Minimally Invasive Hemodynamic Monitoring in Cardiac Ablation
Prospective Clinical Study of Minimally Invasive Hemodynamic Monitoring Outcomes in Cardiac Ablation Procedures
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
Cardiac ablation procedures performed in electrophysiology laboratories are increasingly complex and frequently conducted under non-operating room anesthesia (NORA). These procedures carry a risk of hemodynamic instability due to arrhythmia induction, procedural manipulation, and potential complications such as cardiac tamponade, thromboembolism, or fluid overload. Continuous and accurate hemodynamic monitoring is therefore essential for optimal patient management. However, data on the use of minimally invasive hemodynamic monitoring techniques in this setting remain limited.
This prospective observational clinical study aims to evaluate the clinical utility of Pressure Recording Analytical Method (PRAM)-based minimally invasive hemodynamic monitoring in patients undergoing cardiac ablation procedures. The study will be conducted in the cardiac catheterization laboratory of Istanbul University-Cerrahpaşa Cardiology Institute and will include 27 adult patients scheduled for catheter ablation. Written informed consent will be obtained from all participants, and the study will adhere to the principles of the Declaration of Helsinki.
All patients will undergo standard monitoring, including electrocardiography, heart rate, pulse oximetry, and invasive arterial blood pressure measurement via radial or femoral arterial access. In addition, continuous beat-to-beat hemodynamic data will be obtained using the MostCare® system, which applies the PRAM algorithm for real-time waveform analysis.
Primary hemodynamic parameters include heart rate, systolic, diastolic, and mean arterial pressures. Advanced parameters such as stroke volume, cardiac output, cardiac index, systemic vascular resistance, stroke volume variation, pulse pressure variation, dP/dt max, and cardiac cycle efficiency will also be recorded. Measurements will be collected at three predefined time points: before ablation (T0), during ablation (T1), and after ablation (T2).
The primary objective is to assess time-dependent changes in hemodynamic parameters and evaluate the contribution of PRAM-based monitoring to intra-procedural patient management. Secondary aims include generating evidence to support anesthesiologists' clinical decision-making and contributing to the development of future guidelines for high-risk NORA settings.
Statistical analysis will be performed using repeated measures methods, with a significance level set at p<0.05.
Typ studie
Typ studie
Zápis (Aktuální)
Zápis
Kontakty a umístění
Studijní kontakt
Studijní kontakt
- Jméno: GOZDE ALTUN
- Telefonní číslo: +905544290333
- E-mail: gozde.altun@iuc.edu.tr
Studijní místa
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-
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Istanbul, Turecko (Türkiye)
- Istanbul University-Cerrahpasa, Institute of Cardiology
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-
Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Metoda odběru vzorků
Studijní populace
Popis
Inclusion Criteria:
- Age ≥18 years
- Patients scheduled for cardiac catheter ablation in the electrophysiology laboratory
- Indication for ablation confirmed by a cardiologist
- Ability to provide written informed consent
- Planned invasive arterial blood pressure monitoring during the procedure
Exclusion Criteria:
- Refusal or inability to provide informed consent
- Failure to identify arrhythmogenic focus leading to cancellation of ablation procedure
- Severe hemodynamic instability prior to procedure
- Contraindication to invasive arterial catheterization
- Incomplete hemodynamic data acquisition
- Pregnancy
Studijní plán
Jak je studie koncipována?
Detaily designu
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Change in Cardiac Output measured by PRAM during catheter ablation
Časové okno: Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Cardiac output (L/min) measured using the PRAM-based monitoring system during catheter ablation procedures under non-operating room anesthesia.
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Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Change in Stroke Volume During Catheter Ablation
Časové okno: Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Stroke volume (mL/beat) measured using PRAM-based hemodynamic monitoring during the procedure.
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Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
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Change in Mean Arterial Pressure During Catheter Ablation
Časové okno: Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Mean arterial pressure (mmHg) measured invasively and analyzed during the procedure.
|
Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
|
Change in Systemic Vascular Resistance During Catheter Ablation
Časové okno: Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Systemic vascular resistance (dyn·s/cm⁵) measured using PRAM-based monitoring during catheter ablation.
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Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
|
Change in dP/dt max During Catheter Ablation
Časové okno: Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Maximum arterial pressure rise over time (dP/dt max, mmHg/s) measured using PRAM-based analysis.
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Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
|
Change in Cardiac Cycle Efficiency During Catheter Ablation
Časové okno: Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Cardiac cycle efficiency (%) assessed using the PRAM-based monitoring system during catheter ablation.
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Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
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Change in Arterial Elastance
Časové okno: Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
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Change in arterial elastance derived from PRAM across predefined procedural periods: before, during, and after catheter ablation.
Arterial elastance will be expressed as mmHg/mL.
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Intra-procedural (T0: before ablation, T1: during ablation, T2: after ablation)
|
Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Vyšetřovatelé
Vyšetřovatelé
- Studijní židle: Kerem Erkalp, Istanbul University-Cerrahpasa, Institute of Cardiology
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Začátek studia
Primární dokončení (Aktuální)
Primární dokončení
Dokončení studie (Aktuální)
Dokončení studie
Termíny zápisu do studia
První předloženo
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
První zveřejněno
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Poslední zveřejněná aktualizace
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
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