Pre-ejection period by radial artery tonometry supplements echo Doppler findings during biventricular pacemaker...

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Background:

• Biventricular (Biv) pacemaker optimization improves cardiac output but is complex and not routinely used.
• A novel, simpler method using computerized pre-ejection time (PEP) assessment via radial artery tonometry was investigated to guide Biv pacemaker optimization.

Purpose of the Study:

• To evaluate the effectiveness of radial artery tonometry-derived PEP in guiding Biv pacemaker optimization.
• To assess the correlation between echo Doppler parameters and radial artery tonometry-guided settings.

Main Methods:

• Simultaneous blinded echocardiography and radial artery tonometry in 37 patients undergoing Biv pacemaker optimization.
• Evaluation of echo-derived velocity time integral (VTI), ejection time (ET), myocardial performance index (MPI), and radial artery tonometry-derived PEP.
• Analysis of echo-radial artery tonometry derived PEP/VTI and PEP/ET indices.

Main Results:

• Significant improvements observed in LV ET, LV VTI, MPI, and PEP post-optimization.
• Strong correlations found between echo Doppler and radial artery tonometry-PEP guided optimal atrioventricular delay (AVD) (0.75) and interventricular delay (VVD) (0.69).
• A reduction in New York Heart Association (NYHA) class was noted in patients with follow-up.

Conclusions:

• Radial artery tonometry-derived PEP shortens acutely post-Biv pacemaker optimization.
• This method correlates with hemodynamic improvements measured by echo Doppler.
• Radial artery tonometry presents a cost-efficient approach to assist Biv pacemaker echo optimization.