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Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

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Echocardiography-guided pacemaker optimization and radial artery tonometry.

Tasneem Z Naqvi¹, Asim M Rafique

¹Cardiac Non Invasive Laboratory, Cedars-Sinai Medical Center, UCLA David Geffen School of Medicine, Los Angeles, CA 90033, USA.

Journal of Cardiac Failure

|August 30, 2008

Summary

Radial artery tonometry offers a simple, noninvasive method to assist in biventricular (Biv) pacemaker optimization. This technique accurately complements echocardiography for improving atrioventricular (AV) and interventricular (VV) delays.

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Area of Science:

Cardiology
Biomedical Engineering
Medical Devices

Background:

Biventricular (Biv) pacemaker optimization is crucial for patient outcomes but is underutilized due to time and technical demands.
Echocardiography is the standard for Biv optimization, requiring specialized skills and significant time.

Purpose of the Study:

To evaluate the utility of radial artery tonometry as a complementary tool for echo-guided Biv optimization.
To assess the accuracy of radial artery tonometry in measuring ejection duration (E-dur) during AV and VV delay optimization.

Main Methods:

Sixty patients undergoing Biv pacemaker implantation were studied.
Simultaneous radial artery tonometry and echocardiography were performed to measure left ventricular outflow tract ejection duration (LV E-dur) and radial artery E-dur (RA E-dur).
Optimization of atrioventricular (AV) and interventricular (VV) delays was guided by echocardiography, with RA E-dur as a secondary measure.

Main Results:

AV optimization significantly improved LV E-dur (249 to 260 ms) and RA E-dur (276 to 284 ms).
A strong correlation (0.83) was found between LV E-dur and RA E-dur measurements.
Radial artery tonometry demonstrated significant changes mirroring those seen with echocardiography during AV and VV delay optimization.

Conclusions:

Echocardiography-guided AV and VV optimization significantly improves LV and radial artery ejection durations.
Radial artery tonometry shows promise as a simple, noninvasive method to aid in Biv pacemaker AV delay optimization.