Activity‐Responsive Pacing Produces Long‐Term Heart Rate Variability

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Abstract
Introduction: Long‐term heart rate variability (HRV) measures, including the standard deviation of means of successive 5‐minute epochs of R‐R interval intervals (SDANN) and the power law slope (β), are important prognostic measures, yet their physiologic basis is unknown. We tested the hypothesis that long‐term HRV arises from physical activity in a randomized cross‐over study in patients with rate‐responsive pacemakers. Methods and Results: Ten patients with complete heart block and dual‐chamber pacemakers underwent 24‐hour periods of ambulatory ECG in each of three pacing modes: atrially tracked, fixed‐rate, and rate‐responsive pacing. SDANN, ultralow frequency (ULF; frequencies Conclusion: Rate‐responsive pacing reproduces long‐term, but not short‐term, measures of HRV, suggesting that they may be markers of heart rate responses to patient activity. (J Cardiovasc Electrophysiol, Vol. 15, pp. 179‐183, February 2004)

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