Thoracic impedance measures tissue characteristics in the vicinity of the electrodes, not intervening lung water: implications for heart failure monitoring
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| 024 | 7 | 0 | |a 10.1007/s10877-014-9570-x |2 doi |
| 035 | |a (NATIONALLICENCE)springer-10.1007/s10877-014-9570-x | ||
| 245 | 0 | 0 | |a Thoracic impedance measures tissue characteristics in the vicinity of the electrodes, not intervening lung water: implications for heart failure monitoring |h [Elektronische Daten] |c [Christopher Charles, Miriam Rademaker, Iain Melton, Dan Gutfinger, Neal Eigler, Fujian Qu, Richard Troughton] |
| 520 | 3 | |a The rationale for intrathoracic impedance (Z) detection of worsening heart failure (HF) presupposes that changes in Z reflect changes in pulmonary congestion, but is confounded by poor specificity in clinical trials. We therefore tested the hypothesis that Z is primarily affected by tissue/water content in proximity to electrodes rather than by lung water distribution between electrodes through the use of a new computational model for deriving the near-field impedance contributions from the various electrodes. Six sheep were implanted with a left atrial pressure (LAP) monitor and a cardiac resynchronization therapy device which measured Z from six vectors comprising of five electrodes. The vector-based Z was modelled as the summation of the near-field impedances of the two electrodes forming the vector. During volume expansion an acute increase in LAP resulted in simultaneous reductions in the near-field impedances of the intra-cardiac electrodes, while the subcutaneous electrode showed several hours of lag (all p<0.001). In contrast, during the simulated formation of device-pocket edema (induced by fluid injection) the near-field impedance of the subcutaneous electrode had an instantaneous response, while the intra-cardiac electrodes had a minimal inconsistent response. This study suggests that the primary contribution to the vector based Z is from the tissue/water in proximity to the individual electrodes. This novel finding may help explain the limited utility of Z for detecting worsening HF. | |
| 540 | |a The Author(s), 2014 | ||
| 690 | 7 | |a Implantable monitors |2 nationallicence | |
| 690 | 7 | |a Hemodynamics |2 nationallicence | |
| 690 | 7 | |a Left atrial pressure |2 nationallicence | |
| 700 | 1 | |a Charles |D Christopher |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | |
| 700 | 1 | |a Rademaker |D Miriam |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | |
| 700 | 1 | |a Melton |D Iain |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | |
| 700 | 1 | |a Gutfinger |D Dan |u Implantable Electronic Systems Division, St. Jude Medical, Sylmar, CA, USA |4 aut | |
| 700 | 1 | |a Eigler |D Neal |u Implantable Electronic Systems Division, St. Jude Medical, Sylmar, CA, USA |4 aut | |
| 700 | 1 | |a Qu |D Fujian |u Implantable Electronic Systems Division, St. Jude Medical, Sylmar, CA, USA |4 aut | |
| 700 | 1 | |a Troughton |D Richard |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | |
| 773 | 0 | |t Journal of Clinical Monitoring and Computing |d Springer Netherlands |g 29/1(2015-02-01), 65-76 |x 1387-1307 |q 29:1<65 |1 2015 |2 29 |o 10877 | |
| 856 | 4 | 0 | |u https://doi.org/10.1007/s10877-014-9570-x |q text/html |z Onlinezugriff via DOI |
| 898 | |a BK010053 |b XK010053 |c XK010000 | ||
| 900 | 7 | |a Metadata rights reserved |b Springer special CC-BY-NC licence |2 nationallicence | |
| 908 | |D 1 |a research-article |2 jats | ||
| 949 | |B NATIONALLICENCE |F NATIONALLICENCE |b NL-springer | ||
| 950 | |B NATIONALLICENCE |P 856 |E 40 |u https://doi.org/10.1007/s10877-014-9570-x |q text/html |z Onlinezugriff via DOI | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Charles |D Christopher |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Rademaker |D Miriam |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Melton |D Iain |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Gutfinger |D Dan |u Implantable Electronic Systems Division, St. Jude Medical, Sylmar, CA, USA |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Eigler |D Neal |u Implantable Electronic Systems Division, St. Jude Medical, Sylmar, CA, USA |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Qu |D Fujian |u Implantable Electronic Systems Division, St. Jude Medical, Sylmar, CA, USA |4 aut | ||
| 950 | |B NATIONALLICENCE |P 700 |E 1- |a Troughton |D Richard |u Christchurch Heart Institute, University of Otago, P.O. Box 4345, Christchurch, New Zealand |4 aut | ||
| 950 | |B NATIONALLICENCE |P 773 |E 0- |t Journal of Clinical Monitoring and Computing |d Springer Netherlands |g 29/1(2015-02-01), 65-76 |x 1387-1307 |q 29:1<65 |1 2015 |2 29 |o 10877 | ||