Volume 92, Issue 2, Pages 247-252 (August 1987) Control of Pacemaker Rate by Impedancebased Respiratory Minute Ventilation  Eckhard Alt, M.D., Michael Heinz, M.D., Christoph Hirgstetter, M.D., Hans-Peter Emslander, M.D., Severin Daum, M.D., Hans Blömer, M.D.  CHEST  Volume 92, Issue 2, Pages 247-252 (August 1987) DOI: 10.1378/chest.92.2.247 Copyright © 1987 The American College of Chest Physicians Terms and Conditions

Figure 1 Respiratory rate (RR), respiratory minute ventilation (RMV) and heart rate (HR) in 42-year-old volunteer during bicycle ergometry at 100, 200, and 250 W. After end of exercise, heart rate and ventilation return to their initial values, while respiratory rate remains elevated. CHEST 1987 92, 247-252DOI: (10.1378/chest.92.2.247) Copyright © 1987 The American College of Chest Physicians Terms and Conditions

Figure 2 Ventilation and oxygen uptake as measured during trial described in Figure 1 broken down by heart rate (HR). A (upper left). Respiratory rate (RR) shows steeper increase at high heart rates (HR). Values of relatively high respiratory rate despite lower heart rate represent data obtained after end of exercising (in circle). B (upper right). Note sharp increase of TV at beginning of exercise and its only small increase above heart rates of 120 beats per minute. C (lower left). Respiratory minute ventilation (RMV). D (lower right). Oxygen uptake (Vo2 correlates relatively linearly to heart rate. CHEST 1987 92, 247-252DOI: (10.1378/chest.92.2.247) Copyright © 1987 The American College of Chest Physicians Terms and Conditions

Figure 3 Respiratory rate (RR), ventilation (RMV), and heart rate (HR) in 44-year-old patient with pacemaker with atrioventricular block during bicycle ergometry. Implanted pacemaker was temporarily programmed to WI mode of 70 beats per minute in this trial. Note also adequate increase of respiratory minute volume at onset of exercise (50 W) despite practically no increase of respiratory rate at this initial load. Heart rate exhibits at WI pacing of 70 beats per minute only minor increase due to atrioventricular block. Independently of heart rate and respiratory rate, work load and respiratory minute volume correlate well. CHEST 1987 92, 247-252DOI: (10.1378/chest.92.2.247) Copyright © 1987 The American College of Chest Physicians Terms and Conditions

Figure 4 Part of simultaneous strip-chart recording of ventilation by means of pneumotachygraphy (top channel), impedance plethysmography (middle channel), and heart rate (bottom channel) in healthy volunteer with bicycle ergometry at 50, 100, and 150 W. With higher work loads, ventilatory impedance signal additionally features changes in impedance caused by increased cardiac output. CHEST 1987 92, 247-252DOI: (10.1378/chest.92.2.247) Copyright © 1987 The American College of Chest Physicians Terms and Conditions

Figure 5 Plot of all directly measured data on ventilation vs indirectly gained values. RMV, Respiratory minute ventilation. CHEST 1987 92, 247-252DOI: (10.1378/chest.92.2.247) Copyright © 1987 The American College of Chest Physicians Terms and Conditions