The contribution of rate adaptive pacing with single or dual sensors to health-related quality of life

Aims The characteristics of sensors to perform rate adaptive pacing are well established but whether their contribution improves health-related quality of life (QoL) remains disputable. To compare the effects on QoL with an integrated dual sensor [minute ventilation (MV) and acceleration, TT sensor]...

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Published in:	Europace (London, England) Vol. 9; no. 4; pp. 233 - 238
Main Authors:	van Hemel, Norbert M, Holwerda, Klaas J, Slegers, Paul C, Spierenburg, Han AM, Timmermans, Alphons AJM, Meeder, Joan G, van der Kemp, Peter, Kelder, Johannes C, Stofmeel, Monique AM
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-04-2007 Oxford Publishing Limited (England)
Subjects:	Adult Aged Cardiac Pacing, Artificial - statistics & numerical data Female Heart Block - epidemiology Heart Block - prevention & control Humans Male Middle Aged Netherlands - epidemiology Outcome Assessment (Health Care) - methods Pacemaker, Artificial - statistics & numerical data Patient Satisfaction - statistics & numerical data Quality of Life Risk Assessment - methods Risk Factors Sick Sinus Syndrome - epidemiology Sick Sinus Syndrome - prevention & control Single-Blind Method Treatment Outcome Netherlands Rate adaptive pacing Pacemaker sensor QoL and PM sensor Pacemaker Double sensor Quality of life
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Summary:	Aims The characteristics of sensors to perform rate adaptive pacing are well established but whether their contribution improves health-related quality of life (QoL) remains disputable. To compare the effects on QoL with an integrated dual sensor [minute ventilation (MV) and acceleration, TT sensor] with a single MV sensor, and with no rate adaptive pacing. Methods and results This Dutch multi centre, prospective, single- (patient) blind study was performed in patients after first pacemaker (PM) implant for sick sinus syndrome or AV block. After a 3-month 'sensor off'-period following DDD PM implantation, where the latter 2 months permitted the MV sensor to learn the intrinsic rhythm, a 2-month period of DDDR with TT sensor or 2 months of DDDR with MV sensor, subsequently the two modes were crossed over. Quality of life was determined with Aquarel, the disease-specific instrument for PM patients. Heart rate, percentages of sensor driven and intrinsic rhythm were retrieved from PM memories. Sixty-four patients completed the 7-month study. In sick sinus patients, percentages of sensor-driven pacing occurred significantly more frequently than in AV block patients After implant QoL improved significantly: before 71.3 and after 83.5% (P < 0.001) measured with Aquarel and in 3 of 9 SF-36 scales, but no significant additive QoL benefit with dual or MV sensor pacing was observed. Pacing diagnosis, percentages of rate adaptive pacing, and heart rate influencing medication did not influence this result. Conclusion Pacemaker implantation strongly improves QoL, but neither single- nor dual- sensor-driven pacing offered additional improvement in QoL during the initial 8 months after the first PM implant.
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ISSN:	1099-5129 1532-2092
DOI:	10.1093/europace/eum021