Clinical Experience with Sensolog 703: A New Activity Sensing Rate Responsive Pacemaker

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Abstract
Sensolog 703 is a new activity sensing rate responsive pacemaker which detects body vibration during physical exercise and uses the vibration as an indicator of the physiological need for a rate increase. This pacemaker was implanted in 11 patients with complete heart block and atrial arrhythmias. Their mean age was 58 (range 39–72) years. With appropriate rate response, exercise capacity, as assessed by the duration of graded treadmill exercise using the Bruce protocol, was significantly improved over the WI pacing mode (mean ± SEM, 462 ± 52 s in the rate responsive mode and 368 ± 34 s in the VVI mode, P < 0.02). Cardiac output at peak exercise, as assessed by continuous wave Doppler sampling of aortic root blood flow, was also significantly increased compared to the resting value in both piecing modes. However, the increase was more marked when exercise was performed in the rate response mode (93 ± 22% increase over resting cardiac output in the rate responsive mode and 57 ± 13% increase in the WI mode, P < 0.05). The rate responses of this pacemaker were compared with those of a Medtronic Activitrax pacemaker. Although both pacemakers responded to an increase in walking speed, neither responded appropriately to walking up different gradients. In both cases, ascending and descending four flights of stairs resulted in similar pacing rates. There was no response to physiological activities with minimal body movements such as isometric exercise and the Valsalva maneuver. Technical problems were encountered in two implanted Sensoiog pacemakers: one had spontaneous rate acceleration at rest immediately following implantation and one showed intermittent rate acceleration while the patient was at rest. Both units were programmed to the WI mode. In conclusion, satisfactory rate response, improvement in exercise duration and increase in cardiac output were achieved with the Sensolog 703 pacemaker. However, as body vibration is not closely related to physiological needs, it has similar limitations in rate response as the Activitrax pacemaker.