Acute Decrease of Cerebral Oxygen Saturation during Rapid Ventricular and Supraventricular Rhythm: A Pilot Study. Issue 9 (16th May 2014)

• Record Type: Journal Article
• Authors: WUTZLER, ALEXANDER; OTTO, NATALIE; GRÄSER, SASKIA; BOLDT, LEIF‐HENDRIK; HUEMER, MARTIN; PARWANI, ABDUL; HAVERKAMP, WILHELM; STORM, CHRISTIAN
• Is Part Of: Pacing and clinical electrophysiology. Volume 37:Issue 9(2014)
• Page Start: 1159
• Page End: 1165
• Publication Date: 2014-05-16
• Subjects: Cardiac pacing -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1111/pace.12424
• Languages: English
• ISSNs: 0147-8389

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="pace12424-sec-0010" sec-type="section"> <title>Background</title> <p>Monitoring of cerebral tissue oxygen saturation (SctO<sub>2</sub>) reflects cerebral microcirculation. We sought to characterize the decrease in SctO<sub>2</sub> during supraventricular tachycardia (SVT) and ventricular tachycardia (VT) in adults.</p> </sec> <sec id="pace12424-sec-0020" sec-type="section"> <title>Methods</title> <p>Twenty 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 SctO<sub>2</sub>.</p> </sec> <sec id="pace12424-sec-0030" sec-type="section"> <title>Results</title> <p>Atrial stimulation decreased right (P = 0.014) and left (P = 0.019) hemispheric SctO<sub>2</sub> compared to baseline. Ventricular stimulation also decreased right (P < 0.001) and left (P < 0.001) hemispheric SctO<sub>2</sub>. A negative correlation between age and minimal value under stimulation was found for atrial (right SctO<sub>2</sub> r = –0.641, P = 0.034; left SctO<sub>2</sub> r = –0.694, P = 0.018) and ventricular pacing (right SctO<sub>2</sub> r = –0.564, P = 0.01; left SctO<sub>2</sub> r = –0.604, P = 0.005). A positive correlation was found between left ventricular ejection fraction (LVEF) and minimal value under ventricular stimulation (right SctO<sub>2</sub> r = 0.567, P = 0.009; left SctO<sub>2</sub> r = 0.471, P = 0.036).</p> </sec> <sec id="pace12424-sec-0040" sec-type="section"> <title>Conclusion</title> <p>Cerebral 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.</p> </sec> </abstract>