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Sensor-Triggered, Rate-Variable Cardiac Pacing: Current Technologies and Clinical Implications

DAVID G. BENDITT, M.D.; SIMON MILSTEIN, M.D.; JEFFREY BUETIKOFER, M.D.; CHARLES C. GORNICK, M.D.; MARCUS MIANULLI, M.S.; and JOSEPH FETTER, B.S.E.E.
[+] Article and Author Information

Grant support: this work was completed during Dr. Benditt's tenure as an Established Investigator of the American Heart Association, Dallas, Texas.

▸Requests for reprints should be addressed to David G. Benditt, M.D.; University of Minnesota Hospital, Box 341 UMHC; Minneapolis, MN 55455.


Minneapolis, Minnesota


©1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;107(5):714-724. doi:10.7326/0003-4819-107-5-714
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Conventional implantable dual-chamber cardiac pacemakers adjust heart rate and maintain normal atrial and ventricular contraction by tracking "native" atrial electrical activity and pacing the ventricles after a predetermined programmable atrioventricular delay. However, in patients with symptomatic bradyarrhythmias, optimal function of "atrial-tracking" devices may be limited by concomitant sinoatrial disease. Provision of chronotropic response during physical exertion or emotional stress may be achieved by using physiologic sensors to alter pacing rate independently of atrial activity. Additional systems using sensor technologies are being developed. Future pacing systems will have dual-chamber pacing capability and may use several sensors coupled synergistically in order to take advantage of particular strengths of each. Physiologic sensor technology may be of diagnostic value in both antitachycardia devices and implantable cardioverter and defibrillator systems.

[MeSH terms: arrhythmia; bradycardia; cardiac output; cardiac pacing, artificial; electric stimulation; exertion; heart atrium; heart rate; heart ventricle; implants, artificial; myocardial contraction; pacemaker, artificial; sinoatrial node; stroke volume. Other indexing terms: chronotropic incompetence; evoked QT interval; physiologic sensors; single-chamber rate variable pulse generators]

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