Trigano Alexandre, Lafay Vincent, Blandeau Olivier, Levy Samuel, Gardette Bernard, Micoli Christophe
Department of Cardiology, Centre Hospitalier Universitaire Nord, 13915 cedex 20, Marseille, France.
J Interv Card Electrophysiol. 2006 Apr;15(3):179-83. doi: 10.1007/s10840-006-9004-x. Epub 2006 Aug 10.
The aim of this study was to test a variety of currently available activity-based rate-adaptive pacemakers under hyperbaric conditions.
Sports divers with pacemakers can dive under certain circumstances. The rate response of activity-sensing pacing under hyperbaric conditions has rarely been evaluated.
We manufactured a miniaturized hyperbaric chamber. A pacemaker inside was kept close to the corresponding telemetry wand placed on top of the chamber. An inflation device for coronary balloon angioplasty was used to create hydraulic pressure. Group I pacemakers were exposed to a 30 msw/98 fsw/4 ATA and after a 1-month waiting period to 60 msw/197 fsw-depth/7 ATA. Group II was exposed to only one dive to 60 msw. The electrogram and event marker telemetry were used to monitor the pacing stimuli and measurements were made for case distortion.
The baseline pacing rate did not change in 27 tests. Return to baseline was shown during 18 tests after transient sensor-driven rate. There was a sensor rate response to manual brief shaking during and following testing. A case distortion was shown in 15 of 29 tests at 60 m.
Modern accelerometers showed no sensitivity to pressure on the pacemaker can at 30 msw/98 fsw and 60 msw/197 fsw but in some devices responded to pressure changes. There was no pacing dysfunction or suppression of the sensor response despite the high incidence of case distortion at 60 msw/197 fsw. As a general rule, diving should not be allowed at depths greater than 20 msw/65 fsw.
本研究旨在测试多种目前可用的基于活动的频率自适应起搏器在高压环境下的性能。
植入起搏器的潜水运动员在某些情况下可以潜水。但高压环境下活动感知起搏的频率反应很少被评估。
我们制造了一个小型高压舱。舱内的起搏器靠近置于舱顶的相应遥测棒。使用冠状动脉球囊血管成形术的充气装置来产生液压。第一组起搏器先暴露于30米海水深度/98英尺海水深度/4个绝对大气压的环境，经过1个月的等待期后再暴露于60米海水深度/197英尺海水深度/7个绝对大气压的环境。第二组仅暴露于一次60米海水深度的潜水环境。通过心电图和事件标记遥测来监测起搏刺激，并针对病例失真进行测量。
在27次测试中，基线起搏频率未发生变化。在18次测试中，短暂的传感器驱动频率后恢复到了基线水平。在测试期间及之后，手动短暂摇晃会引起传感器频率反应。在60米深度的29次测试中，有15次出现了病例失真。
现代加速度计在30米海水深度/98英尺海水深度和60米海水深度/197英尺海水深度时，对起搏器罐上的压力不敏感，但在一些设备中对压力变化有反应。尽管在60米海水深度/197英尺海水深度时病例失真发生率较高，但未出现起搏功能障碍或传感器反应受抑制的情况。一般来说，深度大于20米海水深度/65英尺海水深度时不应允许潜水。
