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European Journal of Heart Failure 2004 6(5):627-634; doi:10.1016/j.ejheart.2003.12.021
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© 2004 European Society of Cardiology

Six years follow-up of an implanted SvO2 sensor in the right ventricle*

Barbro Kjellströma,*, Cecilia Lindeb, Tom Bennetta, Åke Ohlssonc and Lars Rydenb

a Heart Failure Management, Medtronic Inc. MS CW210, Minneapolis, MN 55432, USA
b Karolinska Hospital Stockholm, Sweden
c Southern Hospital Stockholm, Sweden

* Corresponding author. Tel.: +1-673-514-8219; Fax: +1-763-514-8347. E-mail address: barbro.kjellstrom{at}medtronic.com


  Abstract

Introduction.: Mixed venous oxygen saturation (SvO2) is a standard invasive measure used in the management of congestive heart failure patients. The reliability of a long-term SvO2 sensor remains unproven.

Methods.: Nine patients (NYHA Class I/II, n=2/7) were implanted with a dual chamber pacemaker modified to utilize a right ventricular SvO2 lead (Medtronic Inc., Models 8007/4327A IPG/Lead). Invasive studies compared sensor SvO2 to reference (Optical Swan–Ganz catheter) at 0, 3 and 9 months. Symptom limited tests (Bikemax) with metabolic assessment and arterial oxygen saturation measurements performed 1–7 days, 3.5 and 9.5 months post-implant allowed for cardiac output calculations. Long-term sensor performance was confirmed by submaximal tests, Bikesubm in years 1–3, and Walkin-place every 6 months for the duration of follow-up.

Results.: Sensor SvO2 readings were stable over time when compared to the Swan–Ganz Catheter. Non-invasive CO measured during Bikemax was in normal ranges for this patient population, 3.7±0.9 l/min at rest and 8.4±2.2 l/min at peak-exercise. Resting SvO2 values from Bikesubm and Walkin-place did not change significantly over time (P0.1 vs. 1 year) and neither did the change from rest to peak exercise during Bikesubm (P0.05 vs. 1 year) or Walkin-place (P0.05 vs. 4 year).

Conclusion.: While limited in size, this small pilot study suggests that long-term monitoring of SvO2 by implanted devices may be feasible. The clinical value remains to be proven in future studies.

Key Words: Abbreviations • CO, cardiac output • PA, pulmonary artery • RV, right ventricle • SaO2, arterial oxygen saturation • SvO2, mixed venous oxygen saturation • S.D., standard deviation • VO2, oxygen uptake

Received June 26, 2003; Revised October 16, 2003; Accepted December 10, 2003

{star} Supported by Medtronic, Bakken Research Center, Maastricht, The Netherlands and the Swedish Heart and Lung Foundation.


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