Physiological rate adaptation in a child with chronotropic incompetence through closed- loop stimulation using epicardial leads  Alfredo di Pino, MD, Elio.

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Physiological rate adaptation in a child with chronotropic incompetence through closed- loop stimulation using epicardial leads  Alfredo di Pino, MD, Elio Caruso, MD, Federica Censi, PhD, Gianfranco Gaudenti, EEng, Alessio Gargaro, MS, Giovanni Calcagnini, PhD  HeartRhythm Case Reports  Volume 2, Issue 1, Pages 36-39 (January 2016) DOI: 10.1016/j.hrcr.2015.07.012 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 Diagnostic data extracted from the device since the last follow-up (133 days). A: Histogram of the atrial paced and sensed beats, represented as gray and black bars, respectively. The histogram shows the percentage of paced and sensed beats as a function of their own heart rate. B: Representation of the percentage number of atrial-ventricular sequences; As = atrium sensed; Ap = atrium paced; Vs = ventricle sensed; Vp = ventricle paced. C: Histogram of the sensor activity. The histogram shows the percentage number of beats as a function of the heart rate that the accelerometer would impose, if activated. HeartRhythm Case Reports 2016 2, 36-39DOI: (10.1016/j.hrcr.2015.07.012) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 Heart rate during the 4 test sessions: basal heart rate, handgrip, video game playing, and Stroop color-word test. Heart rate (as beats per minute [bpm]) is reported as a function of the number of beats (# beat). Circles indicate the spontaneous beats; stars indicate the paced beats. HeartRhythm Case Reports 2016 2, 36-39DOI: (10.1016/j.hrcr.2015.07.012) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 3 Cardiac area involved in closed-loop stimulation impedance measurements. HeartRhythm Case Reports 2016 2, 36-39DOI: (10.1016/j.hrcr.2015.07.012) Copyright © 2016 Heart Rhythm Society Terms and Conditions