"When I added the ALTRUA™ MV blended sensor, this 68-year old man is now able to go hiking and go back hunting and fishing like he used to. He feels like he is 20 years younger."
Dr. O’Cochlain (Ireland)
In the current pacemaker population many patients do not receive the appropriate heart rates for their daily activities.
The main limitation is related to the fact that the accelerometer alone in a pacemaker cannot detect all the movements.
Walking up a flight of stairs or riding a bicycle are just a few examples illustrating the limitations of the accelerometer.
At the end it will leave the patient chronotropically incompetent.
Chronotropic incompetence is real and can be treated. Physicians throughout Europe see the difference in daily practice when they use the ALTRUA™ MV blended sensor to restore their patients’ chronotropic response to daily exercise. In many cases these patients seem completely transformed and are able to do their daily activities they used to do.
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By looking at a patients’ chronotropic response, the level of chronotropic incompetence can be measured. The Wilkoff model has been accepted in the medical community as THE mathematical model of the Cardiac Chronotropic Response to Exercise. The model shows that cardiac chronotropic response can be formated as a simple linear mathematical function of: exercise intensity, age, resting heart rate and maximal functional capacity8.
Normal chronotropic response
Your CR is 16Calculate again
(* Results from the calculation are not predictive of clinical outcome and cannot be used as a clinical evaluation.)
An exercise test may be used as a more precise tool to further investigate chronotropic response. By measuring the chronotropic response patient symptoms (fatigue, shortness of breath or the like) can help to diagnose chronotropic incompetence:
1) 24h-Holter Monitor to measure heart rate while doing normal activities
2) In-Clinic Exercise Test (treadmill or cycle) where heart rate is monitored during an exercise protocol.
Activities of daily living require heart rates greater than 90 bpm regardless of age. Like younger patients, older patients also need to get their heart rates up to perform daily activities like climbing stairs or carrying shopping bags.
As patients age, they rely more on a higher heart rate to increase cardiac output. If, because of a combination of reasons the heart rate does not increase in response to their daily activities, the patient will feel fatigued, lightheaded…etc. These are the typical symptomps of a chronotropically incompetent patient.
Cardiac output is a combination of stroke volume times heart rate. Following conditions can influence cardiac output:
• Stroke volume: decreases through valvular disease and/or hypertension
• Heart rate: decreases through aging and/or chronotropic incompetence and/or beta blockers.
These deteriorating conditions become apparent during excercise when more cardiac output is needed.