Ambulatory monitoring of pulmonary artery pressure. A preliminary clinical evaluation.

Nathan, Anthony W.; Perry, S G; Cochrane, Tom; Banim, S. O.; Spurrell, R. A. J.; Camm, A. John

doi:10.1136/hrt.49.1.33

Cited by 18 publications

(12 citation statements)

References 13 publications

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“…A miniaturised tape recorder was used with the fluid filled catheter and a solid state system was used with the transducer tipped catheter. Data analysis was computerised in both studies.6 7 Fluid filled catheters have many drawbacks, such as difficulty with the localisation of the zero reference point, the requirement for anticoagulation, and…”

mentioning

confidence: 99%

“…Accepted for publication 7 January 1986 the need to use filtering for data retrieval.8 In the previous study in which a transducer tipped catheter was used pressure results were avaraged every thirty seconds. 7 We describe a simple method for continuous ambulatory pulmonary artery pressure monitoring by means of a transducer tipped catheter and widely available ambulatory monitoring recording equipment.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Continuous ambulatory pulmonary artery pressure monitoring. A new method using a transducer tipped catheter and a simple recording system.

Lévy¹,

Cunningham²,

Shapiro³

et al. 1986

Heart

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A transducer tipped catheter and simple recording system were used for the continuous measurement of ambulatory pulmonary artery pressure. The pulmonary artery pressure was recorded on a miniaturised tape recorder and replayed via an optical writer. Pulmonary arterial systolic and diastolic pressures can be analysed on a beat to beat basis. Continuous ambulatory monitoring was performed for a total 288 hours in 13 patients who were undergoing routine investigation for coronary artery disease. There was less than 1% zero drift and 0.25% linearity error per full scale pressure. The frequency response of the entire system was flat to 8 Hz with a linear phase delay. The transducer tipped catheter and a conventional fluid-filled system were used to measure left ventricular and pulmonary artery end diastolic pressures in eight patients. The correlation between the results obtained by the two methods was excellent. This method could be used at any centre equipped for ambulatory electrocardiographic monitoring.

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confidence: 99%

mentioning

confidence: 99%

Continuous ambulatory pulmonary artery pressure monitoring. A new method using a transducer tipped catheter and a simple recording system.

Lévy¹,

Cunningham²,

Shapiro³

et al. 1986

Heart

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show abstract

“…PA pressure and PAWP monitoring have been shown to be effective for tailored therapy in patients admitted with advanced HF [30]. Early attempts have been made to continuously record PA pressure on an ambulatory basis [31,32]. An implantable pressure sensor has been incorporated into a pacing electrode with a preliminary application for rate‐adaptive pacing [33].…”

Section: Sensors For Heart Failure (Table 2)mentioning

confidence: 99%

Optimizing heart failure therapy with implantable sensors

Lau

Siu

Tse

2012

Journal of Arrhythmia

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a b s t r a c tHeart failure (HF)-related hospitalization is associated with significant mortality and morbidity and can be prevented by early intervention. Implantable sensors detect early pathophysiological changes in HF, using an accelerometer, a paced electrogram, impedance and pressure sensors in implanted intracardiac leads, or stand-alone devices. Such sensors monitor daily activity, QT and ST intervals, pulmonary fluid, and intracardiac pressures at various points. Sensor data are available either by patient's or physician's regular interrogation, or using remote patient monitoring. Different sensors have different levels of sensitivity and specificity for HF detection, and they have the ability to antedate HF exacerbation and thereby allow for the initiation of intervention to avert decompensation. Clinical studies suggest that alone or in combination, such sensors have a greater beneficial impact than conventional therapy on acute HF outcome.

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“…[84][85][86] An implantable sensor that measures pressure has been incorporated into a pacing electrode with an initial application for rate adaptive pacing. [84][85][86] An implantable sensor that measures pressure has been incorporated into a pacing electrode with an initial application for rate adaptive pacing.…”

Section: Right Ventricular Pressurementioning

confidence: 99%

Implantable Sensors for Rate Adaptation and Hemodynamic Monitoring

Lau¹,

Siu²,

Tse³

2011

Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy

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In this group, sensor-driven CRT pacing improved maximum oxygen consumption and work capacity compared with CRT pacing without rate adaption. This increment is independent of A-V interval shortening during exercise. These data suggest that rate modulation plays a critical role in some patients with impaired LV function who require pacing therapy, even in those with CRT. HEART RATE MODULATION FOR NONEXERCISE NEEDSExercise is only one of the many physiologic requirements for variation in heart rate. Other changes, such as mental stress, can lead to a rate increase. The sinus rate is also higher when a person assumes the upright posture. Isometric exercise also results in an increase in cardiac output and heart rate in most people. The changes in heart rate that occur during various physiologic maneuvers (e.g., Valsalva) and baroreceptor reflexes may also be important. An appropriate compensatory heart rate response may be especially important in pathophysiologic conditions such as anemia, acute blood loss, or other causes of hypovolemia, and during febrile illness. Ideal Sensor CharacteristicsBased on the physiology of the normal sinus node, a sensor system to overcome chronotropic incompetence needs to be sensitive to both exercise and nonexercise needs. It also should be specific, unaffected by internal or external changes that can cause an inappropriate rate change. The sensor should achieve rate modulation at an appropriate speed, with its response proportional to the level of exercise load. The sensor system should be easy to implement (preferably with standard device casing and lead system), should be stable in the body's internal environment, and should not significantly increase battery consumption. CLASSIFICATION OF SENSORSIn a sensor-driven pacing system, a sensor (or combination of sensors) must first detect a physical or physiologic parameter that is related to metabolic demand 5 ( Fig. 5-1). Second, the rate-modulating circuit in the pulse generator must have an algorithm that relates changes in the sensed parameter to a change in pacing rate. Third, because the magnitude of the physical or physiologic changes monitored by a sensor may differ between patients, clinician input may be necessary to adjust the algorithm, generally by programming one or more rate-responsive variables, to achieve the clinically desired rate response. This requirement for adjustment has decreased with automatic optimization of the rate-responsive settings. Most sensors operate in an open-loop algorithm; that is, the induced rate changes do not induce a negative feedback on the sensed parameter. In a closed-loop sensor system, the induced hemodynamic changes will induce an opposite change in the level of the sensed parameter that is responsible for the initial rate adaptation (negative feedback loop). Theoretically, minimal programming is required in a closed-loop system (see Fig. 5-1). Furthermore, the actual rate response is calculated using rate-response curves after programming a threshold of sensor detection (Fig. 5-2).Im...

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Ambulatory monitoring of pulmonary artery pressure. A preliminary clinical evaluation.

Cited by 18 publications

References 13 publications

Continuous ambulatory pulmonary artery pressure monitoring. A new method using a transducer tipped catheter and a simple recording system.

Continuous ambulatory pulmonary artery pressure monitoring. A new method using a transducer tipped catheter and a simple recording system.

Optimizing heart failure therapy with implantable sensors

Implantable Sensors for Rate Adaptation and Hemodynamic Monitoring

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