• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利：CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法，用中文像聊天一样搜索，搜遍4000万医学文献。AI智能推荐，让科研检索更轻松。

立即免费搜索

文件翻译

保留排版，准确专业，支持PDF/Word/PPT等文件格式，支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述，25分钟生成高质量综述，智能提取关键信息，辅助科研写作。

立即免费体验

心率反应性心脏起搏：技术解决方案及其应用。

Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications.

机构信息

Department of Arrhythmia, The Cardinal Stefan Wyszynski National Institute of Cardiology, 04-628 Warsaw, Poland.

1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.

出版信息

Sensors (Basel). 2023 Jan 27;23(3):1427. doi: 10.3390/s23031427.

DOI:10.3390/s23031427
PMID:36772467
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9920425/
Abstract

Modern cardiac pacemakers are equipped with a function that allows the heart rate to adapt to the current needs of the patient in situations of increased demand related to exercise and stress ("rate-response" function). This function may be based on a variety of mechanisms, such as a built-in accelerometer responding to increased chest movement or algorithms sensing metabolic demand for oxygen, analysis of intrathoracic impedance, and analysis of the heart rhythm (Q-T interval). The latest technologies in the field of rate-response functionality relate to the use of an accelerometer in leadless endocavitary pacemakers; in these devices, the accelerometer enables mapping of the mechanical wave of the heart's work cycle, enabling the pacemaker to correctly sense native impulses and stimulate the ventricles in synchrony with the cycles of atria and heart valves. Another modern system for synchronizing pacing rate with the patient's real-time needs requires a closed-loop system that continuously monitors changes in the dynamics of heart contractions. This article discusses the technical details of various solutions for detecting and responding to situations related to increased oxygen demand (e.g., exercise or stress) in implantable pacemakers, and reviews the results of clinical trials regarding the use of these algorithms.

摘要

现代心脏起搏器配备了一种功能，可在与运动和压力相关的需求增加的情况下（“反应速度”功能）根据患者的当前需求调整心率。该功能可以基于多种机制，例如响应胸部运动增加的内置加速度计，或感应对氧气代谢需求的算法、分析胸内阻抗以及分析心律（QT 间期）。率响应功能领域的最新技术涉及在无导线心内膜起搏器中使用加速度计；在这些设备中，加速度计能够绘制心脏工作周期的机械波，使起搏器能够正确感知原生冲动，并与心房和心脏瓣膜的周期同步刺激心室。另一种用于使起搏速度与患者实时需求同步的现代系统需要一个闭环系统，该系统可以持续监测心脏收缩动力学变化。本文讨论了检测和响应与植入式起搏器中增加的氧气需求（例如运动或压力）相关的各种解决方案的技术细节，并回顾了使用这些算法的临床试验结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/c0e3108b01d8/sensors-23-01427-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/5d35491f8656/sensors-23-01427-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e819d6f94ff2/sensors-23-01427-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e09eae1a9c14/sensors-23-01427-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/a5f92a1c28cd/sensors-23-01427-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/dd3f020246f9/sensors-23-01427-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/4df8e2551c21/sensors-23-01427-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e2df8af9eaa5/sensors-23-01427-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/b541c297ace9/sensors-23-01427-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e043ed9942c2/sensors-23-01427-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/ce3c1fa9e25d/sensors-23-01427-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/c0e3108b01d8/sensors-23-01427-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/5d35491f8656/sensors-23-01427-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e819d6f94ff2/sensors-23-01427-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e09eae1a9c14/sensors-23-01427-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/a5f92a1c28cd/sensors-23-01427-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/dd3f020246f9/sensors-23-01427-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/4df8e2551c21/sensors-23-01427-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e2df8af9eaa5/sensors-23-01427-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/b541c297ace9/sensors-23-01427-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/e043ed9942c2/sensors-23-01427-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/ce3c1fa9e25d/sensors-23-01427-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aece/9920425/c0e3108b01d8/sensors-23-01427-g011.jpg

相似文献

1
Rate-Responsive Cardiac Pacing: Technological Solutions and Their Applications.心率反应性心脏起搏：技术解决方案及其应用。
Sensors (Basel). 2023 Jan 27;23(3):1427. doi: 10.3390/s23031427.
2
Accelerometer-based atrioventricular synchronous pacing with a ventricular leadless pacemaker: Results from the Micra atrioventricular feasibility studies.基于加速度计的房室同步起搏与无导线心室起搏器：Micra 房室可行性研究结果。
Heart Rhythm. 2018 Sep;15(9):1363-1371. doi: 10.1016/j.hrthm.2018.05.004. Epub 2018 May 11.
3
Atrioventricular Synchronous Pacing Using a Leadless Ventricular Pacemaker: Results From the MARVEL 2 Study.使用无导线心室起搏器实现房室同步起搏：MARVEL 2 研究结果。
JACC Clin Electrophysiol. 2020 Jan;6(1):94-106. doi: 10.1016/j.jacep.2019.10.017. Epub 2019 Nov 11.
4
Permanent pacemakers in older persons.老年人的永久性起搏器
J Am Geriatr Soc. 1999 Sep;47(9):1125-35. doi: 10.1111/j.1532-5415.1999.tb05239.x.
5
Benefits of the advances in cardiac pacemaker technology.心脏起搏器技术进步的益处。
Clin Cardiol. 1992 Aug;15(8):601-6. doi: 10.1002/clc.4960150811.
6
Optimised rate-responsive pacing does not improve either right ventricular haemodynamics or exercise capacity in adults with a systemic right ventricle.优化的频率适应性起搏对右心室转位的成人患者的右心室血流动力学或运动能力均无改善作用。
Cardiol Young. 2010 Oct;20(5):485-94. doi: 10.1017/S1047951110000454. Epub 2010 May 11.
7
Reliability of the evoked response in determining the paced ventricular rate and performance of the QT or rate responsive (TX) pacemaker.诱发反应在确定心室起搏频率以及QT或频率应答型（TX）起搏器性能方面的可靠性。
Pacing Clin Electrophysiol. 1985 Sep;8(5):701-14. doi: 10.1111/j.1540-8159.1985.tb05883.x.
8
Closed loop stimulation is effective in improving heart rate and blood pressure response to mental stress: report of a single-chamber pacemaker study in patients with chronotropic incompetent atrial fibrillation.闭环刺激在改善心率和血压对精神应激的反应方面有效：一项针对变时功能不全性心房颤动患者的单腔起搏器研究报告
Pacing Clin Electrophysiol. 2012 Aug;35(8):990-8. doi: 10.1111/j.1540-8159.2012.03445.x. Epub 2012 Jun 9.
9
A real-world experience of atrioventricular synchronous pacing with leadless ventricular pacemakers.无导线心室起搏器进行房室同步起搏的真实世界经验。
J Cardiovasc Electrophysiol. 2022 May;33(5):982-993. doi: 10.1111/jce.15430. Epub 2022 Mar 14.
10
[DDD versus DDDR pacemaker stimulation: comparison of cardiopulmonary performance, incidence of atrial arrhythmias and quality of life].[DDD与DDDR起搏器刺激：心肺功能、房性心律失常发生率及生活质量的比较]
Z Kardiol. 1996 Apr;85(4):226-36.

引用本文的文献

1
Wearable Devices for Exercise Prescription and Physical Activity Monitoring in Patients with Various Cardiovascular Conditions.用于各种心血管疾病患者运动处方和身体活动监测的可穿戴设备
CJC Open. 2025 Mar 3;7(5):695-706. doi: 10.1016/j.cjco.2025.02.017. eCollection 2025 May.
2
Strategies and Considerations for Safe Reinforcement Learning in Programming Cardiac Implantable Electronic Devices.用于心脏植入式电子设备编程的安全强化学习策略与考量
Med Res Arch. 2025 Mar;13(3). doi: 10.18103/mra.v13i3.6363. Epub 2025 Mar 29.
3
Can we improve techniques and patients' selection for nerve stimulation suitable for lower urinary tract dysfunctions? ICI-RS 2023.

本文引用的文献

1
Permanent pacing versus cardioneuroablation for cardioinhibitory vasovagal syncope.永久性起搏与心脏神经消融术治疗心脏抑制型血管迷走性晕厥的比较
J Interv Card Electrophysiol. 2025 Mar;68(2):203-210. doi: 10.1007/s10840-022-01456-x. Epub 2022 Dec 23.
2
Computed tomography with positron emission tomography is more useful in local than systemic infectious process related to cardiac implanted electrotherapy device: a prospective controlled multicenter diagnostic intervention PET-Guidance Trial.正电子发射断层扫描与计算机断层扫描在心脏植入式电疗装置相关局部感染过程中的作用优于全身感染过程：一项前瞻性对照多中心诊断介入性 PET 引导试验。
Int J Cardiovasc Imaging. 2022 Dec;38(12):2753-2761. doi: 10.1007/s10554-022-02663-3. Epub 2022 Sep 7.
3
我们能否改进适合下尿路功能障碍的神经刺激技术和患者选择？ICI-RS 2023.
Neurourol Urodyn. 2024 Aug;43(6):1420-1430. doi: 10.1002/nau.25346. Epub 2023 Dec 4.
4
Importance of timing optimization for closed-loop applications of vagus nerve stimulation.迷走神经刺激闭环应用中定时优化的重要性。
Bioelectron Med. 2023 Apr 27;9(1):8. doi: 10.1186/s42234-023-00110-9.
Application and optimization of the rate response function in dual-chamber pacemakers: Prospective, randomized, cross-over clinical trial study protocol.
双腔起搏器速率应答功能的应用与优化：前瞻性、随机、交叉临床试验研究方案。
Kardiol Pol. 2022;80(11):1139-1141. doi: 10.33963/KP.a2022.0230. Epub 2022 Sep 29.
4
Arrhythmia Burden and Heart Rate Response During Exercise in Anderson-Fabry Disease.安德森-法布里病患者运动期间的心律失常负担和心率反应。
Tex Heart Inst J. 2022 Sep 1;49(5). doi: 10.14503/THIJ-20-7363.
5
Chronotropic incompetence in end-stage liver disease.终末期肝病的变时性功能不全。
PLoS One. 2022 Aug 1;17(8):e0270784. doi: 10.1371/journal.pone.0270784. eCollection 2022.
6
Pacing for vasovagal syncope: Tips for use in practice.血管迷走性晕厥的起搏治疗：实践中的使用技巧。
Auton Neurosci. 2022 Sep;241:102998. doi: 10.1016/j.autneu.2022.102998. Epub 2022 Jun 2.
7
Cardiac Pacing in Cardioinhibitory Reflex Syncope: Clinical Use of Closed-loop Stimulation.心脏抑制性反射性晕厥中的心脏起搏：闭环刺激的临床应用
Arrhythm Electrophysiol Rev. 2021 Dec;10(4):244-249. doi: 10.15420/aer.2021.45.
8
High rate episodes in a dual chamber pacemaker: What is the mechanism?双腔起搏器中的高频事件：其机制是什么？
Pacing Clin Electrophysiol. 2022 Feb;45(2):238-240. doi: 10.1111/pace.14430. Epub 2022 Jan 17.
9
Chronotropic Incompetence in Non-Hospitalized Patients with Post-COVID-19 Syndrome.新冠后综合征非住院患者的变时性功能不全
J Clin Med. 2021 Nov 20;10(22):5434. doi: 10.3390/jcm10225434.
10
Pacing-Induced Cardiomyopathy.起搏诱导性心肌病。
Card Electrophysiol Clin. 2021 Dec;13(4):741-753. doi: 10.1016/j.ccep.2021.06.009. Epub 2021 Sep 23.