When is an optimization not an optimization? Evaluation of clinical implications of information content (signal-to-noise ratio) in optimization of cardiac resynchronization therapy, and how to measure and maximize it
| Autor: | Alun D. Hughes, Andreas Kyriacou, Punam A. Pabari, Darrel P. Francis, Berthold Stegemann, Jamil Mayet, Irene E. van Geldorp, Michela Moraldo, Keith Willson |
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| Přispěvatelé: | Cardiologie, Kindergeneeskunde, Biomedische Technologie, RS: CARIM School for Cardiovascular Diseases |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Optimization
Time Factors medicine.medical_treatment Cardiac resynchronization therapy Signal Models Biological Standard deviation Article Electrocardiography Signal-to-noise ratio Biventricular pacemaker Heart Rate Medicine Humans Velocity-time integral Velocity–time integral Heart Failure business.industry Noise (signal processing) Replicate Confidence interval Evaluation Studies as Topic Echocardiography Content (measure theory) Atrioventricular Node Blood pressure business Cardiology and Cardiovascular Medicine Algorithm |
| Zdroj: | Heart Failure Reviews, 16(3), 277-290. Springer, Cham Heart Failure Reviews |
| ISSN: | 1573-7322 1382-4147 |
| Popis: | Impact of variability in the measured parameter is rarely considered in designing clinical protocols for optimization of atrioventricular (AV) or interventricular (VV) delay of cardiac resynchronization therapy (CRT). In this article, we approach this question quantitatively using mathematical simulation in which the true optimum is known and examine practical implications using some real measurements. We calculated the performance of any optimization process that selects the pacing setting which maximizes an underlying signal, such as flow or pressure, in the presence of overlying random variability (noise). If signal and noise are of equal size, for a 5-choice optimization (60, 100, 140, 180, 220 ms), replicate AV delay optima are rarely identical but rather scattered with a standard deviation of 45 ms. This scatter was overwhelmingly determined (ρ = −0.975, P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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