Theory and cardiac applications of electrical impedance measurements

The methodology of the two-electrode, four-electrode, and guard-ring techniques is presented following a brief history of impedance plethysmography. The theoretical basis for predicting the sampling fields for conductivity and volume changes is presented. Theoretical and experimental studies of the sampling field associated with various electrode arrays are reviewed. With this background, the use of impedance plethysmography for cardiac monitoring and diagnosis is reviewed. The basic methodology is presented and models used to interpret the signal are reviewed. Theoretical and experimental studies of what is sampled are summarized. The accuracy of impedance stroke volume estimates is evaluated by surveying the results of human studies and examining critical animal studies. The usefulness of impedance cardiography for ventricular performance evaluation is also reviewed. Additional uses for cardiopulmonary diagnosis are briefly presented.