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Central venous pressure as a method of optimising atrio-ventricular delay after cardiac surgery

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  • Alexander Tindale
  • Ioana Cretu
  • Naomi Gomez
  • Ross Haynes
  • Hongying Meng
  • Mark J Mason
  • Darrel P Francis

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

Suggested Citation

  • Alexander Tindale & Ioana Cretu & Naomi Gomez & Ross Haynes & Hongying Meng & Mark J Mason & Darrel P Francis, 2025. "Central venous pressure as a method of optimising atrio-ventricular delay after cardiac surgery," PLOS ONE, Public Library of Science, vol. 20(1), pages 1-13, January.
    • Handle: RePEc:plo:pone00:0310905
    DOI: 10.1371/journal.pone.0310905
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