Hemodynamic monitoring by intracardiac impedance measured by cardiac resynchronization defibrillators: Evaluation in a controlled clinical setting (BIO.Detect HF II study)

Autor: Niels Eske Bruun, Christoph Stellbrink, Sebastian Maier, Klaus-Jürgen Gutleben, Peter Søgaard, Hanno Oswald, Stefan Paule, Peter-Paul Henri Marie Delnoy, Jens Brock Johansen
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
CRT
cardiac resynchronization therapy
medicine.medical_treatment
Stroke impedance
Cardiac resynchronization therapy
Hemodynamics
Heart failure
030204 cardiovascular system & hematology
Hemodynamic parameters
HF
heart failure
Intracardiac injection
03 medical and health sciences
QRS complex
0302 clinical medicine
Cardiac resynchronization therapy defibrillator
Physiology (medical)
Internal medicine
EDZ
end-diastolic impedance
medicine
Diseases of the circulatory (Cardiovascular) system
030212 general & internal medicine
SZ
stroke impedance
cardiovascular diseases
NYHA
New York Heart Association
Stroke
LV
left ventricular
Ejection fraction
business.industry
ICI
intracardiac impedance
Ao-VTI
aortic velocity time integral
Stroke volume
ICI-MF
ICI measurement feature
medicine.disease
LVEDD
LV end-diastolic diameter
Zmean
mean impedance
ESZ
end-systolic impedance
LVEF
LV ejection fraction
RC666-701
Cardiology
cardiovascular system
CRT-D
CRT defibrillator
Original Article
Intracardiac impedance
Cardiology and Cardiovascular Medicine
business
RV
right ventricular
Zdroj: Indian Pacing and Electrophysiology Journal, Vol 21, Iss 4, Pp 209-218 (2021)
Delnoy, P-P H M, Gutleben, K-J, Bruun, N E, Maier, S K G, Oswald, H, Stellbrink, C, Johansen, J B, Paule, S & Søgaard, P 2021, ' Hemodynamic monitoring by intracardiac impedance measured by cardiac resynchronization defibrillators : Evaluation in a controlled clinical setting (BIO.Detect HF II study) ', Indian pacing and electrophysiology journal, vol. 21, no. 4, pp. 209-218 . https://doi.org/10.1016/j.ipej.2021.04.003
Indian Pacing and Electrophysiology Journal
Delnoy, P P H M, Gutleben, K J, Bruun, N E, Maier, S K G, Oswald, H, Stellbrink, C, Johansen, J B, Paule, S & Søgaard, P 2021, ' Hemodynamic monitoring by intracardiac impedance measured by cardiac resynchronization defibrillators : Evaluation in a controlled clinical setting (BIO.Detect HF II study) ', Indian Pacing and Electrophysiology Journal, vol. 21, no. 4, pp. 209-218 . https://doi.org/10.1016/j.ipej.2021.04.003
ISSN: 0972-6292
DOI: 10.1016/j.ipej.2021.04.003
Popis: Background In patients with cardiac resynchronization therapy defibrillators (CRT-Ds), intracardiac impedance measured by dedicated CRT-D software may be used to monitor hemodynamic changes. We investigated the relationship of hemodynamic parameters assessed by intracardiac impedance and by echocardiography in a controlled clinical setting. Methods The study enrolled 68 patients (mean age, 66 ± 9 years; 74% males) at 12 investigational sites. The patients had an indication for CRT-D implantation, New York Heart Association class II/III symptoms, left ventricular ejection fraction 15%–35%, and a QRS duration ≥150 ms. Two months after a CRT-D implantation, hemodynamic changes were provoked by overdrive pacing. Intracardiac impedance was recorded at rest and at four pacing rates ranging from 10 to 40 beats/min above the resting rate. In parallel, echocardiography measurements were performed. We hypothesized that a mean intra-individual correlation coefficient (rmean) between stroke impedance (difference between end-systolic and end-diastolic intracardiac impedance) measured by CRT-D and the aortic velocity time integral (i.e., stroke volume) determined by echocardiography would be significantly larger than 0.65. Results The hypothesis was evaluated in 40 patients with complete data sets. The rmean was 0.797, with a lower confidence interval bound of 0.709. The study hypothesis was met (p = 0.007). A stepwise reduction of stroke impedance and stroke volume was observed with increasing heart rate. Conclusions Intracardiac impedance measured by implanted CRT-Ds correlated well with the aortic velocity time integral (stroke volume) determined by echocardiography. The impedance measurements bear potential and are readily available technically, not requiring implantation of additional material beyond standard CRT-D system.
Highlights • Intracardiac impedance measurement feature (ICI-MF) is integrated in some CRT-Ds. • We studied relationship between echo hemodynamic parameters and ICI-MF of CRT-Ds. • Stroke volume by echo correlated well with stroke impedance by ICI-MF of CRT-Ds. • Stepwise reduction in stroke impedance and stroke volume with increasing heart rate. • The ICI-MF bears potential and requires only a ‘standard’ CRT-D system implantation.
Databáze: OpenAIRE
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