41"></count></countGroup><titleGroup><title type="main">Clinical Performance of Automatic Closed‐Loop Stimulation Systems</title><title type="shortAuthors">GRIESBACH, ET AL.</title><title type="short">CLOSED‐LOOP CARDIAC PACING</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>LOTHAR</givenNames><familyName>GRIESBACH</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>BRIGITTA</givenNames><familyName>GESTRICH</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a3"><personName><givenNames>DARIUSZ</givenNames><familyName>WOJCIECHOWSKI</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a4"><personName><givenNames>GEORG</givenNames><familyName>WEYERS</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a5"><personName><givenNames>JÜRGEN</givenNames><familyName>TÖNGES</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a6"><personName><givenNames>MATTHIAS</givenNames><familyName>SCHIER</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a7"><personName><givenNames>DEJAN</givenNames><familyName>DANILOVIC</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><groupName><sc>RAPID study investigators</sc></groupName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Department of Internal Medicine, District General Hospital, Kirchberg</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="DE"><unparsedAffiliation>Department of Cardiology, Brothers of Charity Hospital, Trier, Germany</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="PL"><unparsedAffiliation>Bioengineering Department of the Wolski Hospital and Institute of Biocybernetics and Bioengineering, Polish Academy of Sciences, Warsaw, Poland</unparsedAffiliation></affiliation><affiliation xml:id="a4"><unparsedAffiliation>Department of Internal Medicine, Evangelic Hospital, Bergisch Gladbach</unparsedAffiliation></affiliation><affiliation xml:id="a5"><unparsedAffiliation>Department of Internal Medicine, Cusanus Hospital, Bernkastel‐Kues</unparsedAffiliation></affiliation><affiliation xml:id="a6"><unparsedAffiliation>Department of Biomedical Engineering, Friedrich‐Alexander University, Erlangen‐Nuremberg</unparsedAffiliation></affiliation><affiliation xml:id="a7" countryCode="DE"><unparsedAffiliation>Department of Scientific and Technical Marketing, Biotronik, Erlangen, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1"><i>rate adaptive pacing</i></keyword><keyword xml:id="k2"><i>contraction dynamics</i></keyword><keyword xml:id="k3"><i>closed‐loop stimulation</i></keyword><keyword xml:id="k4"><i>impedance cardiography</i></keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><!-- GRIESBACH, L., et al .: Clinical Performance of Automatic Closed-Loop Stimulation Systems. --><p> <i>Inos pacemakers use contraction dynamics to regulate the pacing rate according to the Closed‐Loop Stimulation (CLS) principle. The physician can program only the lower and upper rate limits, while the internal rate responsive parameters are continually adjusted to changing patient conditions. Seventy‐two patients with sinus node disease were enrolled in the multicenter Rate Behavior of the Pacing System Inos<sup>2</sup> CLS during Daily Life (RAPID) study to evaluate the appropriateness of CLS rates during daily activities and the long‐term stability of the system. The pacemakers clearly differentiated between climbing stairs, descending stairs, and slow walking, with the corresponding peak rates of</i><span type="mathematics"><i>104 ± 18, 95 ± 15</i></span><i>, and</i><span type="mathematics"><i>88 ± 11 beats/min</i></span><i>, respectively (</i><span type="mathematics"><i>P < 0.001</i></span><i>for any pair of activities). The peak CLS rate during the color‐word test was significantly higher than that at rest (</i><span type="mathematics"><i>80 ± 8</i></span><i>vs</i><span type="mathematics"><i>67 ± 7 beats/min, P = 0.002</i></span><i>). The 24‐hour heart rate trends retrieved from the pacemaker memory at 3, 6, and 12 months after implantation appeared appropriate in all patients except for two whose pacing rates were occasionally too fast during the night. Mean diurnal and nocturnal rates determined at 3‐month, 6‐month, and 12‐month examinations fluctuated only slightly, from 74.6–75.3 beats/min (diurnal,</i><span type="mathematics"><i>P = NS</i></span><i>) and from 67.0–68.1 beats/min (nocturnal,</i><span type="mathematics"><i>P = NS</i></span><i>), indicating a satisfactory long‐term stability of the system. The incidence of atrial pacing events during the entire follow‐up was</i><span type="mathematics"><i>82 ± 18%</i></span><i>. A 6.5–8.3 beats/min difference, on average, between day and night</i><span type="mathematics"><i>(P < 0.001)</i></span><i>and distinction between different daily activities seem to evidence sensitivity of the automatic CLS‐driven pacemakers to physiological demands despite minimum programming requirements. (PACE 2003; 26[Pt. I]:1432–1437)</i> </p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="n-fnt-1" numbered="no"><p>Supported in part by Biotronik, Berlin, Germany.</p></note><note xml:id="n-fnt-2" numbered="no"><p>Received May 22, 2002; revised July 30, 2002; accepted August 15, 2002.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Clinical Performance of Automatic Closed‐Loop Stimulation Systems</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>CLOSED‐LOOP CARDIAC PACING</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Clinical Performance of Automatic Closed‐Loop Stimulation Systems</title></titleInfo><name type="personal"><namePart type="given">LOTHAR</namePart><namePart type="family">GRIESBACH</namePart><affiliation>Department of Internal Medicine, District General Hospital, Kirchberg</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">BRIGITTA</namePart><namePart type="family">GESTRICH</namePart><affiliation>Department of Cardiology, Brothers of Charity Hospital, Trier, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">DARIUSZ</namePart><namePart type="family">WOJCIECHOWSKI</namePart><affiliation>Bioengineering Department of the Wolski Hospital and Institute of Biocybernetics and Bioengineering, Polish Academy of Sciences, Warsaw, Poland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">GEORG</namePart><namePart type="family">WEYERS</namePart><affiliation>Department of Internal Medicine, Evangelic Hospital, Bergisch Gladbach</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JÜRGEN</namePart><namePart type="family">TÖNGES</namePart><affiliation>Department of Internal Medicine, Cusanus Hospital, Bernkastel‐Kues</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">MATTHIAS</namePart><namePart type="family">SCHIER</namePart><affiliation>Department of Biomedical Engineering, Friedrich‐Alexander University, Erlangen‐Nuremberg</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">DEJAN</namePart><namePart type="family">DANILOVIC</namePart><affiliation>Department of Scientific and Technical Marketing, Biotronik, Erlangen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="corporate"><namePart>RAPID study investigators</namePart><description>Department of Internal Medicine, District General Hospital, KirchbergDepartment of Cardiology, Brothers of Charity Hospital, Trier, GermanyBioengineering Department of the Wolski Hospital and Institute of Biocybernetics and Bioengineering, Polish Academy of Sciences, Warsaw, PolandDepartment of Internal Medicine, Evangelic Hospital, Bergisch GladbachDepartment of Internal Medicine, Cusanus Hospital, Bernkastel‐KuesDepartment of Biomedical Engineering, Friedrich‐Alexander University, Erlangen‐NurembergDepartment of Scientific and Technical Marketing, Biotronik, Erlangen, Germany</description></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Futura Publishing, Inc.</publisher><place><placeTerm type="text">350 Main Street , Malden , MA 02148‐5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK .</placeTerm></place><dateIssued encoding="w3cdtf">2003-07</dateIssued><copyrightDate encoding="w3cdtf">2003</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">2</extent><extent unit="formulas">43</extent><extent unit="references">20</extent></physicalDescription><abstract lang="en">Inos pacemakers use contraction dynamics to regulate the pacing rate according to the Closed‐Loop Stimulation (CLS) principle. The physician can program only the lower and upper rate limits, while the internal rate responsive parameters are continually adjusted to changing patient conditions. Seventy‐two patients with sinus node disease were enrolled in the multicenter Rate Behavior of the Pacing System Inos2 CLS during Daily Life (RAPID) study to evaluate the appropriateness of CLS rates during daily activities and the long‐term stability of the system. The pacemakers clearly differentiated between climbing stairs, descending stairs, and slow walking, with the corresponding peak rates of 104 ± 18, 95 ± 15 , and 88 ± 11 beats/min , respectively ( P < 0.001 for any pair of activities). The peak CLS rate during the color‐word test was significantly higher than that at rest ( 80 ± 8 vs 67 ± 7 beats/min, P = 0.002 ). The 24‐hour heart rate trends retrieved from the pacemaker memory at 3, 6, and 12 months after implantation appeared appropriate in all patients except for two whose pacing rates were occasionally too fast during the night. Mean diurnal and nocturnal rates determined at 3‐month, 6‐month, and 12‐month examinations fluctuated only slightly, from 74.6–75.3 beats/min (diurnal, P = NS ) and from 67.0–68.1 beats/min (nocturnal, P = NS ), indicating a satisfactory long‐term stability of the system. The incidence of atrial pacing events during the entire follow‐up was 82 ± 18% . A 6.5–8.3 beats/min difference, on average, between day and night (P < 0.001) and distinction between different daily activities seem to evidence sensitivity of the automatic CLS‐driven pacemakers to physiological demands despite minimum programming requirements. (PACE 2003; 26[Pt. I]:1432–1437)</abstract><subject lang="en"><genre>keywords</genre><topic>rate adaptive pacing</topic><topic>contraction dynamics</topic><topic>closed‐loop stimulation</topic><topic>impedance cardiography</topic></subject><relatedItem type="host"><titleInfo><title>Pacing and Clinical Electrophysiology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0147-8389</identifier><identifier type="eISSN">1540-8159</identifier><identifier type="DOI">10.1111/(ISSN)1540-8159</identifier><identifier type="PublisherID">PACE</identifier><part><date>2003</date><detail type="volume"><caption>vol.</caption><number>26</number></detail><detail type="issue"><caption>no.</caption><number>7p1</number></detail><extent unit="pages"><start>1432</start><end>1437</end><total>6</total></extent></part></relatedItem><identifier type="istex">1583C3778EB547778540C8BBB5D1700C3A115D5C</identifier><identifier type="DOI">10.1046/j.1460-9592.2003.t01-1-00207.x</identifier><identifier type="ArticleID">PACE207</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Futura Publishing, Inc.</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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