Department of Neurosurgery, Osaka Rosai Hospital.
Neurol Med Chir (Tokyo). 2023 Nov 15;63(11):526-534. doi: 10.2176/jns-nmc.2023-0093. Epub 2023 Aug 30.
This prospective observational study will evaluate the change in heart rate (HR) during the periprocedural course of carotid artery stenting (CAS) via continuous monitoring using a wearable device. The participants were recruited from our outpatient clinic between April 2020 and March 2023. They were instructed to continuously wear the device from the last outpatient visit before admission to the first outpatient visit after discharge. The changes in HR of interest throughout the periprocedural course of CAS were assessed. In addition, the Bland-Altman analysis was adopted to compare the HR measurement made by the wearable device during CAS with that made by the electrocardiogram (ECG). A total of 12 patients who underwent CAS were included in the final analysis. The time-series analysis revealed that a percentage change in HR decrease occurred on day 1 following CAS and that the most significant HR decrease rate was 12.1% on day 4 following CAS. In comparing the measurements made by the wearable device and ECG, the Bland-Altman analysis revealed the accuracy of the wearable device with a bias of -1.12 beats per minute (bpm) and a precision of 3.16 bpm. Continuous HR monitoring using the wearable device indicated that the decrease in HR following CAS could persist much longer than previously reported, providing us with unique insights into the physiology of carotid sinus baroreceptors.
这项前瞻性观察研究将通过可穿戴设备对颈动脉支架置入术 (CAS) 围手术期的心率 (HR) 变化进行连续监测。参与者是 2020 年 4 月至 2023 年 3 月期间从我们的门诊招募的。他们被指示从入院前的最后一次门诊就诊开始，到出院后的第一次门诊就诊期间，持续佩戴设备。评估了 CAS 围手术期 HR 的变化。此外，采用 Bland-Altman 分析比较了可穿戴设备在 CAS 期间和心电图 (ECG) 测量的 HR。共有 12 名接受 CAS 的患者纳入最终分析。时间序列分析显示，CAS 后第 1 天 HR 下降百分比发生变化，CAS 后第 4 天 HR 下降率最大，为 12.1%。在比较可穿戴设备和 ECG 的测量值时，Bland-Altman 分析显示可穿戴设备的准确性为 -1.12 次/分钟 (bpm) 的偏差和 3.16 bpm 的精度。使用可穿戴设备进行连续 HR 监测表明，CAS 后 HR 的下降可能持续时间比之前报道的更长，为我们提供了颈动脉窦压力感受器生理学的独特见解。
