Abstract 17573: Reliability of Non-Invasive Arterial Pressure Monitoring via ClearSight System™ During Cardiac Ablation and Transvenous Pacemaker Lead Removal
Colton D Thompson, Dejan Vrtikapa, Jeffrey Olech, Jennifer Wright, John Dollerschell- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Background: Invasive arterial catheter (IAC) placement can lead to hematoma, vessel occlusion, pain and & procedure delay. The ClearSight System™ (CSS) is a non-invasive blood pressure (NIBP) device that measures beat-to-beat arterial pressures (AP) via a finger cuff. The validity of CSS during cardiac ablation & transvenous pacemaker lead removal has not been described. Therefore, we performed a single center observational study to validate AP monitoring by CSS compared to IAC in such patients (pts).
Methods: Pts undergoing cardiac ablation or lead removal from June-November 2022 were included. AP was simultaneously measured via CSS & IAC. Measurements were compared using Bland-Altman analysis. Acceptable bias & precision (standard deviation) were defined as <5 mm Hg & <8 mm Hg respectively based on Association for the Advancement of Medical Instrumentation standards. An exploratory analysis on impacts of BMI, sex, & type of procedure on validity of CSS was also assessed.
Results: Paired AP measurements were available for 61 pts (6967 paired measurements). Median age was 67 (IQR 60.5-73.5), BMI 29.2 (IQR 26.1-37.1) & 31% of pts were female. Procedures included atrial fibrillation ablation (n=32), SVT ablation (n=13), lead extraction (n=9), & VT ablation (n=7). Bland-Altman analysis comparing AP via CSS vs IAC showed that the CSS overestimated systolic arterial pressure (SAP) & underestimated both diastolic arterial pressure (DAP) & mean arterial pressure (MAP). Mean bias was 4.2 ± 12.9 (SAP), -4.99 ± 9.2 (DAP) & -2.4 ± 11.78 (MAP) (Figure 1). Exploratory analysis showed that CSS was not interchangeable with IAC monitoring regardless of subgroup (MAP male sex -1.9 ± 11.1; BMI ≥30 -2.7 ± 9.7; ablation -1.8 ± 12.2).
Conclusion: Continuous NIBP monitoring via CSS was not interchangeable with IAC monitoring in pts undergoing cardiac ablation & lead extraction.