[New algorithm for oscillometric noninvasive automatic arterial pressure measurement in patients with atrial fibrillation].
Oscillometric noninvasive arterial pressure monitoring devices frequently fail to measure pressure precisely in patients with arrhythmia, such as atrial fibrillation, because beat-by-beat changes in pulse pressure and mean pressure level distort the relation between cuff pressure and oscillometric wave amplitude. To overcome this problem, we developed a new algorithm for oscillometric measurement in which oscillometric wave amplitude is corrected according to changes in pulse pressure and mean arterial pressure level. In 7 patients with atrial fibrillation, we compared systolic pressure thus estimated with that simultaneously measured invasively in the radial artery and averaged during oscillometric measurement. Correction based on invasively obtained beat-by-beat pulse pressure and mean pressure level decreased the ratio of unmeasurable cases from 11 to 4%. Correction based on plethysmographically estimated pulse pressure decreased unmeasurable cases to 6% (P < 0.01). Standard error of systolic pressure estimates was 6.44 +/- 1.83, 4.10 +/- 0.85, and 4.75 +/- 1.26 mmHg with no, invasive, and plethysmographical correction in this order (P < 0.01). We conclude that oscillometric wave amplitude correction based on beat-by-beat pulse pressure and mean arterial pressure level lessened the number of unmeasurable cases and improved measurement precision in patients with atrial fibrillation.
Sugimachi
Masaru
M
Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, Suita 565-8565.
Sunagawa
Kenji
K
Okamoto
Hirotsugu
H
Hoka
Sumio
S
D000465:Algorithms; D001281:Atrial Fibrillation / Q000503:physiopathology*; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation; D006801:Humans; D009991:Oscillometry