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Non-invasive continuous blood pressure monitoring of tachycardic episodes during interventional electrophysiology.

Maggi R, Viscardi V, Furukawa T, Brignole M - Europace (2010)

Bottom Line: The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case.A linear correlation for a range of BP values from 41 to 190 mmHg was found between non-invasive and intra-arterial BP among a total of 1055 beats from three patients who underwent simultaneous recordings with both methods (coefficient of correlation of 0.81, P < 0.0001).In conclusion, continuous non-invasive BP monitoring is feasible in the clinical practise of an interventional electrophysiology laboratory without the need of utilization of an intra-arterial BP line.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Arrhythmologic Centre, Ospedali del Tigullio, Lavagna, Italy.

ABSTRACT

Aims: We thought to evaluate feasibility of continuous non-invasive blood pressure monitoring during procedures of interventional electrophysiology.

Methods and results: We evaluated continuous non-invasive finger blood pressure (BP) monitoring by means of the Nexfin device in 22 patients (mean age 70 ± 24 years), undergoing procedures of interventional electrophysiology, in critical situations of hypotension caused by tachyarrhythmias or by intermittent incremental ventricular temporary pacing till to the maximum tolerated systolic BP fall (mean 61 ± 14 mmHg per patient at a rate of 195 ± 37 bpm). In all patients, Nexfin was able to detect immediately, at the onset of tachyarrythmia, the changes in BP and recorded reliable waveforms. The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case. In basal conditions, calibrations of the signal occurred every 49.2 ± 24.3 s and accounted for 4% of total monitoring time; during tachyarrhythmias their frequency increased to one every 12.7 s and accounted for 19% of total recording duration. A linear correlation for a range of BP values from 41 to 190 mmHg was found between non-invasive and intra-arterial BP among a total of 1055 beats from three patients who underwent simultaneous recordings with both methods (coefficient of correlation of 0.81, P < 0.0001).

Conclusion: In conclusion, continuous non-invasive BP monitoring is feasible in the clinical practise of an interventional electrophysiology laboratory without the need of utilization of an intra-arterial BP line.

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Patient's case. Blood pressure curve during ventricular pacing at 240 bpm for 30 s. Automatic calibration of the system for a period of 2.5 s toward the end of the pacing period.
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EUQ333F4: Patient's case. Blood pressure curve during ventricular pacing at 240 bpm for 30 s. Automatic calibration of the system for a period of 2.5 s toward the end of the pacing period.

Mentions: In total, 102 episodes of tachyarrhythmia were recorded in 22 patients (incremental ventricular pacing in 100 cases and induced ventricular tachycardia in 2 cases): of these, 79 episodes caused a fall in systolic BP to an absolute value <100 mmHg with a mean fall of 64.9 ± 22.3 mmHg. At the onset of tachyarrythmia, Nexfin was able to immediately detect the changes in BP in all patients and recorded reliable waveforms for the whole duration of the tachyarrhythmia. Specifically, Nexfin was able to detect BP waveforms even in the recordings in which BP suddenly dropped to <100 mmHg (Figures 3–5). Whereas in basal conditions the system performed calibration of the signal every 49.2 ± 24.3 s (or 52.8 ± 20.4 beats) for 2.5 s each corresponding to 4% of total monitoring time, during tachyarrhythmias the frequency of calibrations increased to one every 12.7 s (40.1 ± 23.7 beats) on average: in total there were 260 calibrations during 3.323 s of recording, corresponding to 19% of total recording duration. In particular, there were 23 episodes of ventricular tachyarrhythmia at a heart rate ≥200 bpm (mean heart rate 221 ± 24 bpm). During these episodes the mean BP measured with Nexfin was 101.3 ± 23.7 mmHg; calibrations occurred every 12.5 s (41.3 ± 20.6 beats) corresponding to 21.4% of total recording time. The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case.Figure 3


Non-invasive continuous blood pressure monitoring of tachycardic episodes during interventional electrophysiology.

Maggi R, Viscardi V, Furukawa T, Brignole M - Europace (2010)

Patient's case. Blood pressure curve during ventricular pacing at 240 bpm for 30 s. Automatic calibration of the system for a period of 2.5 s toward the end of the pacing period.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2963482&req=5

EUQ333F4: Patient's case. Blood pressure curve during ventricular pacing at 240 bpm for 30 s. Automatic calibration of the system for a period of 2.5 s toward the end of the pacing period.
Mentions: In total, 102 episodes of tachyarrhythmia were recorded in 22 patients (incremental ventricular pacing in 100 cases and induced ventricular tachycardia in 2 cases): of these, 79 episodes caused a fall in systolic BP to an absolute value <100 mmHg with a mean fall of 64.9 ± 22.3 mmHg. At the onset of tachyarrythmia, Nexfin was able to immediately detect the changes in BP in all patients and recorded reliable waveforms for the whole duration of the tachyarrhythmia. Specifically, Nexfin was able to detect BP waveforms even in the recordings in which BP suddenly dropped to <100 mmHg (Figures 3–5). Whereas in basal conditions the system performed calibration of the signal every 49.2 ± 24.3 s (or 52.8 ± 20.4 beats) for 2.5 s each corresponding to 4% of total monitoring time, during tachyarrhythmias the frequency of calibrations increased to one every 12.7 s (40.1 ± 23.7 beats) on average: in total there were 260 calibrations during 3.323 s of recording, corresponding to 19% of total recording duration. In particular, there were 23 episodes of ventricular tachyarrhythmia at a heart rate ≥200 bpm (mean heart rate 221 ± 24 bpm). During these episodes the mean BP measured with Nexfin was 101.3 ± 23.7 mmHg; calibrations occurred every 12.5 s (41.3 ± 20.6 beats) corresponding to 21.4% of total recording time. The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case.Figure 3

Bottom Line: The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case.A linear correlation for a range of BP values from 41 to 190 mmHg was found between non-invasive and intra-arterial BP among a total of 1055 beats from three patients who underwent simultaneous recordings with both methods (coefficient of correlation of 0.81, P < 0.0001).In conclusion, continuous non-invasive BP monitoring is feasible in the clinical practise of an interventional electrophysiology laboratory without the need of utilization of an intra-arterial BP line.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Arrhythmologic Centre, Ospedali del Tigullio, Lavagna, Italy.

ABSTRACT

Aims: We thought to evaluate feasibility of continuous non-invasive blood pressure monitoring during procedures of interventional electrophysiology.

Methods and results: We evaluated continuous non-invasive finger blood pressure (BP) monitoring by means of the Nexfin device in 22 patients (mean age 70 ± 24 years), undergoing procedures of interventional electrophysiology, in critical situations of hypotension caused by tachyarrhythmias or by intermittent incremental ventricular temporary pacing till to the maximum tolerated systolic BP fall (mean 61 ± 14 mmHg per patient at a rate of 195 ± 37 bpm). In all patients, Nexfin was able to detect immediately, at the onset of tachyarrythmia, the changes in BP and recorded reliable waveforms. The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case. In basal conditions, calibrations of the signal occurred every 49.2 ± 24.3 s and accounted for 4% of total monitoring time; during tachyarrhythmias their frequency increased to one every 12.7 s and accounted for 19% of total recording duration. A linear correlation for a range of BP values from 41 to 190 mmHg was found between non-invasive and intra-arterial BP among a total of 1055 beats from three patients who underwent simultaneous recordings with both methods (coefficient of correlation of 0.81, P < 0.0001).

Conclusion: In conclusion, continuous non-invasive BP monitoring is feasible in the clinical practise of an interventional electrophysiology laboratory without the need of utilization of an intra-arterial BP line.

Show MeSH
Related in: MedlinePlus