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Cardiac Resynchronization Therapy Optimization by Ultrasonic Cardiac Output Monitoring (USCOM) Device
Author(s) -
SIU CHUNGWAH,
TSE HUNGFAT,
LEE KATHY,
CHAN HONWAH,
CHEN WAIHONG,
YUNG CINDY,
LEE STEPHEN,
LAU CHUPAK
Publication year - 2007
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2007.00579.x
Subject(s) - medicine , cardiac output , cardiac resynchronization therapy , heart failure , cardiology , ultrasonic sensor , hemodynamics , biomedical engineering , radiology , ejection fraction
Objectives: We investigated the accuracy and feasibility of a 2D echo‐independent ultrasonic continuous wave Doppler cardiac output monitoring device (USCOM) operated by trained nurse for the atrio‐ventricular interval (AVI) optimization in cardiac resynchronization therapy (CRT).Background: CRT is of proven benefit in patients with advanced chronic heart failure and ventricular conduction delay. Appropriate AVI selection is critical to optimize hemodynamic in CRT. Currently, most non‐invasive methods for AVI optimization are often complicated and labor‐intensive.Methods: USCOM method, Ritter method, and aortic outflow cardiac output method were used to determine the optima AVI in 20 patients with CRT. The accuracy and time for measurement of each method were determined.Results: The optimal AVI determined by USCOM method had good correlation with Ritter's method and aortic outflow estimated cardiac output method (r 2 = 0.78, P < 0.01 and r 2 = 0.73, P < 0.01, respectively). The optimal AVI determined USCOM method showed good agreement (within 10 msec range) with Ritter's method (85% patients) and aortic outflow estimated cardiac output method (80%). The mean time for determining AVI using USCOM method was shorter than that with aortic outflow method (7.1 ± 0.7 min vs 12.7 ± 1.1 min, P < 0.01), whereas the mean time was shortest for Ritter method (4.7 ± 1.6 min vs 7.1 ± 0.7 min, P < 0.01).Conclusion: USCOM device operated by trained nurse can provide a simple, accurate, and fast non‐invasive method for the AVI optimization in CRT population.