Elimination of the effects of irregular cardiac cycles in the determination of cardiovascular parameters
A cardiac cycle and cardiovascular technology, applied in cardiac catheterization, vascular assessment, electrocardiography, etc., can solve problems such as loss of accuracy
Inactive Publication Date: 2012-12-19
EDWARDS LIFESCIENCES CORP
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However, this ease of use comes at the cost of a potential loss of accuracy, since the PCM may not be more accurate than the rather simple three-parameter model from which it was derived
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[0047] As illustrated in Equations 1 to 5 above, regularity, consistency, and reliability of the cardiac cycle are important for accurate assessment of SVV, PPV, SPV, and other cardiovascular parameters. For example, the occurrence of irregular cardiac cycles during the measurement cycle, such as, for example, irregular cardiac cycles caused by cardiac arrhythmias, premature ventricular contractions, atrial fibrillation, or by noise, electrical interference or motion artifacts The affected cardiac cycle can significantly affect the accuracy of SVV, PPV, SPV or other cardiovascular parameters as indicators of preload responsiveness. For example, in the setting of cardiac arrhythmias, the cycle-to-cardiac variation in stroke volume reflects changing cardiac infusion times rather than changes in preload induced by mechanical ventilation. In those types of conditions, SVV, PPV, SPV, or other cardiovascular parameters may not be used to predict preload dependence and fluid responsi...
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Methods for determining a cardiovascular parameter, e.g., a parameter reflecting fluid or volume responsiveness, using a modified waveform dataset are described. The waveform dataset corresponds to a signal, for example, from an arterial blood pressure, or any signal proportional to, or derived from the arterial pressure signal. These methods involve identifying individual cardiac cycles in the waveform dataset, measuring the waveform characteristics for the individual cycles, then determining if the individual cardiac cycles are regular cardiac cycles or irregular cardiac cycles. Once any irregular cardiac cycles are detected, a respiratory parameter is measured.; Next, a modified waveform dataset containing the waveform characteristics of the regular cardiac cycles and the waveform characteristics of the irregular cardiac cycles is created wherein the waveform characteristics of the irregular cardiac cycles are replaced with estimated waveform characteristics. Finally, a cardiovascular parameter is determined using the modified waveform dataset.
Description
Background technique [0001] Indicators such as stroke volume (SV), cardiac output (CO), end-diastolic volume, ejection fraction, stroke volume variation (stroke volume variation, SVV), pulse pressure variation (pulse pressure variation , PPV) and systolic pressure variation (SPV), among others, are important not only for disease diagnosis, but also for "real-time" monitoring of preload-dependent, fluid-responsive, or volume-responsive conditions in human and animal subjects . Consequently, few hospitals do not have some form of equipment to monitor one or more of these cardiac parameters. Many techniques, including invasive techniques, non-invasive techniques, and combinations thereof, are in use and even more have been proposed in the literature. [0002] Many techniques for measuring SV can also be adapted to provide an estimate of CO, since CO is usually defined as SV multiplied by heart rate (HR), which is commonly available from monitoring equipment. Conversely, most d...
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Login to View More IPC IPC(8): A61B5/0205A61B5/0452A61B5/08
CPCA61B5/08A61B5/0205A61B5/0452A61B5/021A61B5/726A61B5/7278A61B5/02108A61B5/349
Inventor 蹇忠平F·哈迪布
Owner EDWARDS LIFESCIENCES CORP