Intrathoracic impedance monitoring in patients with heart failure : Correlation with fluid status and feasibility of early warning preceding hospitalization

Patients with heart failure are frequently hospitalized for fluid overload. A reliable method for chronic monitoring of fluid status is therefore desirable. We evaluated an implantable system capable of measuring intrathoracic impedance to identify potential fluid overload before heart failure hospi...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2005-08, Vol.112 (6), p.841-848
Main Authors: YU, Cheuk-Man, LI WANG, CHAU, Elaine, CHAN, Raymond Hon-Wah, KONG, Shun-Ling, TANG, Man-Oi, CHRISTENSEN, Jill, STADLER, Robert W, LAU, Chu-Pak
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Body Fluids - physiology
Cardiography, Impedance - instrumentation
Cardiography, Impedance - methods
Cardiology. Vascular system
Cardiovascular system
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Feasibility Studies
Female
Heart Failure - diagnosis
Heart Failure - physiopathology
Heart Rate
Hospitalization
Humans
Male
Medical sciences
Pacemaker, Artificial
Pharmacology. Drug treatments
Prostheses and Implants
Reproducibility of Results
Vasodilator agents. Cerebral vasodilators
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Summary:Patients with heart failure are frequently hospitalized for fluid overload. A reliable method for chronic monitoring of fluid status is therefore desirable. We evaluated an implantable system capable of measuring intrathoracic impedance to identify potential fluid overload before heart failure hospitalization and to determine the correlation between intrathoracic impedance and standard measures of fluid status during hospitalization. Thirty-three patients with NYHA class III and IV heart failure were implanted with a special pacemaker in the left pectoral region and a defibrillation lead in the right ventricle. Intrathoracic impedance was regularly measured and recorded between the lead and the pacemaker case. During hospitalizations, pulmonary capillary wedge pressure and fluid status were monitored. Ten patients were hospitalized for fluid overload 25 times over 20.7+/-8.4 months. Intrathoracic impedance decreased before each admission by an average of 12.3+/-5.3% (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.104.492207