Behavior of different activity-based pacemakers during treadmill exercise testing with variable slopes: a comparison of three activity-based pacing systems.

A new generation of activity-based pacemakers incorporates an accelerometer sensitive to low frequency acceleration signals in the anteroposterior direction for sensing of bodily stress. The purpose of our investigation was to test a representative model of these new activity-based pacemakers (Relay) and compare it with current vibration- and housing pressure-sensing systems. We tested ten pacemaker patients with implanted Activitrax, Sensolog, and Relay systems during treadmill exercise testing with variable slopes. Devices from the three systems were also strapped externally to the chest of each patient and to ten normal test subjects in the control group. Exercise tests were conducted with changes of treadmill speed and/or treadmill slope. For comparable workloads during constant speed/variable slope and constant slope/variable speed, Relay had similar rate responses (difference not significant). Significant differences (P < 0.05) in rate adaptation attributable to the kind of treadmill exercise (change in treadmill speed or slopes) were observed in the housing pressure- and vibration-based pacemakers. Activity-based pacemakers with an acceleration sensor adapt pacing rates during treadmill exercises independent of treadmill speed or slope better than those controlled by a conventional housing pressure or vibration sensor.