{"id":685,"date":"2025-07-31T14:08:02","date_gmt":"2025-07-31T14:08:02","guid":{"rendered":"https:\/\/cardiocases.com\/?page_id=685"},"modified":"2026-01-02T10:19:15","modified_gmt":"2026-01-02T10:19:15","slug":"programming-for-exercise-biotronik","status":"publish","type":"page","link":"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/biotronik\/programming-for-exercise-biotronik\/","title":{"rendered":"Programming for Exercise Biotronik"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"685\" class=\"elementor elementor-685\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1084799 e-con-full e-flex e-con e-parent\" data-id=\"1084799\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9c1fe7d elementor-widget elementor-widget-heading\" data-id=\"9c1fe7d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Biotronik - Programming for exercise<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26e9275 elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"26e9275\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h3&quot;,&quot;h4&quot;,&quot;h5&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;marker_view&quot;:&quot;bullets&quot;,&quot;icon&quot;:{&quot;value&quot;:&quot;fas fa-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;,&quot;rendered_tag&quot;:&quot;&lt;svg class=\\&quot;e-font-icon-svg e-fas-circle\\&quot; viewBox=\\&quot;0 0 512 512\\&quot; xmlns=\\&quot;http:\\\/\\\/www.w3.org\\\/2000\\\/svg\\&quot;&gt;&lt;path d=\\&quot;M256 8C119 8 8 119 8 256s111 248 248 248 248-111 248-248S393 8 256 8z\\&quot;&gt;&lt;\\\/path&gt;&lt;\\\/svg&gt;&quot;},&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t\t\t\t<h4 class=\"elementor-toc__header-title\">\n\t\t\t\tContent\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__26e9275\" aria-expanded=\"true\" aria-label=\"Ouvrir la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__26e9275\" aria-expanded=\"true\" aria-label=\"Fermer la table des mati\u00e8res\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<div id=\"elementor-toc__26e9275\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b43bcc1 elementor-widget elementor-widget-heading\" data-id=\"b43bcc1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Rate adaptive pacing<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b918365 elementor-widget elementor-widget-text-editor\" data-id=\"b918365\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>The device achieves rate adaptation through programming of either standard motion-based pacing via a capacitive accelerometer or by the means of the principle of closed loop stimulation (CLS) which involves the translation of myocardial contractility into patient-specific pacing rates.<\/p><ul><li>for standard motion-based rate adaptation, the pacemaker is equipped with an accelerometer located on the hybrid circuit of the pacemaker; this sensor produces an electric signal during physical activity of the patient<\/li><li>when in CLS mode, the pacemaker monitors and processes the intracardiac impedance signal associated with myocardial contraction dynamics; changes in the waveform of this impedance signal are associated with changes in the contraction dynamics of the patient\u2019s heart due to the heart\u2019s inotropic response to exercise<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7d490d5 elementor-widget elementor-widget-image\" data-id=\"7d490d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"248\" src=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/BIOTRONIC.jpg\" class=\"attachment-large size-large wp-image-6517\" alt=\"\" srcset=\"https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/BIOTRONIC.jpg 801w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/BIOTRONIC-300x93.jpg 300w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/BIOTRONIC-768x238.jpg 768w, https:\/\/cardiocases.com\/wp-content\/uploads\/2026\/01\/BIOTRONIC-18x6.jpg 18w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-345489e elementor-widget elementor-widget-text-editor\" data-id=\"345489e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>Sensor Gain<\/strong><\/p><p>The sensor gain defines the slope of the linear function between exertion and pacing rate.<\/p><ul><li>the optimum setting is achieved when the desired maximum pacing rate during exertion is reached during maximum exercise levels<\/li><li>if the sensor-driven rate is not sufficient at high levels of exertion, the sensor gain setting should be increased<\/li><li>the sensor gain should be reduced if high pacing rates are obtained at low levels of exertion<\/li><\/ul><p>When the Automatic Sensor Gain setting is programmed, the Sensor Gain parameter is adjusted automatically.<\/p><ul><li>the device samples the sensor-indicated rate<\/li><li>the sensor gain is increased by 10%, if the activity rate does not reach or exceed the programmed activity rate (fixed to 90% of maximum sensor rate) for 30 minutes each day over 7 consecutive days; an increase in gain cannot occur more often than every 7 days<\/li><li>if, during the 24 hour period beginning at midnight, the activity rate reaches or exceeds the programmed activity rate (90% of maximum sensor rate) for one hour, the sensor gain setting is reduced by 10%<\/li><li>a change in the sensor gain only occurs at midnight<\/li><\/ul><p>The Automatic Sensor Gain function is primarily influenced by the Maximum Sensor Rate setting. Therefore the Maximum Sensor Rate must be appropriately selected.<\/p><p><strong>Sensor Threshold<\/strong><\/p><p>The effects of rate adaptation are limited to sensor signals exceeding the programmable sensor threshold. Sensor signals below this threshold do not affect rate response.<\/p><ul><li>the programmable sensor threshold ensures that a stable rate at rest can be achieved by ignoring sensor signals of low amplitude that are not related to exertion<\/li><li>if the pacing rate at rest is unstable, or tends to stay above the lower rate without activity, the sensor threshold should be increased<\/li><li>the sensor threshold should be reduced if a sufficient rate increase is not observed at a given level of exertion<\/li><\/ul><p><strong>Rate Increase<\/strong><\/p><p>The rate increase parameter determines the maximum rate of change in the pacing rate if the sensor signal indicates increasing exertion.<\/p><p><strong>Rate Decrease<\/strong><\/p><p>The rate decrease parameter determines the maximum rate of change in the pacing rate, if the sensor signal indicates decreasing exertion.<\/p><p><strong>Maximum Activity (Sensor) Rate<\/strong><\/p><p>Regardless of the sensor signal strength, the pacing rate during sensor-driven operation cannot exceed the programmed maximum sensor rate.<\/p><p><strong>Closed Loop Rate<\/strong><\/p><p>The device can be programmed to use a unique rate-adaptive principle called Closed Loop Stimulation (CLS) to adapt the patient\u2019s pacing rate. The DDD-CLS and VVI-CLS mode use the CLS concept to determine the pacing rate variations.<\/p><ul><li>the device measures electrical impedance by injecting a small AC current between the pacemaker case and the ventricular electrode tip<\/li><li>the induced voltage (which is proportional to the intracardiac impedance) is measured between pacemaker case and ventricular electrode tip<\/li><\/ul><p>When the pacemaker is programmed to CLS rate adaptation, the pacing rate during CLS-driven operation will never exceed the programmed maximum closed loop rate.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Biotronik &#8211; Programming for exercise Content Rate adaptive pacing The device achieves rate adaptation through programming of either standard motion-based pacing via a capacitive accelerometer or by the means of the principle of closed loop stimulation (CLS) which involves the translation of myocardial contractility into patient-specific pacing rates. for standard motion-based rate adaptation, the pacemaker [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":55,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-685","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Biotronik Pacemaker Exercise Programming | Cardiocases<\/title>\n<meta name=\"description\" content=\"Program Biotronik pacemakers for exercise \u2014 CLOSED LOOP Stimulation, rate response &amp; ECG tracings.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cardiocases.com\/fr\/pacing-defibrillation\/devices-per-company\/biotronik\/programming-for-exercise-biotronik\/\" 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