© 2001 by European Society of Cardiology
PACING
Evaluation of the quality of rate adaptation algorithms for cardiac pacing
1Biomedical Engineering Centre, Tallinn Technical University Ehitajate tee 5, 19086, Tallinn, Estonia; 2Estonian Institute of Cardiology Ravi 18, 10138, Tallinn, Estonia; 3Informatique Médicale Paris VI, Faculté de Médecine Broussais-Hotel Dieu, 15, rue de l'Ecole de la Médecine, 75006, Paris, France
Abstract
The aim of this study was a comparative evaluation of some commonly used pacemaker control parameter combinations and algorithms for heart rate (HR) reconstruction. The quality of heart rate reconstruction was estimated comparing the reconstructed heart rate and intrinsic heart rate on the basis of a healthy person model. The model was developed on the basis of simultaneous measurement of intrinsic HR and different control parameters, which can electrically be recorded: QT-interval, (QT), ventilation (V) and body movement activity (ACT). Relative mean square error (RMSE) between natural and reconstructed HR was used as a measure of HR reconstruction quality.
It was shown that the results of linear and polynomial approximations for HR reconstruction practically coincided inside the range of interest for pacing in clinical practice 60–120 beats . min–1and there was no need to implement more complex algorithms. As for single-parameter systems the QT parameter had better reconstruction accuracy compared with ACT and V. All double-parameter systems presented HR reconstruction error level of around 10% that were within the limits suitable for clinical practice. The application of more than two parameters for HR reconstruction seems to be unnecessary, as the triple-parameter models appeared not to improve remarkably the quality of HR reconstruction.
Key Words: Cardiac pacemaker, rate adaptation algorithms, ventilation sensor, QT-interval sensor, activity sensor
Correspondence: Jaanus Lass, M.Sc., Biomedical Engineering Centre, Tallinn Technical University Ehitajate tee 5, 19086 Tallinn, Estonia. E-mail: jaanus{at}cb.ttu.ee
References
[1] Alt E, Schlegl MJ, Matula MM. Intrinsic heart rate response as a predictor of rate-adaptive pacing benefit. Chest 1995; 107: 925–930.
[2] Alt E, Combs W, Willhaus R, et al. A comparative study of activity and dual sensor: activity and minute ventilation pacing responses to ascending and descending stairs. Pacing Clin Electrophysiol 1998; 21: 1862–1868.[CrossRef][Medline]
[3] Leung SK, Lau CP, Tang MO. Cardiac output is a sensitive indicator of difference in exercise performance between single and dual sensor pacemakers. Pacing Clin Electrophysiol 1998; 21: 35–41.[CrossRef][Medline]
[4] Bellocci F, Spampinato A, Ricci R, et al. Antiarrhythmic benefits of dual chamber stimulation with rate-response in patients with paroxysmal atrial fibrillation and chronotropic incompetence. Europace 1999; 1: 220–225.
[5] Sulke N, Tan K, Kamalvand K, et al. Dual sensor VVIR mode pacing: is it worth it? Pacing Clin Electrophysiol 1996; 19: 1560–1567.[Medline]
[6] Clementy J, Barold SS, Jais P, et al. Clinical significance of multiple sensor options: rate response optimization, sensor blending, and trending. Am J Cardiol 1999; 83: 166D–171D.[Medline]
[7] Lau CP, Leung SK, Guerola M, et al. Comparison of continuously recorded sensor and sinus rates during daily life activities and standardized exercise testing: efficacy of automatically optimized rate adaptive dual sensor pacing to simulate sinus rhythm. Pacing Clin Electrophysiol 1996; 19: 1672–1677.[Medline]
[8] Theres H, Philippon F, Melzer C, et al. The influence of sensor orientation on activity-based rate responsive pacing. Sensor Orientation Study Group. Pacing Clin Electrophysiol 1998; 21: 2095–2099.[Medline]
[9] Bonnet JL, Geroux L, Cazeau S. Evaluation of a dual sensor rate responsive pacing system based on a new concept. French Talent DR Pacemaker Investigators. Pacing Clin Electrophysiol 1998; 21: 2198–2203.[CrossRef][Medline]
[10] Celiker A, Ceviz N, Alehan D, et al. Comparison of normal sinus rhythm and pacing rate in children with minute ventilation single chamber rate adaptive permanent pacemakers. Pacing Clin Electrophysiol 1998; 21: 2100–2104.[CrossRef][Medline]
[11] Osswald S, Leiggener C, Buser PT, et al. Benefits and limitations of rate adaptive pacing under laboratory and daily life conditions in patients with minute ventilation single chamber pacemakers. Pacing Clin Electrophysiol 1996; 19: 890–898.[Medline]
[12] Greco EM, Guardini S, Ferrario M, Romano S. How to program rate responsive pacemakers. Pacing Clin Electrophysiol 2000; 23: 165–173.[CrossRef][Medline]
[13] Min M and Parve T. Current mode signal processing in lock-in instruments for bioimpedance measurement. Med Biol Eng Comput 1996; 34:suppl. 1, 167–168.
[14] Lass J, Meigas K, Hinrikus H, Kaik J. Noninvasive multiparameter registration system for evaluating physiological condition. Proc Estonian Acad Sci Eng 1999; 4: 293–303.
[15] Candinas R, Jakob M, Buckingham TA, et al. Vibration, acceleration, gravitation, and movement: activity controlled rate adaptive pacing during treadmill exercise testing and daily life activities. Pacing Clin Electrophysiol 1997; 20: 1777–1786.[CrossRef][Medline]
[16] Lass J, Hinrikus H, Kaik J, Meigas K. Measurement of Correlation Between Heart Rate and Physiological Parameters Variations. Proceedings of the 19th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Chicago 1997; 308–310.
[17] Schmidt M, Ammer R, Evans F, et al. Improving accelerometer-based rate adaptive pacing by means of second-generation signal processing. Pacing Clin Electrophysiol 1996; 19: 1698–1703.[CrossRef][Medline]
[18] Werner J, Hexamer M, Meine M, Lemke B. Restoration of cardio-circulatory regulation by rate-adaptive pacemaker systems: the bioengineering view of a clinical problem. IEEE Transact Biomedical Eng 1999; 46: 1057–1064.[CrossRef]
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