It has not been possible to measure wave speed in the human coronary artery, because the vessel is too short for the conventional two-point measurement technique used in the aorta. We present a new...

https://www.physiology.org/doi/pdf/10.1152/ajpheart.00751.2005

Use of simultaneous pressure and velocity measurements to estimate arterial wave speed at a single site in humans

Modern pacemaker technology renders possible the adaptation of pacing rate to hemodynamic requirements. The most ambitious approach aims at restoration of the physiological closed-loop system lay utilizing the information supplied by the autonomic nervous system (ANS) and extracted from myocardial contractile performance. Measurement is accomplished by the impedance method using the stimulation electrode as the measuring electrode. The ventricular inotropic parameter (VIP) has been identified as an ANS dependent parameter. A special detection algorithm, regional effective slope quantity (RQ), with high ANS sensitivity has been developed. Rate adaptation has been achieved by using an individually adjustable inotropic index (II). The concept has been evaluated in a multicenter study using a standardized exercise protocol. The results in patients with AV block demonstrate excellent agreement between spontaneous sinus rhythm and the ANS-controlled stimulation rate during different forms of exercise. Measurement of mean arterial blood pressure (MABP) supports the physiological approach of adapting the pacing rate to various types of hemodynamic challenges.

Intracardiac Impedance to Determine Sympathetic Activity in Rate Responsive Pacing

The conductance catheter system is a tool to determine instantaneous left ventricular volume in vivo by converting measured conductance to volume. The currently adopted conductance-to-volume conversion equation was proposed by Baan, and the accuracy of this equation is limited by the assumption of a linear conductance-volume relationship. The electric field generated by a conductance catheter is nonuniform, which results in a nonlinear relationship between conductance and volume. This paper investigates this nonlinear relationship and proposes a new nonlinear conductance-to-volume conversion equation. The proposed nonlinear equation uses a single empirically determined calibration coefficient, derived from independently measured stroke volume. In vitro experiments and numerical model simulations were performed to verify and validate the proposed equation.

/pdf/nonlinear-conductance-volume-relationship-for-murine-33htkp2x5v.pdf

Nonlinear conductance-volume relationship for murine conductance catheter measurement system

The optimal performance of the cardiovascular system, as well as the break-down of this performance with disease, both involve complex biomechanical interactions between the heart, conduit vascular networks and microvascular beds. 'Wave analysis' refers to a group of techniques that provide valuable insight into these interactions by scrutinizing the shape of blood pressure and flow/velocity waveforms. The aim of this review paper is to provide a comprehensive introduction to wave analysis, with a focus on key concepts and practical application rather than mathematical derivations. We begin with an overview of invasive and non-invasive measurement techniques that can be used to obtain the signals required for wave analysis. We then review the most widely used wave analysis techniques-pulse wave analysis, wave separation and wave intensity analysis-and associated methods for estimating local wave speed or characteristic impedance that are required for decomposing waveforms into forward and backward wave components. This is followed by a discussion of the biomechanical phenomena that generate waves and the processes that modulate wave amplitude, both of which are critical for interpreting measured wave patterns. Finally, we provide a brief update on several emerging techniques/concepts in the wave analysis field, namely wave potential and the reservoir-excess pressure approach.

/pdf/measurement-analysis-and-interpretation-of-pressure-flow-30jdi5itup.pdf

Measurement, Analysis and Interpretation of Pressure/Flow Waves in Blood Vessels

The conductance-volume method is an important clinical tool which allows the assessment of left ventricular function in vivo. However, the accuracy of this method is limited by the homogeneity of electric field the conductance catheter produces and the parallel conductance of surrounding structures. This paper examines these sources of error in volumes seen clinically, The characteristics of electric field within a chamber were examined using computer simulation. Nonconductive and conductive models were constructed and experimental measurements obtained using both single-field (SF) and dual-field (DF) excitation. Results from computer simulations and in vitro measurements were compared to validate the proposed theoretical model of conductance-volume method. The effects of field homogeneity and significance of parallel conductance in volume measurement were then determined. The results of this study show that DF provide a more accurate measure of intraventricular volume than SF, especially at larger volumes. However, both significantly underestimate true volume at larger volumes. In addition, the parallel conductance due to the chamber wall is significant at small volumes, but diminishes at larger volumes. Furthermore, the effect of parallel conductance beyond the chamber wall may be negligible. This study demonstrates the limitations in applying current conductance technology to patients with dilated hearts.

Accuracy of the conductance catheter for measurement of ventricular volumes seen clinically: effects of electric field homogeneity and parallel conductance

A finite-difference computer model has been used to determine the potential distributions arising from a dipole current source aligned parallel to the axis of bounding cylinders. The radial position of this source had large and nonlinear influence on the potentials along the dipole axis. The accuracy of the computer simulation was established from comparison with an analytic solution of a simple geometry. Measurements using a conductance catheter in saline-filled cylinders also demonstrated the dependence of the conductance on the radial position. The dependence of the potential distribution on the radial position of the dipole places limits on the ultimate accuracy of the conductance catheter technique when used for the measurement of ventricular volume. Radial movement of the catheter within the ventricular cavity, resulting in changes in the potential distribution, could explain some artefacts that appear on volume recordings from the conductance catheter.

B. S. Gow

Papers

Effect of radial position on volume measurements using the conductance catheter.

Comparison of different methods for the determination of the true wave propagation coefficient, in rubber tubes and the canine thoracic aorta