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Pacing Clin Electrophysiol · Sep 2014
Acute decrease of cerebral oxygen saturation during rapid ventricular and supraventricular rhythm: a pilot study.
- Alexander Wutzler, Natalie Otto, Saskia Gräser, Leif-Hendrik Boldt, Martin Huemer, Abdul Parwani, Wilhelm Haverkamp, and Christian Storm.
- Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
- Pacing Clin Electrophysiol. 2014 Sep 1;37(9):1159-65.
BackgroundMonitoring of cerebral tissue oxygen saturation (SctO2 ) reflects cerebral microcirculation. We sought to characterize the decrease in SctO2 during supraventricular tachycardia (SVT) and ventricular tachycardia (VT) in adults.MethodsTwenty patients (mean age: 46.3 ± 18.1 years, 40% men) were included. Rapid atrial and ventricular pacing (200/min) was used as a model for VT and SVT. Near-infrared spectroscopy (NIRS) was used to measure SctO2 .ResultsAtrial stimulation decreased right (P = 0.014) and left (P = 0.019) hemispheric SctO2 compared to baseline. Ventricular stimulation also decreased right (P < 0.001) and left (P < 0.001) hemispheric SctO2 . A negative correlation between age and minimal value under stimulation was found for atrial (right SctO2 r = -0.641, P = 0.034; left SctO2 r = -0.694, P = 0.018) and ventricular pacing (right SctO2 r = -0.564, P = 0.01; left SctO2 r = -0.604, P = 0.005). A positive correlation was found between left ventricular ejection fraction (LVEF) and minimal value under ventricular stimulation (right SctO2 r = 0.567, P = 0.009; left SctO2 r = 0.471, P = 0.036).ConclusionCerebral perfusion decreased during simulated SVT and VT and is influenced by age and LVEF. Clinicians can consider NIRS monitoring in patients during ablation procedures and in critical care. NIRS may especially be appropriate for the elderly and for patients with impaired LVEF.©2014 Wiley Periodicals, Inc.
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