| Identification of hemodynamically unstable arrhythmias using subcutaneous photoplethysmography. | |
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MedLine Citation:
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PMID: 19845814 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Determination of hemodynamic status is central to arrhythmia management in the inpatient setting. In contrast, therapy decisions in implantable cardioverter defibrillators (ICDs) are based exclusively on the arrhythmia's electrical signature. Hemodynamic sensing in ICDs would allow tailoring of therapy according to perfusion status. Subcutaneous photoplethysmography (PPG) is an attractive technology for this application because it responds to changes in arterial pressure and can be readily incorporated into the housing of implanted devices. This study evaluated the accuracy of PPG in identifying hemodynamically unstable simulated arrhythmias in an animal model. METHODS AND RESULTS: Rapid atrial and ventricular pacing was used to simulate arrhythmias in an acute preparation of 7 healthy dogs. Aortic pressure and subcutaneous PPG were simultaneously recorded. Simulated arrhythmias were defined as hemodynamically unstable if aortic pressure decreased by >or=15 mmHg, marginally unstable if pressure decreased by 5-15 mmHg, and hemodynamically stable if pressure either increased or decreased by no more than 5 mmHg. An average of 56 arrhythmias were simulated in each animal. Changes in pressure and PPG output were highly correlated, with correlation coefficient of 0.7-0.9. Subcutaneous PPG identified hemodynamically unstable episodes with a sensitivity of 100% for 6 subjects and 80% for 1 subject. Specificity was more than 90% for 6 subjects and was 50% for 1 subject. CONCLUSIONS: Subcutaneous PPG detects hemodynamically unstable simulated arrhythmias in an acute canine preparation. If successfully validated in humans, this technology may allow ICD therapy to be specifically tailored according to the hemodynamic status of the arrhythmia. |
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Authors:
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Robert G Turcott; Todd J Pavek |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-10-20 |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 21 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-05-21 Completed Date: 2010-09-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 448-54 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California 94305-5406, USA. turcott@stanford.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Flow Velocity Blood Pressure* Blood Volume* Diagnosis, Computer-Assisted / methods Dogs Female Male Photoplethysmography / methods* Ventricular Fibrillation / diagnosis*, physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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LM 07033/LM/NLM NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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