Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand.
J Cardiovasc Transl Res. 2011 Feb;4(1):3-13. doi: 10.1007/s12265-010-9229-z. Epub 2010 Oct 14.
We report the stability, accuracy, and development history of a new left atrial pressure (LAP) sensing system in ambulatory heart failure (HF) patients. A total of 84 patients with advanced HF underwent percutaneous transseptal implantation of the pressure sensor. Quarterly noninvasive calibration by modified Valsalva maneuver was achieved in all patients, and 96.5% of calibration sessions were successful with a reproducibility of 1.2 mmHg. Absolute sensor drift was maximal after 3 months at 4.7 mmHg (95% CI, 3.2-6.2 mmHg) and remained stable through 48 months. LAP was highly correlated with simultaneous pulmonary wedge pressure at 3 and 12 months (r = 0.98, average difference of 0.8 ± 4.0 mmHg). Freedom from device failure was 95% (n = 37) at 2 years and 88% (n = 12) at 4 years. Causes of failure were identified and mitigated with 100% freedom from device failure and less severe anomalies in the last 41 consecutive patients (p = 0.005). Accurate and reliable LAP measurement using a chronic implanted monitoring system is safe and feasible in patients with advanced heart failure.
我们报告了一种新的左心房压力（LAP）感测系统在慢性心力衰竭（HF）患者中的稳定性、准确性和发展历史。共有 84 名晚期 HF 患者接受了经皮房间隔穿刺植入压力传感器。所有患者均进行了季度性的经改良瓦尔萨尔瓦动作的非侵入性校准，96.5%的校准过程成功，可重复性为 1.2mmHg。绝对传感器漂移在 3 个月时最大，为 4.7mmHg（95%CI，3.2-6.2mmHg），并在 48 个月时保持稳定。LAP 在 3 个月和 12 个月时与同时测量的肺楔压高度相关（r=0.98，平均差值为 0.8±4.0mmHg）。2 年时设备无故障的比例为 95%（n=37），4 年时为 88%（n=12）。通过识别并减轻故障原因，在最后 41 例连续患者中实现了 100%无设备故障和较少严重异常（p=0.005）。在晚期心力衰竭患者中，使用慢性植入监测系统进行准确可靠的 LAP 测量是安全可行的。
