Monitoring Cardiac Output and Left Atrial Pressure by Analysis of the Right Ventricular Pressure Waveform Based on Missing Output Identification

A proven implantable device is now available for long-term ambulatory monitoring of the right ventricular pressure (RVP) waveform of congestive heart failure patients. However, cardiac output (CO) and left atrial pressure (LAP) are far more useful for assessing cardiac function and managing volume status. We developed a new technique to monitor both CO and LAP by analysis of the RVP waveform based on missing output identification. We initially evaluated the technique against gold standard reference CO and LAP measurements from two dogs during common hemodynamic interventions. We report overall CO and LAP errors of 13.3% and 1.9 mmHg, respectively. With further successful testing, the technique may potentially be employed with an established implantable device for chronic monitoring of vital hemodynamic variables.