Higano S T, Hayes D L, Eisinger G
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905.
Pacing Clin Electrophysiol. 1989 Jun;12(6):922-9. doi: 10.1111/j.1540-8159.1989.tb05029.x.
DDD pacemakers may have large cycle-to-cycle variations in rate at the upper rate limit because of 2:1 block or Wenckebach-type block. Rate smoothing was introduced as an option to eliminate these large variations. Now, DDDR pacemakers can produce similar electrocardiographic displays through a different mechanism that uses an activity sensor. This is termed "sensor-driven rate smoothing" because it occurs only when the activity sensor is driving the pacemaker. In the case described, as the atrial rate exceeded the maximum tracking rate and reverted to Wenckebach-type block, the RR interval varied only from 600 msec to 680 msec (13.3% rate-smoothing value) because of sensor-driven pacing. Maximal sensor-driven rate smoothing requires optimal programming of the rate response indicators. This sensor-driven rate-smoothing effect is an electrocardiographic manifestation that will undoubtedly be seen more frequently as DDDR devices come into widespread clinical use.
由于存在2:1阻滞或文氏型阻滞，DDD起搏器在上限频率时可能会出现较大的逐搏周期频率变化。引入频率平滑功能作为消除这些大幅变化的一种选择。现在，DDDR起搏器可通过一种使用活动传感器的不同机制产生类似的心电图表现。这被称为“传感器驱动的频率平滑”，因为它仅在活动传感器驱动起搏器时发生。在所描述的病例中，当心房率超过最大跟踪频率并转变为文氏型阻滞时，由于传感器驱动起搏，RR间期仅在600毫秒至680毫秒之间变化（频率平滑值为13.3%）。最大程度的传感器驱动频率平滑需要对频率反应指标进行优化编程。这种传感器驱动的频率平滑效应是一种心电图表现，随着DDDR设备在临床广泛应用，无疑会更频繁地出现。
