Is a dual-sensor pacemaker appropriate in patients with sino-atrial disease? Results from the DUSISLOG study

Luigi Padeletti, Paolo Pieragnoli, Luigi Di Biase, Andrea Colella, Maurizio Landolina, Eugenio Moro, Serafino Orazi, Alfredo Vicentini, Giampiero Maglia, Orazio Pensabene, Giovanni Raciti, S. Serge Barold

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28 Scopus citations

Abstract

Background: Rate-responsive pacemakers (PMs) are often supplied with accelerometer (XL) and minute ventilation (MV) sensors to provide a physiologic rate response according to patient needs. No information is available about the real benefit of dual-sensor rate-responsive pacing on the daily life of patients. Methods: DUSISLOG (Dual Sensor vs Single Sensor comparison using patient activity LOGbook) is a two-arm prospective, randomized, multicenter study that enrolled 105 patients who received a rate-responsive PM (Insignia®, Guidant Corp.). After 1 month of DDD pacing at 60 ppm lower rate, a single sensor (XL or MV, randomized) was activated for 3 months at the manufacturer's suggested nominal settings, followed by a 3-month period with dual sensors optimized with automatic response. During the last month of each period, the following data concerning patient physical activity were retrieved from PM diagnostics (Activity Log): mean percentage of physical activity, mean intensity of activity. Quality of life (QoL) scores and 6-minute walk test (WT) were also recorded. Results: Single-sensor rate-responsive pacing resulted in symptomatic benefit equally with XL and MV sensors while no additional benefit was found using dual sensor. In a subgroup analysis, patients (17%) with marked chronotropic incompetence and with 0% atrial sensing received benefits from single sensor with an additional advantage from sensor (QoL: +21 ± 14% P < 0.05; WT: +17 ± 7% P < 0.02). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)34-40
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2006

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Keywords

  • Atrial chronotropic incompetence
  • Cardiac pacemaker
  • Cardiac pacing
  • Rate-responsive pacing
  • Sick sinus syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Padeletti, L., Pieragnoli, P., Di Biase, L., Colella, A., Landolina, M., Moro, E., Orazi, S., Vicentini, A., Maglia, G., Pensabene, O., Raciti, G., & Barold, S. S. (2006). Is a dual-sensor pacemaker appropriate in patients with sino-atrial disease? Results from the DUSISLOG study. PACE - Pacing and Clinical Electrophysiology, 29(1), 34-40. https://doi.org/10.1111/j.1540-8159.2006.00301.x