Improved lung edema monitoring with coronary vein pacing leads: a simulation study
This computer simulation study compared the ability of left ventricular coronary vein (LV) pacemaker leads against right ventricular (RV) and right atrial (RA) leads to monitor lung edema using electrical impedance measurements. MRI images were used to construct electrical models of the thorax. Four...
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Veröffentlicht in: | Physiological measurement 2004-04, Vol.25 (2), p.475-487 |
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description | This computer simulation study compared the ability of left ventricular coronary vein (LV) pacemaker leads against right ventricular (RV) and right atrial (RA) leads to monitor lung edema using electrical impedance measurements. MRI images were used to construct electrical models of the thorax. Four lead configurations were tested with increases of pulmonary edema, intravascular fluids and heart dilation. The impedance changes observed at end systole with severe lung edema were 8.5%, 11.2%, 12.3% and 26.8% for the RA, RV, RV coil and LV configurations, respectively. Sensitivities in ohms per litre of lung fluid were 19.15, 19.15, 25.07 and 52.11 for the same configurations. The impedance changes for intravascular fluid overload with constant lung status were 1%, 1.3%, 9.2% and 6.4% while the sensitivities were 2, 2, 17 and 11 ohms per litre of intravascular fluid, respectively. Regional analysis of the thoracic sources of impedance revealed a high sensitivity near pacing electrodes and generator, and a low sensitivity to the right lung and all pulmonary vessels. Simulations showed that LV leads have a threefold advantage in sensitivity when monitoring lung edema in comparison to conventional RV leads. To monitor vascular and lung fluids independently, combined impedance configurations may be used. Regional sensitivities must be taken into account for proper clinical interpretation of impedance changes. |
doi_str_mv | 10.1088/0967-3334/25/2/007 |
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MRI images were used to construct electrical models of the thorax. Four lead configurations were tested with increases of pulmonary edema, intravascular fluids and heart dilation. The impedance changes observed at end systole with severe lung edema were 8.5%, 11.2%, 12.3% and 26.8% for the RA, RV, RV coil and LV configurations, respectively. Sensitivities in ohms per litre of lung fluid were 19.15, 19.15, 25.07 and 52.11 for the same configurations. The impedance changes for intravascular fluid overload with constant lung status were 1%, 1.3%, 9.2% and 6.4% while the sensitivities were 2, 2, 17 and 11 ohms per litre of intravascular fluid, respectively. Regional analysis of the thoracic sources of impedance revealed a high sensitivity near pacing electrodes and generator, and a low sensitivity to the right lung and all pulmonary vessels. Simulations showed that LV leads have a threefold advantage in sensitivity when monitoring lung edema in comparison to conventional RV leads. To monitor vascular and lung fluids independently, combined impedance configurations may be used. Regional sensitivities must be taken into account for proper clinical interpretation of impedance changes.</description><identifier>ISSN: 0967-3334</identifier><identifier>EISSN: 1361-6579</identifier><identifier>DOI: 10.1088/0967-3334/25/2/007</identifier><identifier>PMID: 15132313</identifier><language>eng</language><publisher>England: IOP Publishing</publisher><subject>Cardiac Pacing, Artificial - methods ; Computer Simulation ; Coronary Vessels - physiology ; Humans ; Male ; Middle Aged ; Models, Cardiovascular ; Pulmonary Edema - diagnosis ; Pulmonary Edema - physiopathology ; Signal Processing, Computer-Assisted - instrumentation</subject><ispartof>Physiological measurement, 2004-04, Vol.25 (2), p.475-487</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-3751ca8a6394ba882d25bd132467b3d751482023ef0b96db20101938a05928d23</citedby><cites>FETCH-LOGICAL-c371t-3751ca8a6394ba882d25bd132467b3d751482023ef0b96db20101938a05928d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://iopscience.iop.org/article/10.1088/0967-3334/25/2/007/pdf$$EPDF$$P50$$Giop$$H</linktopdf><link.rule.ids>314,780,784,27924,27925,53830,53910</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15132313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Belalcazar, Andres</creatorcontrib><creatorcontrib>Patterson, Robert P</creatorcontrib><title>Improved lung edema monitoring with coronary vein pacing leads: a simulation study</title><title>Physiological measurement</title><addtitle>Physiol Meas</addtitle><description>This computer simulation study compared the ability of left ventricular coronary vein (LV) pacemaker leads against right ventricular (RV) and right atrial (RA) leads to monitor lung edema using electrical impedance measurements. MRI images were used to construct electrical models of the thorax. Four lead configurations were tested with increases of pulmonary edema, intravascular fluids and heart dilation. The impedance changes observed at end systole with severe lung edema were 8.5%, 11.2%, 12.3% and 26.8% for the RA, RV, RV coil and LV configurations, respectively. Sensitivities in ohms per litre of lung fluid were 19.15, 19.15, 25.07 and 52.11 for the same configurations. The impedance changes for intravascular fluid overload with constant lung status were 1%, 1.3%, 9.2% and 6.4% while the sensitivities were 2, 2, 17 and 11 ohms per litre of intravascular fluid, respectively. Regional analysis of the thoracic sources of impedance revealed a high sensitivity near pacing electrodes and generator, and a low sensitivity to the right lung and all pulmonary vessels. Simulations showed that LV leads have a threefold advantage in sensitivity when monitoring lung edema in comparison to conventional RV leads. To monitor vascular and lung fluids independently, combined impedance configurations may be used. Regional sensitivities must be taken into account for proper clinical interpretation of impedance changes.</description><subject>Cardiac Pacing, Artificial - methods</subject><subject>Computer Simulation</subject><subject>Coronary Vessels - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Cardiovascular</subject><subject>Pulmonary Edema - diagnosis</subject><subject>Pulmonary Edema - physiopathology</subject><subject>Signal Processing, Computer-Assisted - instrumentation</subject><issn>0967-3334</issn><issn>1361-6579</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1LxDAQhoMo7rr6BzxIToKH2kzStKk3WfxYWBBEzyFtUo20TW3alf33puyiBy-eBmaeeZl5EDoHcg1EiJjkaRYxxpKY8pjGhGQHaA4shSjlWX6I5j_ADJ14_0EIgKD8GM2AA6MM2Bw9r5qudxujcT22b9ho0yjcuNYOrreh8WWHd1y63rWq3-KNsS3uVDlNaqO0v8EKe9uMtRqsa7EfRr09RUeVqr0529cFer2_e1k-Ruunh9Xydh2VLIMhYhmHUgmVsjwplBBUU17ocFeSZgXTYZoISigzFSnyVBeUAIGcCUV4ToWmbIEud7nhgc_R-EE21pemrlVr3OhlBjkkJGUBpDuw7J33valk19sm_COByMmknETJSZSkXFIZTIali336WDRG_67s1QUg2gHWdf8LvPrL_-Vkpyv2DW23h8k</recordid><startdate>20040401</startdate><enddate>20040401</enddate><creator>Belalcazar, Andres</creator><creator>Patterson, Robert P</creator><general>IOP Publishing</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040401</creationdate><title>Improved lung edema monitoring with coronary vein pacing leads: a simulation study</title><author>Belalcazar, Andres ; Patterson, Robert P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-3751ca8a6394ba882d25bd132467b3d751482023ef0b96db20101938a05928d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Cardiac Pacing, Artificial - methods</topic><topic>Computer Simulation</topic><topic>Coronary Vessels - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Cardiovascular</topic><topic>Pulmonary Edema - diagnosis</topic><topic>Pulmonary Edema - physiopathology</topic><topic>Signal Processing, Computer-Assisted - instrumentation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Belalcazar, Andres</creatorcontrib><creatorcontrib>Patterson, Robert P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Physiological measurement</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Belalcazar, Andres</au><au>Patterson, Robert P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improved lung edema monitoring with coronary vein pacing leads: a simulation study</atitle><jtitle>Physiological measurement</jtitle><addtitle>Physiol Meas</addtitle><date>2004-04-01</date><risdate>2004</risdate><volume>25</volume><issue>2</issue><spage>475</spage><epage>487</epage><pages>475-487</pages><issn>0967-3334</issn><eissn>1361-6579</eissn><abstract>This computer simulation study compared the ability of left ventricular coronary vein (LV) pacemaker leads against right ventricular (RV) and right atrial (RA) leads to monitor lung edema using electrical impedance measurements. MRI images were used to construct electrical models of the thorax. Four lead configurations were tested with increases of pulmonary edema, intravascular fluids and heart dilation. The impedance changes observed at end systole with severe lung edema were 8.5%, 11.2%, 12.3% and 26.8% for the RA, RV, RV coil and LV configurations, respectively. Sensitivities in ohms per litre of lung fluid were 19.15, 19.15, 25.07 and 52.11 for the same configurations. The impedance changes for intravascular fluid overload with constant lung status were 1%, 1.3%, 9.2% and 6.4% while the sensitivities were 2, 2, 17 and 11 ohms per litre of intravascular fluid, respectively. Regional analysis of the thoracic sources of impedance revealed a high sensitivity near pacing electrodes and generator, and a low sensitivity to the right lung and all pulmonary vessels. Simulations showed that LV leads have a threefold advantage in sensitivity when monitoring lung edema in comparison to conventional RV leads. To monitor vascular and lung fluids independently, combined impedance configurations may be used. Regional sensitivities must be taken into account for proper clinical interpretation of impedance changes.</abstract><cop>England</cop><pub>IOP Publishing</pub><pmid>15132313</pmid><doi>10.1088/0967-3334/25/2/007</doi><tpages>13</tpages></addata></record> |
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subjects | Cardiac Pacing, Artificial - methods Computer Simulation Coronary Vessels - physiology Humans Male Middle Aged Models, Cardiovascular Pulmonary Edema - diagnosis Pulmonary Edema - physiopathology Signal Processing, Computer-Assisted - instrumentation |
title | Improved lung edema monitoring with coronary vein pacing leads: a simulation study |
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