Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/30626
Title: Central venous pressure as a method of optimising atrio-ventricular delay after cardiac surgery
Authors: Tindale, A
Cretu, I
Gomez, N
Haynes, R
Meng, H
Mason, MJ
Francis, DP
Keywords: blood pressure;optimization;quality control;signal to noise ratio;cardiac surgery;cardiac pacing;hemodynamics;wavelet transforms
Issue Date: 17-Jan-2025
Publisher: Public Library of Science (PLoS)
Citation: Tindale, A. et al. (2025) ‘Central venous pressure as a method of optimising atrio-ventricular delay after cardiac surgery’, PLoS ONE, 20 (1), e0310905, pp. 1- 13. doi:10.1371/journal.pone.0310905.
Abstract: Introduction: Haemodynamic atrioventricular delay (AVD) optimisation has primarily focussed on signals that are not easy to acquire from a pacing system itself, such as invasive left ventricular catheterisation or arterial blood pressure (ABP). In this study, standard clinical central venous pressure (CVP) signals are tested as a potential alternative. Methods: Sixteen patients with a temporary pacemaker after cardiac surgery were studied. AV delay optimisation was performed by alternating between a reference AVD of 120ms and tested settings ranging from 40 to 280ms, with 8 replicates for each setting. Alongside (a) the raw data, three methods of correcting for respiration were tested: (b) limiting analysis to a respiratory cycle, (c) asymmetric least squares (ALS) and (d) discrete wavelet transform (DWT). The utility of a quality control step was tested. Results: CVP signals were a mirror image of the systolic ABP signals: The four R values were -0.674, -0.692, -0.631, -0.671 respectively (all p<0.001). With quality control, the mirror image was best for DWT (R = -0.76, p<0.001), with the CVP and ABP optima agreeing well (R = 0.78, p<0.001). The automated quality control signal correctly predicted the gap between the AVD optima calculated from ABP and CVP (R = 0.8, p<0.001). Conclusions: Central venous pressure signals could be used to optimise AVD, because they have a reliable inverse relationship with ABP when pacemaker settings undergo protocolised testing. However, protocols need careful design to circumvent spontaneous biological variability.
Description: Data Availability: The data used in this publication can be downloaded from https://github.com/CodingForCardiologists/AVD-CVP-data .
Supporting information is available online at: https://figshare.com/articles/journal_contribution/Human_participants_research_checklist_/28230346 .
Kudos summary is available online at: https://www.growkudos.com/publications/10.1371%25252Fjournal.pone.0310905/reader .
URI: https://bura.brunel.ac.uk/handle/2438/30626
DOI: https://doi.org/10.1371/journal.pone.0310905
Other Identifiers: ORCiD: Alexander Tindale https://orcid.org/0000-0002-8199-4275
ORCiD: Ioana Cretu https://orcid.org/0000-0003-2498-625X
ORCiD: Naomi Gomez https://orcid.org/0009-0004-9447-7789
ORCiD: Darrel P Francis https://orcid.org/0000-0002-3410-0814
ORCiD: Hongying Meng https://orcid.org/0000-0002-8836-1382
e0310905
Appears in Collections:Dept of Electronic and Electrical Engineering Research Papers

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