Rodríguez García J, Silvestre García J, Coma Samartín R, Sieres Pérez J, Sánchez-Izquierdo Riera J A, Hernando Lorenzo A, Díez Prieto F
Unidad Coronaria, Hospital 12 de Octubre, Madrid.
Rev Esp Cardiol. 1990;43 Suppl 2:58-66.
Patients with atrioventricular block and ventricular pacemakers at a fixed rate have their exercise ability limited. This situation has been solved through dual chamber pacing in those patients keeping an adequate sinus node function. For the remaining, showing chronotropic failure or atrial fibrillation, the ability to increase their pacing rate is only possible when signals other than atrial activity, and reflecting metabolic needs, are used as a guide. These signals detected by a sensor, act through an algorithm modifying the pacing rate and are the cornerstone of rate-responsive pacing. Indications for these stimulation modes are analyzed as so are characteristics of different sensors used for this aim (pH, respiratory rate, QT interval, body activity, minute respiratory volume, central venous pressure, preejection period + stroke volume, right ventricular dp/dt, evoked QRS response and venous oxygen saturation).
患有房室传导阻滞且使用固定频率心室起搏器的患者,其运动能力受限。对于那些窦房结功能正常的患者,通过双腔起搏解决了这一情况。对于其余表现为变时性功能不全或心房颤动的患者,只有在将反映代谢需求的、而非心房活动的信号用作指导时,才有可能提高起搏频率。传感器检测到的这些信号通过一种算法来改变起搏频率,是频率应答性起搏的基石。本文分析了这些刺激模式的适应证以及用于该目的的不同传感器的特性(pH值、呼吸频率、QT间期、身体活动、每分通气量、中心静脉压、射血前期+每搏量、右心室dp/dt、诱发QRS反应和静脉血氧饱和度)。