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Continuous ventricular volume assessment for diagnosis and pacemaker control.

R W Salo, B D Pederson, A L Olive

Pacing and Clinical Electrophysiology : PACE

|November 1, 1984

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A novel intracardiac impedance system accurately measured stroke volume in a pacemaker-dependent patient. This system successfully regulated pacing during exercise, optimizing cardiac output and stroke volume.

Area of Science:

Cardiovascular Physiology
Biomedical Engineering

Background:

Stroke volume (SV) assessment is crucial for cardiovascular health monitoring.
Accurate SV measurement in pacemaker-dependent individuals presents unique challenges.
Existing methods for SV quantification can be invasive or limited in dynamic conditions.

Purpose of the Study:

To evaluate the accuracy of a catheter-based, right ventricular, intracardiac impedance system for measuring stroke volume.
To assess the feasibility of using impedance-derived SV to control ventricular pacing rate during exercise.
To investigate the impact of impedance-guided pacing on cardiac output (CO) and SV during exercise.

Main Methods:

Stroke volume was measured at rest and during exercise using an intracardiac impedance system.

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Measurements were validated against acetylene rebreathing and radionuclide ventriculography.

An algorithm controlled ventricular pacing rate to maintain a constant SV during bicycle ergometry.

Main Results:

The intracardiac impedance system demonstrated high correlation with established SV measurement techniques (r = 0.96).
Impedance-guided pacing during exercise resulted in a 23% increase in cardiac output.
Ventricular pacing optimization led to a 70% decrease in stroke volume compared to fixed-rate pacing.

Conclusions:

Catheter-based intracardiac impedance is a valid method for measuring stroke volume in pacemaker-dependent patients.
Dynamic, impedance-guided pacing can effectively modulate cardiac output during exercise.
This technology offers potential for improved hemodynamic management in patients with pacing dependency.