Continuous monitoring of cardiac function by 3-dimensional accelerometers in a closed-chest pig model

Grymyr, Ole-Johannes; Nguyen, Anh-Tuan Thai; Tjuļkins, Fjodors; Espinoza, Andreas; Remme, Espen W.; Skulstad, Helge; Fosse, Erik; Imenes, Kristin; Halvorsen, Per Steinar

doi:10.1093/icvts/ivv191

Cited by 14 publications

(15 citation statements)

References 18 publications

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“…This may be relevant for assessing the effects of inotropic and chronotropic medications, especially in the situation in which a drug is added to an existing regimen. Hyler et al [9] and Grymyr et al [10] report similar responses of the epicardial accelerometer to catecholamine administration.…”

Section: Discussionmentioning

confidence: 86%

“…PEA provides continuous measurement of cardiac contractility, but it was not reported to monitor the twist–untwist motion of the heart. Hyler et al [9] and Grymyr et al [10] reported their experience with epicardial 3D accelerometer as a tool for detecting LV function in the experimental setting of post-cardiac surgery care.…”

Section: Discussionmentioning

confidence: 99%

“…Hyler et al rapidly infused 500 ml of a colloid fluid to produce an increase in tissue velocity from 14.1 to 14.8 cm/s ( p < 0.05) [9]. Grymyr et al used a bolus of 500 ml Ringer acetate to increase preload, yet their velocity signal (derived from the accelerometer) showed an increase in velocity at the basal area of the LV, where in contrast velocity decreased in both the basal area of the RV and LV apex [10]. …”

Section: Discussionmentioning

confidence: 99%

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A novel system for continuous, real-time monitoring of heart motion signals

et al. 2017

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BackgroundUnderstanding cardiac mechanics is important for developing cardiac therapies. Current modalities for assessing cardiac mechanics sample patient’s heart at specific heart rate, contractility, preload, and afterload. The objective of this study was to test the feasibility of a novel system composed of intra-cardiac leads equipped with an inertial module chip (3D accelerometers and 3D gyroscopes) in monitoring continuous heart motion.MethodsIn this descriptive study, four healthy pigs were anesthetized and instrumented with motion-sensitive intra-cardiac leads; the temporal correlation between signals from motion sensors and tissue Doppler from the chest wall were studied; changes in real-time heart accelerations (ACC) and angular velocity (ANGV) were reported as percentages of change from baseline.ResultsHeart motion signals were sensed continuously from the right ventricular apex (RVa) and coronary sinus (CS). Volume expansion did not produce significant changes in the ACC and ANGV signals. Increasing heart rate increased the peak systolic ACC signal recorded from RVa and CS by 94 and 76%, respectively, and increased both peak systolic (61% RVa and 27% CS) and diastolic ANGV (200% CS vs. 31% RVa). Epinephrine administration increased peak systolic ACC signals at both sites (246% RVa; 331% CS). Peak systolic and diastolic ANGV increased in response to epinephrine (systolic: 198% RVa and 175% CS; diastolic: 723% CS and 89% RVa) (p = 0.125 for all changes expressed in percent). Temporal correlation between the ANGV signal and tissue Doppler signal was detected throughout all interventions.ConclusionsA novel system for continuously monitoring heart motion signals from within the heart was presented. Heart motion signals in response to physiologic manipulations were characterized.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A novel system for continuous, real-time monitoring of heart motion signals

et al. 2017

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“…This technique may therefore represent a future clinical tool for the detection of complications and for the guidance of vasoactive and inotropic treatment during cardiac surgery. The usefulness of the accelerometer has been demonstrated in closed-chest situations [6], and a smaller device (2.0 mm) with an incorporated pacemaker lead is being developed. The multifunctional sensor will be placed and removed like ordinary pacemaker leads and thereby provides cardiac function monitoring postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously demonstrated the applicability of this technique in continuous monitoring of LV function in open and closed-chest experimental studies, and in patients undergoing off-pump coronary artery bypass grafting [5][6][7]. Epicardial systolic velocity as revealed by the accelerometer correlates with echocardiographic measurements during coronary occlusion [8], and a great advantage of the accelerometer is that automated signal analysis is possible [9].…”

Section: Introductionmentioning

confidence: 99%

Detection of intraoperative myocardial dysfunction by accelerometer during aortic valve replacement

Grymyr

Beitnes

Eidet

et al. 2016

Interact CardioVasc Thorac Surg

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OBJECTIVES: Myocardial dysfunction may occur during weaning from cardiopulmonary bypass (CPB). Epicardial accelerometers have been shown to be useful in continuous monitoring of myocardial ischaemia during beating-heart surgery. We aimed to investigate whether an accelerometer can detect myocardial dysfunction during weaning from CPB. METHODS:In 23 patients undergoing isolated aortic valve replacement (AVR), a three-axis accelerometer was attached to the left ventricle and 3D velocity was calculated from the signals. Peak early systolic velocity (V sys ) and velocity at aortic valve closure (V avc ) were measured. Measurements were undertaken during normothermia with 50% bypass flow and atrial pacing (90 beats/min) before aortic cross-clamping and after cross-clamp removal. Myocardial dysfunction was defined as V sys < V avc , and patients were classified as having normal function or dysfunction. Left ventricular (LV) stroke work via pulmonary artery catheter and systolic velocity by echocardiography were compared between groups and used as reference methods. RESULTS:The accelerometer identified a substantial proportion of patients with myocardial dysfunction during weaning from CPB, 56% of patients compared with 11% before aortic cross-clamping. Patients classified with normal myocardial function during weaning significantly improved their LV stroke work and systolic velocity by echocardiography in response to AVR, whereas those classified with dysfunction did not. Accelerometer classification of normal function predicted an increase in echocardiographic systolic velocity [r = 0.63, regression coefficient 1.98, 95% CI (0.57, 3.40) (P < 0.01)]. CONCLUSIONS:The accelerometer detected myocardial dysfunction during weaning from CPB in accordance with measures obtained by echocardiography and pulmonary artery catheter.Clinical Trials identifier: NCT01926067. https://clinicaltrials.gov/.

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Long-term continuous monitoring of arrhythmias in pigs with insertable cardiac monitors

Airaksinen,

Siimes,

Hartikainen

et al. 2024

Pflugers Arch - Eur J Physiol

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Arrhythmia detection is essential when assessing the safety of novel drugs and therapies in preclinical studies. Many short-term arrhythmia monitoring methods exist, including non-invasive ECG and Holter. However, there are no reliable, long-term, non-invasive, or minimally invasive methods for cardiac arrhythmia follow-up in large animals that allows free movement with littermates. A long follow-up time is needed when estimating the impact of long-lasting drugs or therapies, such as gene therapy. We evaluated the feasibility and performance of insertable cardiac monitors (ICMs) in pigs for minimally invasive, long-term monitoring of cardiac arrhythmias that allows free movement and species-specific behavior. Multiple implantation sites were tested to assess signal quality. ICMs recognized reliably many different arrhythmias but failed to detect single extrasystoles. They also over-diagnosed T-waves, resulting in oversensing. Muscle activity and natural startles of the animals caused noise, leading to a heterogeneous signal requiring post-recording evaluation. In spite of these shortcomings, the ICMs showed to be very useful for minimally invasive long-term monitoring of cardiac rhythm in pigs.

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Continuous monitoring of cardiac function by 3-dimensional accelerometers in a closed-chest pig model

Abstract: Miniaturized 3D accelerometers placed on the heart can assess global and regional function in a closed-chest model. The technique may be used for continuous postoperative monitoring after cardiac surgery.

Cited by 14 publications

References 18 publications

A novel system for continuous, real-time monitoring of heart motion signals

A novel system for continuous, real-time monitoring of heart motion signals

Detection of intraoperative myocardial dysfunction by accelerometer during aortic valve replacement

Long-term continuous monitoring of arrhythmias in pigs with insertable cardiac monitors

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