INITIAL EXPERIENCE WITH A NEW SINGLE CHAMBER, DUAL SENSOR RATE-RESPONSIVE PACEMAKER

In August 1991, a new single chamber pacemaker became available that u tilizes information from two sensors, activity and stimulus-to-T wave (QT) interval. We are reporting on the first 90 implants in 21 centers . T wave sensing was adequate at implantation in 88/90 patients, with a safety margin of > 100% in 86/90. Activity sensing was adequate in a ll patients. The contribution of each sensor (sensor blending) is prog rammable for each patient. Of 75 patients assessed at 1 month after im plant, three have been programmed to ''Activity-Only'' mode, and 72 to dual sensor mode. Of these, 18 have been programmed to ''QT < Activit y,'' 48 to ''QT = Activity,'' and 6 to ''QT > Activity.'' Forty-five p atients underwent exercise testing in dual sensor mode and a subgroup of 15 also underwent exercise testing in Activity-Only mode. The dual sensor mode produced a more gradual increase in pacing rate. Sensor Cr oss Checking(TM) satisfactorily prevented a sustained high pacing rate in tests of false-positive activity sensing (tapping, vibrating pacem aker, or static pressure). The maximum pacing rate on walking downstai rs (94.2 +/- 7.2 ppm) was similar to that produced by walking upstairs (91.6 +/- 5.9 ppm). We conclude that initial assessment of this dual sensor, single chamber, rate responsive pacemaker confirms that the al gorithm for combining data from two sensors functions satisfactorily. Dual sensor rate responsive pacing may offer significant advantages ov er single sensor devices, and further studies of this novel device are indicated.