The ILR allowed the automatic detection of brady- and tachyarrhythmias in post-AMI patients, though a high incidence of false activations were observed. Clinically significant arrhythmias were recorded in a large number of patients with depressed left ventricular function early after AMI. This prompted the implantation of ICD or PM in nearly one third of patients.

Late HAVB development in post-AMI patients with left ventricular dysfunction can be predicted by risk stratification tests. Measures of HRV reflecting autonomic dysfunction revealed the highest predictive capabilities.

Computerized heart allograft recipient monitoring (CHARM) is a unique concept of patient surveillance after heart transplantation (HTx), based on the evaluation of intramyocardial electrograms (IEGMs) recorded non-invasively with telemetric pacemakers. Previous open, single-center studies had indicated a high correlation between CHARM results and clinical findings. The present study was initiated to assess the suitability of CHARM for monitoring the absence of rejection in a blind, multicenter context. During the HTx

(1) One-way ANOVA significant effect of the MAL recorded during the calibration test on subsequent rate modulation (P = 0.0001); (2) The sensor amplifier gain was inversely related to the MAL: high MAL induced lower amplifier gain and lower PR for identical accelerations; (3) Lower amplifier gain allowed to discriminate highest acceleration magnitudes before reaching an overflow of the sensor; (4) The maximum achievable PR increased not only with the programmed slope, but also with decreasing MAL (P = 0.0055): a low MAL shifts to the left calibration point located on the part of the RRC and makes the last steep part of the RRC start earlier, thus leading to higher maximum achievable PR. In conclusion the calibration procedure is crucial not only in defining a moderate acceleration intensity but also in determining the sensor amplifier gain and the maximum achievable PR.

Sensolog 703 is a new single chamber activity sensing rate modulated pacemaker that offers an automatic adjustment of settings called Autoset. Units were implanted in 11 patients (mean age: 67 years) for atrioventricular block (two patients), sinoatrial block (three patients), sick sinus syndrome (four patients), chronotropic incompetence (one patient), and atrial fibrillation with slow ventricular response (one patient). The devices were programmed in VVIR mode using Autoset. The accuracy of the settings was verified by the built-in histogram function. In 6/11 patients, these settings were not satisfactory. Autoset was repeated at 6 months (nine patients) and 10 months (five patients) after implantation. External telemetric recordings during daily life activities, Holter monitoring, bicycle or treadmill stress tests helped in the evaluation of the rate response obtained with the automatic programming. The following problems were encountered: maximum pacing rate for a low level of exercise (four patients), insufficient rate increase (four patients), higher pacing rate during low than during heavy exercises (four patients). A time-consuming (15 to 48 minutes) manual programming was necessary in eight out of nine patients (6 months) and five out of five patients (10 months). In our study, Sensolog 703 algorithm tended to behave as an on/off system; automatic programming was time consuming and only indicative.