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Hemodynamic Assessment with an Implanted Pacing Device

  • Maria Grazia Bongiorni
  • Ezio Soldati
  • Giuseppe Arena
  • Giulio Zucchelli
  • Andrea di Cori
  • Alberto Barbetta
  • Franco di Gregorio
Conference paper

Abstract

Continuous hemodynamic monitoring could be highly valuable in the treatment of cardiac diseases characterized by a deterioration of pump function, allowing detection of the early signs of heart failure and thus prompt adaptation of the pharmacological regimen to the patient’s changing clinical condition [1]. Therefore, specific implantable devices have been developed to record right ventricular blood pressure and dP/dt in the outflow tract, in order to assess diastolic pulmonary pressure [2]. Indications of the pressure sensor were shown to be correlated with invasive hemodynamic measurements and anticipated the clinical course of the disease, predicting and potentially reducing the need for hospitalization [2]–[4]. However, an increasing proportion of heart-failure patients have already received implantable rhythm-control devices (pacemakers and defibrillators), which are often designed to provide cardiac resynchronization therapy. In such patients, the same hardware needed for cardiac stimulation could be used to also assess the hemodynamic state. For instance, a system intended to reveal fluid accumulation in the lung based on thoracic impedance measurements by an implanted biventricular defibrillator was recently introduced in the clinical setting. Impedance is assessed between the defibrillation coil placed in the right ventricle and the device case in the left pectoral region. An inverse correlation with both pulmonary capillary wedge pressure and net change in body fluids during hospital care was reported [5].

Keywords

Cardiac Resynchronization Therapy Cardiac Stimulation Intrathoracic Impedance Continuous Hemodynamic Monitoring Invasive Hemodynamic Measurement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Maria Grazia Bongiorni
    • 1
  • Ezio Soldati
    • 1
  • Giuseppe Arena
    • 1
  • Giulio Zucchelli
    • 1
  • Andrea di Cori
    • 1
  • Alberto Barbetta
    • 2
  • Franco di Gregorio
    • 2
  1. 1.Cardiothoracic DepartmentUniversity of PisaPisa
  2. 2.Clinical Research UnitMedico SpaRubano (PD)Italy

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