Browsing by Subject "Cardiac output"
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Item A multi-vector admittance measurement system for increased sensitivity to right ventricular volume(2020-12) Wang, Andrew Peter; Valvano, Jonathan W., 1953-; Feldman, Marc D; Pearce, John A; Rylander, Henry G; Swartzlander, Earl EImplantable cardioverter defibrillators (ICDs) prevent sudden cardiac death by shocking the heart out of life-threatening ventricular arrhythmias. However, around 5.7% of patients experience an “inappropriate” shock within the first 1-3 years of receiving an implant. Adding a hemodynamic measurement to ICDs will reduce inappropriate shocks because current shocking algorithms are based solely upon intracardiac electrograms (IEGMs). Utilizing commercial pacemaker leads, a multi-vector admittance measurement system sensitive to the right ventricular blood pool has been developed. A figure of merit (sensitivity score) was created using finite element modeling to quantify sensitivity to the right ventricular blood pool. Optimal admittance vector configurations were found using the sensitivity score and applied to experimental data taken from a congestive heart failure arrhythmia study in canines. There was a high correlation between the sensitivity score optimized admittance configurations and the cardiac output ground truth using Echo LVOT VTI (r2 = 0.940 ± .026). The strong positive correlation between cardiac output and the optimized admittance measurement is an encouraging indicator that adding a hemodynamic component to ICD arrhythmia discrimination algorithms is viable and can help decrease inappropriate shocks.