Is a Dual‐Sensor Pacemaker Appropriate in Patients with Sino‐Atrial Disease? Results from the DUSISLOG Study

Abstract

In most patients with rate-responsive devices, a single sensor is sufficient to achieve a satisfactory rate response. A dual sensor combination and optimization provides an additional benefit only in a selected population with an advanced atrial chronotropic disease.

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

“…The benefit of rate response programming has been evaluated in patients with bradycardia in 5 multicenter, randomized trials and in 1 systematic review that also included 7 single-center studies [17][18][19][20][21][22]. Most of these data were obtained from pacemaker studies and must be interpreted in that light.…”

“…In 2 small studies on patients with chronotropic incompetence comparing DDD and DDDR pacing, the latter had improved quality of life and exercise capacity; however, a larger, multicenter randomized trial (Advanced Elements of Pacing Randomized Controlled Trial [ADEPT]) failed to show a difference in patients with a modest blunted heart rate response to exercise [17][18][19]. In addition, DDDR programming in cardiac resynchronization therapy (CRT) patients has the potential to impair AV synchrony and timing.…”

HRS/ACCF Expert Consensus Statement on Pacemaker Device and Mode Selection

“…Rate adaptive pacing can be useful in patients with significant symptomatic chronotropic incompetence, and its need should be reevaluated during follow-up (Level of Evidence: C) (11,12). 2.…”

New Developments in Cardiac Pacemakers

“…Although small studies 41,42 have shown a superiority for rate-adaptive pacing in terms of quality of life and exercise capacity, the larger multicenter, randomized Advanced Elements of Pacing Randomized Controlled Trial (ADEPT), involving patients with moderate chronotropic incompetence, 43 did not confirm these results, although a higher rate of hospitalization for heart failure was observed in the patients with rate-adaptive pacing compared with those without rate-adaptive pacing. In addition, an increased risk of AF has been associated with frequent atrial pacing.…”