"If a 24-h holter monitor shows a heart rate below 100 bpm, there is a good likelihood the patient may have chronotropic incompetence."
Dr. Botti (Cleveland, US)
Chronotropic incompetence is real and can be treated by using the right sensor in the pacemaker.
Before starting the treatment it is important to have a scanning protocol to improve the quality of life of the right patients.
In my practice I use an Assess-Investigate–Confirm protocol to scan for chronotropic incompetence.
With this protocol I am able to help more patients and they are very grateful that we have given them back their lives and made them feel young again.
To learn more about this protocol; click on the 'how to identify patients with chronotropic incompetence video' on this page.
Up to 42% of pacemaker patients and
around 20% of the non-paced population
are diagnosed with chronotropic incompetence.
In the following studies the prevalence of chronotropic incompetence in the general population and in pacemaker (PM) patients pre- and post-implant was:
The Lukl study further classifies chronotropic incompetence in following pacemaker indications:
Identify patients
with chronotropic incompetence.
It is important to monitor paced patients even if not previously diagnosed with CI. A protocol has been developed by Dr Botti to help to identify patients suffering from chronotropic incompetence.
These are just a few of the complaints you
might hear from a chronotropically
incompetent patient.
"I frequently feel fatigued"
"I cannot do the things I used to do"
"When I am active I feel lightheaded"
According to the Lukl study two out of every three pacemaker patients with atrial fibrillation and one out of every two pacemaker patients with SSS suffer from chronotropic incompetence. These patients can be helped by providing the appropriate heart rate with ALTRUA™ MV blended sensor pacemakers. Below patient cases provide some insight in how the ALTRUA™ MV blended sensor can restore chronotropic competence with your CI patient.
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"The physician checked the ‘accelerometer only’ response with the trending simulation capability. He clearly realized the response difference between ‘accelerometer only’ and the ‘MV Blended sensor’." |
"The MV sensor measures transthoracic impedance to monitor changes in respiratory rate and tidal volume.This is a real need for my patient, she suffers of dyspnea during hard exercise. I am sure: the contributors of two sensors are better than only ACC sensor." |
"Since the patient is young (43-year-old female) and pacemaker dependent, the MV blended sensor supports the patient in reaching the right frequencies in her daily routine." |
| Download case report | Download case report | Download case report |
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"This report illustrates a case where chronotropic response persisted inadequate after pacemaker implantation with single accelerometer sensor at nominal settings." |
"Patients with an active lifestyle suffering from CI induced by His ablation and ongoing AF require a pacemaker with optimal rate response." |
"Since the pacemaker was repro- |
| Download case report | Download case report | Download case report |
|
"After 6 weeks, I called my patient to evaluate the new sensor settings. |
"The report shows how important it is to choose the right sensor system for active patients and how it can improve outcomes." |
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| Download case report | Download case report | |
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