Human feasibility study of hemodynamic monitoring via continuous intrathoracic impedance monitoring. 2009

Douglas A Hettrick, and David Schwartzman
Cardiac Rhythm and Disease Management Medtronic, Inc., Mounds View, MN 55112, USA. doug.hettrick@medtronic.com

The ultimate hemodynamic sensor for an implantable device would provide information about cardiovascular performance including systolic function, diastolic function, preload, and afterload. We examined the potential clinical utility of simultaneous measurement of left ventricular pressure and continuous intrathoracic impedance in a group of 20 patients undergoing acute intravenous ablation for atrial fibrillation. Following baseline measurements of traditional left ventricular (LV) conductance volume (control), LV pressure and conductance measurement were repeated using alternate impedance stimulation and sensing vectors that encompassed combinations of the lung, left ventricle, right ventricle and left atrium, respectively. Various relative indices of LV function, including end systolic pressure to volume (conductance) ratio, end diastolic pressure to volume (conductance) ratio, and preload recruitable stroke work (analog) were derived by combining real-time pressure and conductance. The raw morphometry of the LV vector seemed to most closely resemble the gold standard LV conductance volume. For this vector, strong linear correlations between LV pressure and end systolic conductance (r = 0.84 + or - 0.14), end diastolic conductance (r = 0.78 + or - 0.10) and preload recruitable stroke work analog (r = 0.93 + or - 0.05) were observed. The LV vector provides a robust continuous intracardiac hemodynamic signal that may be useful for quantifying cardiovascular function.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002307 Cardiography, Impedance A type of impedance plethysmography in which bioelectrical impedance is measured between electrodes positioned around the neck and around the lower thorax. It is used principally to calculate stroke volume and cardiac volume, but it is also related to myocardial contractility, thoracic fluid content, and circulation to the extremities. Impedance, Transthoracic,Plethysmography, Impedance, Transthoracic,Impedance Cardiography,Impedance Plethysmography, Transthoracic,Plethysmography, Transthoracic Impedance,Transthoracic Impedance Plethysmography,Cardiographies, Impedance,Impedance Cardiographies,Impedance Plethysmographies, Transthoracic,Impedances, Transthoracic,Plethysmographies, Transthoracic Impedance,Transthoracic Impedance,Transthoracic Impedance Plethysmographies,Transthoracic Impedances
D005240 Feasibility Studies Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project. Feasibility Study,Studies, Feasibility,Study, Feasibility
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001281 Atrial Fibrillation Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation. Auricular Fibrillation,Familial Atrial Fibrillation,Paroxysmal Atrial Fibrillation,Persistent Atrial Fibrillation,Atrial Fibrillation, Familial,Atrial Fibrillation, Paroxysmal,Atrial Fibrillation, Persistent,Atrial Fibrillations,Atrial Fibrillations, Familial,Atrial Fibrillations, Paroxysmal,Atrial Fibrillations, Persistent,Auricular Fibrillations,Familial Atrial Fibrillations,Fibrillation, Atrial,Fibrillation, Auricular,Fibrillation, Familial Atrial,Fibrillation, Paroxysmal Atrial,Fibrillation, Persistent Atrial,Fibrillations, Atrial,Fibrillations, Auricular,Fibrillations, Familial Atrial,Fibrillations, Paroxysmal Atrial,Fibrillations, Persistent Atrial,Paroxysmal Atrial Fibrillations,Persistent Atrial Fibrillations
D012815 Signal Processing, Computer-Assisted Computer-assisted processing of electric, ultrasonic, or electronic signals to interpret function and activity. Digital Signal Processing,Signal Interpretation, Computer-Assisted,Signal Processing, Digital,Computer-Assisted Signal Interpretation,Computer-Assisted Signal Interpretations,Computer-Assisted Signal Processing,Interpretation, Computer-Assisted Signal,Interpretations, Computer-Assisted Signal,Signal Interpretation, Computer Assisted,Signal Interpretations, Computer-Assisted,Signal Processing, Computer Assisted

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