Standardized informal exercise testing for programming rate adaptive pacemakers.

It is essential that patients with pacemakers capable of rate modulation undergo some form of exercise testing to assure appropriate rate modulation. Informal exercise testing is a reasonable and less expensive alternative to formal treadmill testing. Empiric adjustment of the rate response parameters by assessing the patient's rate response while walking at a self-determined casual and brisk pace has been used. However, no normals exist to determine the appropriate rate response for a "casual" and "brisk" walk. Volunteers were tested with metronome-guided casual and brisk walks in an effort to standardize the informal exercise and determine expected heart rate response for these levels of activity. Results of the metronome-guided rate response in normal volunteers may be useful in determining the appropriate rate response for pacemaker patients when tested in such an informal manner.