Document Detail

Automatic real-time detection of myocardial ischemia by epicardial accelerometer.
MedLine Citation:
PMID:  19717169     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Myocardial ischemia may be detected with epicardial accelerometers. We developed and tested automated algorithms for real-time detection of myocardial ischemia by accelerometer measurements in both experimental and clinical settings. METHODS: In 10 pigs, an accelerometer was fixed to the epicardium in the area perfused by left anterior descending coronary artery. Acceleration and electrocardiogram were simultaneously recorded, and the QRS complex was automatically detected for exact timing of systole. Peak circumferential velocity and displacement were automatically calculated from epicardial acceleration signal within 150 milliseconds after peak R on electrocardiography. Global myocardial function was reduced by esmolol infusion, and regional function was altered by temporary left anterior descending occlusion. Automated ischemia detection analyses were tested in 7 patients during off-pump coronary artery bypass grafting. Left anterior descending coronary artery was occluded for 3 minutes before grafting. In both models, echocardiographic myocardial circumferential strain was used to confirm ischemia. RESULTS: Systolic displacement changed most during left anterior descending occlusion. Negative displacement during ischemia was found in pigs (11.5 +/- 2.3 to -1.2 +/- 2.8 mm, P < .01); regional hypokinesia was found in clinical study (12.8 +/- 8.1 to 3.5 +/- 4.4 mm, P < .01). Ischemia was confirmed by echocardiography in both settings. Esmolol infusion induced smaller changes in automated accelerometer measurements than did left anterior descending occlusion (P < .01). CONCLUSIONS: Automatic real-time detection of myocardial ischemia with epicardial accelerometer was feasible. Automated ischemia detection analysis may be used for continuous monitoring of myocardial ischemia during cardiac surgery.
Per Steinar Halvorsen; Espen W Remme; Andreas Espinoza; Helge Skulstad; Runar Lundblad; Jacob Bergsland; Lars Hoff; Kristin Imenes; Thor Edvardsen; Ole Jakob Elle; Erik Fosse
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-29
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  139     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-05-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1026-32     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
The Interventional Centre, Rikshospitalet University Hospital, NO-0027 Oslo, Norway.
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MeSH Terms
Disease Models, Animal
Kinetocardiography / methods*
Middle Aged
Models, Animal
Myocardial Ischemia / diagnosis*

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