Diaz Sanmartin Luis A, Gruslova Aleksandra B, Nolen Drew R, Feldman Marc D, Valvano Jonathan W
Department of Medicine, Division of Cardiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Department of Electrical Engineering, University of Texas at Austin, Austin, TX, USA.
Med Biol Eng Comput. 2024 Dec;62(12):3737-3747. doi: 10.1007/s11517-024-03168-y. Epub 2024 Jul 15.
Percutaneous ventricular assist devices (pVADs) incorporated with admittance electrodes have been validated in animal studies for accurate instantaneous volumetric measurements. Since miniaturization of the pVAD profile is a priority to reduce vascular complications in patients, our study aimed to validate admittance measurements using three electrodes instead of the standard four. Complex admittance was measured between an electrode pair and a pVAD metallic blood-intake tip, both with finite element analysis and on the benchtop. The catheter and electrode arrays were first simulated inside prolate ellipsoid models of the left ventricle (LV) demonstrating current flow throughout all parts of the LV as well as minimal influence of off-center catheter placement in the recorded signal. Admittance measurements were validated in 3D-printed models of healthy and dilated hearts (100-400 mL end-diastolic volumes). Minimal interference between a pVAD motor and the current signal of our admittance system was demonstrated. A modified Wei's equation focused on three electrodes was developed to be compatible with reduced profile pVADs occurring clinically, incorporated with admittance electrodes and wires. The modified equation was compared against Wei's original equation showing improved accuracy of calculated volumes. Reducing electrode footprint can simplify the incorporation of Admittance technology on any pVAD, allowing for instantaneous recognition of native heart recovery and assistance with pVAD weaning.
结合导纳电极的经皮心室辅助装置(pVADs)已在动物研究中得到验证,可进行准确的瞬时容积测量。由于缩小pVAD外形尺寸是减少患者血管并发症的首要任务,我们的研究旨在验证使用三个电极而非标准的四个电极进行导纳测量。通过有限元分析和在实验台上,测量了电极对与pVAD金属采血尖端之间的复导纳。首先在左心室(LV)的长椭球体模型中模拟导管和电极阵列,结果表明电流在LV的所有部位流动,并且偏心导管放置对记录信号的影响最小。在健康和扩张心脏的3D打印模型(舒张末期容积为100 - 400 mL)中验证了导纳测量。证明了pVAD电机与我们导纳系统的电流信号之间的干扰最小。开发了一个专注于三个电极的修正魏氏方程,以与临床上出现的外形尺寸减小的pVAD兼容,该pVAD结合了导纳电极和导线。将修正方程与魏氏原始方程进行比较,结果表明计算体积的准确性有所提高。减少电极占用面积可以简化导纳技术在任何pVAD上的整合,从而能够即时识别天然心脏的恢复情况并辅助pVAD撤机。