This 75-year-old man underwent implantation of an Ensura dual chamber pacemaker for complete AV block, programmed in DDDR mode; the pacemaker was interrogated.
Rate responsiveness must be programmed for chronotropic insufficiency. Without it, an unnecessary competition takes place between paced and spontaneous rhythms. Normal sinus rhythm is the best indicator of the physiologic metabolic demand. Rate responsiveness is an additional factor of energy consumption. Consequently, it seems appropriate, in this patient, to eliminate the rate response and reprogram the device to DDD mode.
