Begemann M J, Boute W
Clinical Research, Vitatron Medical BV, Dieren, The Netherlands.
Pacing Clin Electrophysiol. 1988 Nov;11(11 Pt 2):1687-92. doi: 10.1111/j.1540-8159.1988.tb06296.x.
Increasing pacemaker memory allows integration of heart rate monitoring into the pacemaker. Two main methods can be distinguished. 1. Heart rate monitoring in histograms. 2. Heart rate monitoring in the time domain (heart rate holter). Method 1 is useful in antitachycardia and diagnostic pacemakers when short specific events must be detected (tachycadia, bradycardia). For the analysis of a rate adaptive pacemaker this method is less appropriate as it does not give any information about the dynamics of rate changes or its time relations. For this purpose Method 2 will give more information about the functioning of the pacemaker as it does not only store the heart rate but also the timing of the heart rate so that changes in heart rate can be correlated to the activity of the patient. An algorithm was developed to store the average heart rate over 7.8 minute periods in a pacemaker. On interrogation of the pacemaker the information will always reveal the heart rate over the 24 hours prior to interrogation. This monitor can also be temporarily programmed to store the average heart rate in 20 second intervals to monitor the response to an exercise test for a period of 1 hour. The time needed for a standard follow-up procedure of a rate adaptive pacemaker can be dramatically reduced to a value close to the follow-up time of a standard VVI pacemaker.
起搏器内存容量的增加使得心率监测能够整合到起搏器中。可区分两种主要方法。1. 直方图中的心率监测。2. 时域中的心率监测（心率动态心电图）。方法1在抗心动过速起搏器和诊断起搏器中很有用，用于检测特定的短暂事件（心动过速、心动过缓）。对于频率自适应起搏器的分析，此方法不太合适，因为它无法提供任何有关心率变化动态或其时间关系的信息。为此，方法2能提供更多有关起搏器功能的信息，因为它不仅存储心率，还存储心率的时间，这样心率变化就可以与患者的活动相关联。开发了一种算法，用于在起搏器中存储7.8分钟时间段内的平均心率。在询问起搏器时，信息将始终显示询问前24小时的心率。该监测器还可以临时编程，以20秒的间隔存储平均心率，以监测对1小时运动测试的反应。频率自适应起搏器标准随访程序所需的时间可以大幅缩短至接近标准VVI起搏器的随访时间。
