{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T19:26:46Z","timestamp":1770060406224,"version":"3.49.0"},"reference-count":18,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1998,1,27]]},"published-print":{"date-parts":[[1998,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To compare the value of a series of cardiovascular measurements in patients with symptomatic disease receiving an effective treatment (rate responsive pacing).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>12 pacemaker dependent patients with VVIR units.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Single blind crossover between VVI and VVIR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures<\/jats:title>\n                  <jats:p>Exercise capacity was assessed by treadmill tests (modified Bruce protocol and a fixed workload protocol) with respiratory gas analysis. Self paced corridor walk tests were also undertaken. Quality of life (QOL) was assessed by questionnaire. Daily activity was measured in the patients\u2019 homes using shoe and belt pedometers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Treadmill tests and QOL questionnaires correctly identified the clinical benefit associated with VVIR. The modified Bruce protocol was superior to the fixed workload protocol as it was better tailored to the fairly well preserved exercise capacity of the patients. Symptom scores, but not walking times, were improved with VVIR during corridor walk tests. VVIR did not improve daily activity measured using either the belt or shoe pedometers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>VVIR pacing improved some but not all measures of exercise capacity. This finding illustrates the difficulty of selecting an instrument to measure symptomatic improvement in clinical research; and raises the question, what is the best way of measuring exercise capacity?<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.80.4.383","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"383-386","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["\u201cValue\u201d of improved treadmill exercise capacity: lessons from a study of rate responsive pacing"],"prefix":"10.1136","volume":"80","author":[{"given":"A D","family":"Staniforth","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Queen\u2019s Medical Centre, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Queen\u2019s Medical Centre, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Queen\u2019s Medical Centre, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Queen\u2019s Medical Centre, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A J","family":"Cowley","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Queen\u2019s Medical Centre, University of Nottingham, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1998,10,1]]},"reference":[{"key":"2025092005455879000_80.4.383.1","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1111\/j.1540-8159.1991.tb04110.x","article-title":"Quality of life in patients with rate responsive pacemakers: a randomised, cross-over study.","volume":"14","author":"Oto","year":"1991","journal-title":"PACE"},{"key":"2025092005455879000_80.4.383.2","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1111\/j.1540-8159.1990.tb02150.x","article-title":"Is accurate rate response programming necessary?","volume":"13","author":"Sulke","year":"1990","journal-title":"PACE"},{"key":"2025092005455879000_80.4.383.3","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1111\/j.1540-8159.1989.tb02671.x","article-title":"QT sensing rate responsive pacing compared to fixed rate ventricular inhibited pacing: a controlled clinical study.","volume":"12","author":"Hedman","year":"1989","journal-title":"PACE"},{"key":"2025092005455879000_80.4.383.4","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.75.1.184"},{"key":"2025092005455879000_80.4.383.5","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.58.6.613"},{"key":"2025092005455879000_80.4.383.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60519-X"},{"key":"2025092005455879000_80.4.383.7","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1111\/j.1540-8159.1992.tb02992.x","article-title":"Evaluation by cardiopulmonary exercise test of DDDR versus DDD pacing.","volume":"15","author":"Capucci","year":"1992","journal-title":"PACE"},{"key":"2025092005455879000_80.4.383.8","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90238-0"},{"key":"2025092005455879000_80.4.383.9","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1136\/hrt.74.4.373","article-title":"Failure of \u201ceffective\u201d treatment for heart failure to improve normal customary activity.","volume":"73","author":"Walsh","year":"1995","journal-title":"Br Heart J"},{"key":"2025092005455879000_80.4.383.10","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.72.2.192"},{"key":"2025092005455879000_80.4.383.11","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1093\/oxfordjournals.eurheartj.a060291","article-title":"Ventricular rate adaptive pacing in the elderly.","volume":"72","author":"Lau","year":"1992","journal-title":"Eur Heart J"},{"key":"2025092005455879000_80.4.383.12","first-page":"90","article-title":"Perceived exertion: a note on \u201chistory\u201d and methods.","volume":"5","author":"Borg","year":"1973","journal-title":"Med Sci Sports"},{"key":"2025092005455879000_80.4.383.13","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1016\/S0140-6736(86)92734-0","article-title":"A non-invasive method for measuring cardiac output: the effect of Christmas lunch.","volume":"ii","author":"Cowley","year":"1986","journal-title":"Lancet"},{"key":"2025092005455879000_80.4.383.14","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(94)90088-4"},{"key":"2025092005455879000_80.4.383.15","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.72.3.226"},{"key":"2025092005455879000_80.4.383.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)10488-8"},{"key":"2025092005455879000_80.4.383.17","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/BF00690900","article-title":"Validation of a simple mechanical accelerometer (pedometer) for the estimation of walking activity.","volume":"56","author":"Bassey","year":"1987","journal-title":"Eur J Appl Physiol"},{"key":"2025092005455879000_80.4.383.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00141-0"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.80.4.383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T12:46:09Z","timestamp":1758372369000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.80.4.383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,10,1]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1998,10,1]]},"published-print":{"date-parts":[[1998,10,1]]}},"alternative-id":["10.1136\/hrt.80.4.383"],"URL":"https:\/\/doi.org\/10.1136\/hrt.80.4.383","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,10,1]]}}}