Comparison of normal sinus rhythm and pacing rate in children with minute ventilation single chamber rate adaptive permanent pacemakers

Rate adaptive pacemakers are used to achieve a better cardiac performance during exercise by increasing the heart rate and cardiac output. The ideal rate adaptive sensor should be able to mimic sinus node modulation under various degrees of exercise and other metabolic needs. Minute ventilation sensing has proven to be one of the most accurate sensor systems. In this study, alterations in sinus rhythm and pacing rates during daily life conditions in II children (median age 11 years, range 6-14 years) with minute ventilation single chamber pacemakers rr ere investigated. Correlation of sin us rhythm with pacing rates was assessed. ECG records rr ere obtained from 24-hour Holter monitoring. Average rates of five consecutive P waves and pace waves were determined every half hour. The average of the two values et as then used to determine hourly rates. Correlation coefficients between the sinus rhythm and pacing rates were calculated In nine patients, pacing rates correlated well to sinus rhythm (range 0.6793-0.9558, P < 0.001 and P < 0.05), whereas in two cases correlation was not sufficient (P > 0.05). Most of the patients, in whom rate response factor (RRF) measurements during peak exercise by treadmill with chronotropic assessment exercise protocol were performed and pacemakers tc ere programmed to these parameters, had more appropriate ventricular rates compared to spontaneous sinus rates. In these patients mean RRF value was 15.3 +/- 2.7 (range 12-20, median 15). This study shorts that during daily activities minute ventilation rate adaptive pacemakers can achieve pacing rates rt ell correlated to sin us rhythm that reflects the physiological heart rate in children.