Daniel Robert Quast1, Thomas Hummel2, Alexander Wutzler3, Juris Jendrik Meier1. 1. Diabetes Center Bochum-Hattingen, Medical Department I, St Josef-Hospital, University Hospital of the Ruhr-University Bochum, Bochum, Germany. 2. Department of Vascular Surgery, St Josef-Hospital, University Hospital of the Ruhr-University Bochum, Bochum, Germany. 3. Cardiovascular Center, St Josef-Hospital, University Hospital of the Ruhr-University Bochum, Bochum, Germany.
Abstract
BACKGROUND: Near-infrared spectroscopy (NIRS) is a noninvasive method to measure regional tissue oxygenation (rSO2 ). In patients with atrial fibrillation (AF), cardiac output and endothelial function are altered. Peripheral tissue oxygenation may therefore be reduced. This study aims to describe the peripheral tissue oxygenation of the feet before and after synchronized electrical cardioversion (CV) of patients with AF using NIRS. METHODS: Patients with AF undergoing CV were included and screened for peripheral arterial disease (PAD), diabetes mellitus (DM), and peripheral neuropathy (PN). NIRS was performed before and after CV under continuous ECG and monitoring of peripheral oxygen saturation. NIRS was registered on the dorsoplantar and plantar area of both feet. Capillary blood gas analysis was performed and left ventricular ejection fraction (LVEF) was determined. RESULTS: Twelve patients (five women, seven men, age 70.8 ± 10.8 years) participated. None had history of PAD. DM was present in three (25%) patients. Two patients (16.7%) had PN. CV was successful in 11 patients. Overall, rSO2 improved significantly in all patients after CV (P = .0003). Mean improvement was 7.17%. There were no significant changes in body temperature, ankle-brachial index, sO2 , pO2 , pCO2 , pH, or lactate after CV. Heart rate was significantly lower (P < .0001) and LVEF significantly higher (P = .0123) after CV. CONCLUSIONS: In patients with AF, peripheral tissue oxygen saturation improves significantly after successful CV. This suggests that patients with PAD may not only benefit from interventional or surgical improvement of arterial vascularization, but also from CV in case of AF.
BACKGROUND: Near-infrared spectroscopy (NIRS) is a noninvasive method to measure regional tissue oxygenation (rSO2 ). In patients with atrial fibrillation (AF), cardiac output and endothelial function are altered. Peripheral tissue oxygenation may therefore be reduced. This study aims to describe the peripheral tissue oxygenation of the feet before and after synchronized electrical cardioversion (CV) of patients with AF using NIRS. METHODS:Patients with AF undergoing CV were included and screened for peripheral arterial disease (PAD), diabetes mellitus (DM), and peripheral neuropathy (PN). NIRS was performed before and after CV under continuous ECG and monitoring of peripheral oxygen saturation. NIRS was registered on the dorsoplantar and plantar area of both feet. Capillary blood gas analysis was performed and left ventricular ejection fraction (LVEF) was determined. RESULTS: Twelve patients (five women, seven men, age 70.8 ± 10.8 years) participated. None had history of PAD. DM was present in three (25%) patients. Two patients (16.7%) had PN. CV was successful in 11 patients. Overall, rSO2 improved significantly in all patients after CV (P = .0003). Mean improvement was 7.17%. There were no significant changes in body temperature, ankle-brachial index, sO2 , pO2 , pCO2 , pH, or lactate after CV. Heart rate was significantly lower (P < .0001) and LVEF significantly higher (P = .0123) after CV. CONCLUSIONS: In patients with AF, peripheral tissue oxygen saturation improves significantly after successful CV. This suggests that patients with PAD may not only benefit from interventional or surgical improvement of arterial vascularization, but also from CV in case of AF.
Authors: Rachel M J van der Velden; Astrid N L Hermans; Nikki A H A Pluymaekers; Monika Gawalko; Adrian Elliott; Jeroen M Hendriks; Frits M E Franssen; Annelies M Slats; Vanessa P M van Empel; Isabelle C Van Gelder; Dick H J Thijssen; Thijs M H Eijsvogels; Carsten Leue; Harry J G M Crijns; Dominik Linz; Sami O Simons Journal: Int J Cardiol Heart Vasc Date: 2022-07-19