Key result
An intra-cardiac motion detection catheter identified acute cardiac tamponade after 40 ml of fluid infusion, preceding significant changes in systolic blood pressure which occurred at 200 ml.
Why the study?
Early detection of evolving pericardial effusion is critical for timely treatment, and researchers hypothesized that reduced lateral heart border movement could be quantified using an intracardiac accelerometer.
Does an intra-cardiac motion detection catheter detect acute pericardial tamponade earlier than hemodynamic changes in an ovine model?
Does an intra-cardiac motion detection catheter detect acute pericardial tamponade earlier than hemodynamic changes in an ovine model?
An intra-cardiac motion detection catheter can identify acute cardiac tamponade prior to significant changes in systolic blood pressure in a sheep model, offering a potential early warning system during invasive cardiac procedures.
Answers are grounded in this paper and cite their sources.
May enable pre-hemodynamic pericardial effusion detection during catheterization; leaves open clinical outcome benefit and requires prospective validation.
Objectives To develop and test an intra-cardiac catheter fitted with accelerometers to detect acute pericardial effusion prior to the onset of hemodynamic compromise. Background Early detection of an evolving pericardial effusion is critical in ensuring timely treatment. We hypothesized that the reduction in movement of the lateral heart border present in developing pericardial effusions could be quantified by positioning an accelerometer in a lateral cardiac structure. Methods A “motion detection” catheter was created by implanting a 3-axis accelerometer at the distal tip of a cardiac catheter. The pericardial space of 5 adult sheep was percutaneously accessed, and pericardial tamponade was created by infusion of normal saline. The motion detection catheter was positioned in the coronary sinus. Intracardiac echocardiography was used to confirm successful creation of pericardial effusion and hemodynamic parameters were collected. Results Statistically significant reduction in acceleration from baseline was detected after infusion of only 40 ml of normal saline ( p < 0.05, ANOVA). In comparison, clinically significant change in systolic blood pressure (defined as >10% drop in baseline systolic blood pressure) occurred after infusion of 80 ml of normal saline (107 ± 22 mmHg vs. 90 ± 12 mmHg p = 0.97, ANOVA), and statistically significant change was recorded only after infusion of 200 ml (107 ± 22 mmHg vs. 64 ± 5 mmHg, p < 0.05, ANOVA). Conclusions An intra-cardiac motion detection catheter is highly sensitive in identifying acute cardiac tamponade prior to clinically and statistically significant changes in systolic blood pressure, allowing for early detection and treatment of this potentially life-threatening complication of all modern percutaneous cardiac interventions.
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Selvakumar et al. (2024) studied Acute pericardial tamponade (n=5). Intra-cardiac motion detection catheter vs. Systolic blood pressure monitoring was evaluated on Volume of pericardial fluid infusion (ml) required to detect statistically significant change from baseline (p=<0.05). An intra-cardiac motion detection catheter identified acute cardiac tamponade after 40 ml of fluid infusion, preceding significant changes in systolic blood pressure which occurred at 200 ml.
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