Non-invasive cardiac output measurements based on bioreactance for optimization of atrio- and interventricular delays
| Autor: | Munmohan Virdee, Fakhar Z. Khan, Peter J. Pugh, Philip A. Read, Simon P. Fynn, David P. Dutka |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Cardiac output medicine.medical_specialty medicine.medical_treatment Cardiac resynchronization therapy Sensitivity and Specificity Physiology (medical) Internal medicine Electric Impedance medicine Humans Plethysmograph Sinus rhythm Plethysmography Impedance Cardiac Output Aged Ventricular function business.industry Non invasive Reproducibility of Results Arrhythmias Cardiac Av delay Treatment Outcome Cardiac output monitoring cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Europace. 11:1666-1674 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/eup358 |
| Popis: | Non-invasive cardiac output monitoring (NICOM) based on bio-reactance offers a portable method to assess ventricular function. Optimization of cardiac resynchronization therapy (CRT) by echocardiography is labour-intensive. We compared the ability of NICOM and echocardiography to facilitate optimum CRT device programming.Forty-seven patients in sinus rhythm were evaluated within 14 days of CRT implantation. The atrio- (AV) and interventricular (VV) delay intervals were incrementally adjusted and at each setting, NICOM and echocardiographic data were recorded. Left ventricular (LV) volumes and function were assessed by echocardiography at baseline and 3 months. Response to CRT was defined as a reduction in LV end-systolic volume (LVESV) by15%. In all patients, cardiac output (CO) increased significantly at optimized settings compared with baseline (5.66 +/- 1.4 vs. 4.35 +/- 1.1 L/min, P0.001). A 20% increase in acute CO following CRT predicted LVESV reduction of15% with a sensitivity of 81% and specificity of 92% (AUC 0.86). The optimum AV delay determined by NICOM was confirmed by echocardiography in 40 of 47 patients (85%, r = 0.89, P0.01) and for VV delay in 39 of 47 patients (83%, r = 0.89, P0.01).Non-invasive cardiac output monitoring is a simple, reliable, and portable alternative to echocardiography to program CRT devices. |
| Databáze: | OpenAIRE |
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