TY - JOUR
T1 - Automatic intraaortic balloon pump timing using an intrabeat dicrotic notch prediction algorithm
AU - Schreuder, Jan J.
AU - Castiglioni, Alessandro
AU - Donelli, Andrea
AU - Maisano, Francesco
AU - Jansen, J. R C
AU - Hanania, Ramzi
AU - Hanlon, Pat
AU - Bovelander, Jan
AU - Alfieri, Ottavio
PY - 2005/3
Y1 - 2005/3
N2 - Purpose. The efficacy of intraaortic balloon counterpulsation (IABP) during arrhythmic episodes is questionable. A novel algorithm for intrabeat prediction of the dicrotic notch was used for real time IABP inflation timing control. Description. A windkessel model algorithm was used to calculate real-time aortic flow from aortic pressure. The dicrotic notch was predicted using a percentage of calculated peak flow. Automatic inflation timing was set at intrabeat predicted dicrotic notch and was combined with automatic IAB deflation. Evaluation. Prophylactic IABP was applied in 27 patients with low ejection fraction (<35%) undergoing cardiac surgery. Analysis of IABP at a 1:4 ratio revealed that IAB inflation occurred at a mean of 0.6 ± 5 ms from the dicrotic notch. In all patients accurate automatic timing at a 1:1 assist ratio was performed. Seventeen patients had episodes of severe arrhythmia, the novel IABP inflation algorithm accurately assisted 318 of 320 arrhythmic beats at a 1:1 ratio. Conclusions. The novel real-time intrabeat IABP inflation timing algorithm performed accurately in all patients during both regular rhythms and severe arrhythmia, allowing fully automatic intrabeat IABP timing.
AB - Purpose. The efficacy of intraaortic balloon counterpulsation (IABP) during arrhythmic episodes is questionable. A novel algorithm for intrabeat prediction of the dicrotic notch was used for real time IABP inflation timing control. Description. A windkessel model algorithm was used to calculate real-time aortic flow from aortic pressure. The dicrotic notch was predicted using a percentage of calculated peak flow. Automatic inflation timing was set at intrabeat predicted dicrotic notch and was combined with automatic IAB deflation. Evaluation. Prophylactic IABP was applied in 27 patients with low ejection fraction (<35%) undergoing cardiac surgery. Analysis of IABP at a 1:4 ratio revealed that IAB inflation occurred at a mean of 0.6 ± 5 ms from the dicrotic notch. In all patients accurate automatic timing at a 1:1 assist ratio was performed. Seventeen patients had episodes of severe arrhythmia, the novel IABP inflation algorithm accurately assisted 318 of 320 arrhythmic beats at a 1:1 ratio. Conclusions. The novel real-time intrabeat IABP inflation timing algorithm performed accurately in all patients during both regular rhythms and severe arrhythmia, allowing fully automatic intrabeat IABP timing.
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U2 - 10.1016/j.athoracsur.2004.07.074
DO - 10.1016/j.athoracsur.2004.07.074
M3 - Article
C2 - 15734425
AN - SCOPUS:14244266934
VL - 79
SP - 1017
EP - 1022
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 3
ER -