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The image of sensor(s) used may impact the ability of the pacer to answer to various exercise modalities." Motion/activity sensors issue in sluggish HR response to activities that are plane such as on the bicycle ergometer or with supine, seated, or standing exercise, and rapid replication to ambulation. However, these pacers have poor proportionality (ie, faster rates when descending stairs than when ascending), and poor specificity (ie, inappropriate high rates when riding through the whole extent of a bumpy road).7 In patients with motion sensors, activities that exalt movement of the thorax (hallway ambulation) or treadmill protocols that include increases in one as well as the other speed and grade should be used to trigger an increase in HR QT sensors and ventilatory driven sensors may require longer warm up periods appropriate to delayed responses to activity, however, these sensors have profitable proportionality and specificity. The QT sensors are the solely sensors that respond to emotional stres however, medication and electrolyte even changes may impact responsivness of HR with QT interval sensors.7

Combinations of sensors, or dual sensor rate modulation pacers, appear to be to offer the best HR replication to immediate activity demands through exploiting strengths and counteracting weaknesses of individual sensors. In a arrange of 16 subjects with dual sensor pacemakers (activity and ventilation) with preserv left ventricular function, Page12 demonstrated similar HR and hemodynamic answers with healthy age-activity matched rules Ventilation sensors provide the predominant contribution during intense effort with activity sensors failing to reach required HR for optimal hemodynamic response12-15