Improved delivery of rate-adaptive pacing using an impedance-derived contractility sensor in high-intensity exercise: A case report.
William Thomas Christopher ProcterJames ElliottAbdul H ButtChristopher MonkhouseAnish N BhuvaPhilip MoorePublished in: Pacing and clinical electrophysiology : PACE (2023)
Effective rate-adaptive pacing may be difficult in the presence of atrial fibrillation (AF), and is important during high-intensity exercise. This case presents a 74-year-old elite cyclist with AF and a biventricular pacemaker after atrioventricular (AV) node ablation. He reported sudden breathlessness due to heart rate drops, caused by breaching the artefact threshold on the minute-ventilation sensor. He was exchanged to a generator with an impedance-derived contractility sensor (closed-loop stimulation), resulting in resolution of symptoms, and no further rate drops. This is the first description of the utility of closed-loop stimulation in high-intensity exercise.
Keyphrases
- high intensity
- atrial fibrillation
- heart rate
- catheter ablation
- resistance training
- cardiac resynchronization therapy
- heart rate variability
- blood pressure
- left atrial
- heart failure
- left atrial appendage
- oral anticoagulants
- smooth muscle
- lymph node
- direct oral anticoagulants
- body composition
- percutaneous coronary intervention
- left ventricular
- mechanical ventilation
- acute coronary syndrome
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- radiofrequency ablation
- vena cava