Real-Time Ventricular Volume Measured Using the Intracardiac Electromyogram.
Journal
ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109
Informations de publication
Date de publication:
01 12 2021
01 12 2021
Historique:
pubmed:
27
4
2021
medline:
15
12
2021
entrez:
26
4
2021
Statut:
ppublish
Résumé
Left ventricular end-diastolic volume (EDV) is an important parameter for monitoring patients with left ventricular assist devices (LVADs) and might be useful for automatic LVAD work adaptation. However, continuous information on the EDV is unavailable to date. The depolarization amplitude (DA) of the noncontact intracardiac electromyogram (iEMG) is physically related to the EDV. Here, we show how a left ventricular (LV) volume sensor based on the iEMG might provide beat-wise EDV estimates. The study was performed in six pigs while undergoing a series of controlled changes in hemodynamic states. The LV volume sensor consisted of four conventional pacemaker electrodes measuring the far-field iEMG inside the LV blood pool, using a novel unipolar amplifier. Simultaneously, noninvasive measurements of EDV and hematocrit were recorded. The proposed EDV predictor was tested for statistical significance using a mixed-effect model and associated confidence intervals. A statistically significant (p = 3e-07) negative correlation was confirmed between the DA of the iEMG and the EDV as measured by electric impedance at a slope of -0.069 (-0.089, -0.049) mV/mL. The DA was slightly decreased by increased hematocrit (p = 0.039) and moderately decreased with the opening of the thorax (p = 0.003). The DA of the iEMG proved to be a significant, independent predictor of EDV. The proposed LV volume sensor is simple to integrate into the inflow cannula of an LVAD and thus has the potential to inform the clinician about the state of LV volume in real time and to automatically control the LVAD.
Identifiants
pubmed: 33899813
doi: 10.1097/MAT.0000000000001444
pii: 00002480-202112000-00006
pmc: PMC8614557
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1312-1320Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASAIO.
Déclaration de conflit d'intérêts
Disclosure: Prof. Dr. Volkmar Falk has relevant (institutional) financial activities outside the summited work with following commercial entities: Medtronic GmbH, Biotronik SE & Co., Abbott GmbH & Co. KG, Boston Scientific, Edwards Lifesciences, Berlin Heart, Novartis Pharma GmbH, JOTEC GmbH, and Zurich Heart in relation to educational grants (including travel support), fees for lectures and speeches, fees for professional consultation and research, and study funds. Outside the summited work, Prof. Dr. C. Starck has received consulting fees and travel expenses from Medtronic; consulting fees and research support from Biotronik; research support from Abbott; workshop fees, consulting fees, educational grants, and research support from Cook Medical; consulting fees from Spectranetics/Philipps; and consulting fees from Angiodynamics. Dr. Seraina A. Dual, Prof. Mirko Meboldt, and Dr. Schmid Daners reports have a patent EP19169059.3 pending. The other authors report no conflicts of interest.
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