频率应答功能教学课件.ppt

As we have seen, older individuals require the same submaximal heart rate support as younger patients. In addition, women need at least the same heart rate support as men. And finally, less active, less fit subjects require more aggressive submaximal heart rate support. When you are at rest, oxygen delivery is in equilibrium with oxygen consumption. This need for oxygen and its replacement stays rather steady until you start to exercise. When you start to exert yourself, the cells in your body begin to burn, or consume, more oxygen. Oxygen consumption rises immediately in a stepwise fashion, while oxygen delivery rises exponentially until it reaches a new steady state. The difference between the oxygen consumed at the onset of exercise and oxygen delivered is called the oxygen deficit, oxygen which must be replaced. The body resupplies oxygen to the cells via the cardiovascular system. The heart rate increases exponentially and oxygen-rich blood is pumped throughout the body, although it tends to take a bit more time to reach a new steady state. When it does, oxygen delivered reaches equilibrium with oxygen consumed. On the other hand, once the heart reaches a steady-state rate, any further increase in rate from the activity sensor may or may not be proportional to workload for all types of exercise. Such an increase in rate requires a sensor whose output is proportional to workload. This will allow the heart rate to meet metabolic demand which increases in a linear fashion once the initial steady state rate is reached -- precisely the role of the minute ventilation sensor. From acceleration to sensor indicated heart rate Many pacemaker patients suffer from some form of chronotropic incompetence, mainly caused by cardiac disorders. Rate responsive pacing is designed to restore the hearts natural response to metabolic need. The accelerometer sensor system of the pacemaker detects and measures body movements (acceleration) and converts this information into a sensor i