Electrical Cardiometry in Patients undergoing Cardiac Catheterisation

Introduction: Reliable noninvasive estimation of haemodynamics may be helpful in decision making in critically ill patients to improve outcome. We have compared the clinical utility of electrical cardiometry (EC) and pulmonary artery catheterisation (PAC) derived parameters in awake, spontaneously breathing patients undergoing percutaneous trans-mitral commissurotomy (PTMC). The parameters compared were cardiac output (CO), stroke volume (SV), systemic vascular resistance (SVR) and their respective indices. Materials and methods: Prospective observational clinical study was conducted in cardiac catheterisation laboratory of a tertiary hospital in rheumatic heart disease patients (n = 50) undergoing PTMC, for comparison of the two techniques. CO and other parameters by EC and PAC were collected simultaneously at T1 (pre-PTMC) and T2 (post-PTMC). Intraclass correlation coefficient (ICC), limits of agreement and mean bias within the data set group and within each patient over time were calculated. Accuracy of CO measured was assessed with BlandAltman analysis. Results: EC-CO 3.91 ± 1.16 Lmin–1 and PAC-CO 3.94 ± 1.12 Lmin–1 were measured at T1 and EC-CO 4.54 ± 1.15 Lmin–1 and PAC-CO 4.55 ± 1.13 Lmin–1 were measured at T2. ICC, mean bias and limits of agreement for CO at T1 were 0.98 – 0.03 and – 0.41 to + 0.35 respectively and T2 were 0.99 – 0.00 and – 0.22 to + 0.21 respectively. Bland-Altman analysis showed a good agreement between EC and PAC derived parameters. Conclusion: Electrical cardiometry is equivalent to PACderived cardiac output in patients undergoing PTMC, provides a novel monitoring technique and a noninvasive, low-cost alternative ideally suited for use during interventional catheter procedures.