Segmental composition of whole-body impedance cardiogram estimated by computer simulations and clinical experiments.

Whole-body impedance cardiography (ICGWB) has been proposed as a feasible means of measuring cardiac output (CO). However, the source distribution of heart-related impedance variations in the whole body is not known. To establish how much of a signal originates in each segment of the body and what the contribution of each is to stroke volume (SV) in ICGWB, impedance in the extremities and trunk were investigated in 15 healthy volunteers. In addition, the theoretical measurement properties of ICGWB were studied using a computer model of the whole-body anatomy as a volume conductor. The model confirmed the expected result that most of the basal impedance originates from the extremities. Clinical experiments revealed that the heart-related amplitude variations in the ICGWB signal originate more evenly from various body segments, the trunk slightly more than the arms or legs. The heart-related ICGWB signal represents a weighted sum of segmental pulsatile events in the body yielding physiologically meaningful data on almost the whole circulatory system.

Multiple lead recordings improve accuracy of bio-impedance plethysmographic technique.

We have developed the theory and instrumentation of multiple multi-electrode bio-impedance (BI) measurements based on lead field theoretical approach. To derive reliable information based on BI data, a quantity of measurements should be taken with electrode configurations possessing regional measurement sensitivity. An apparatus has been developed with an eye to the requirements imposed by the theoretical aspects of achieving multiple multi-electrode BI measurements. It has features compensating electrode-contact related errors and errors due to imbalance between the conductive pathways when multiple electrodes are utilised for BI measurement. The proposed design allows simultaneous multi-electrode BI and bioelectric recording with the same electrode system. Initial operation experiences in clinical environment indicate that the device functions as intended, and allows user-friendly utilisation of multiple BI measurements. Contributions presented to BI methodology and instrumentation improve the reliability of BI measurements.

Lead field theoretical approach in bioimpedance measurements: towards more controlled measurement sensitivity.

This study was conducted to demonstrate the potentiality of lead field theoretical approach in analyzing bioimpedance (BI) measurements. Anatomically accurate computer models and the lead field theory were used to develop BI measurement configurations capable of detecting more localized BI changes in the human body. The methods were applied to assess the measurement properties of conventional impedance cardiography (ICG) and such BI measurement configurations as can be derived using (i) the 12-lead electrocardiography (ECG) and (ii) the international 10-20 electroencephalography (EEG) electrode systems. Information as to how various electrode configurations are sensitive to detecting conductivity changes in different tissues and organs was thus obtained. Theoretical results with the 12-lead system suggested that, compared to conventional ICGs, significantly more selective ICG configurations can be derived for cardiovascular structures. In addition to theoretical investigations, clinical test measurements were made with the 12-lead system to establish whether characteristic waveforms are available. Sensitivity distributions obtained with the 10-20 electrode system give promise of the possibility of monitoring noninvasively cerebrospinal fluid (CSF) impedance changes related to impending epileptic seizures.

Sensitivity distributions of impedance cardiography using band and spot electrodes analyzed by a three-dimensional computer model.

Impedance cardiography (ICG) offers a safe, noninvasive, and inexpensive method to track stroke volume estimates over long periods of time. Several modified ICG measurement configurations have been suggested where for convenience or improved performance the standard band electrodes are replaced with electrocardiogram electrodes. This report assesses the sensitivity of the conventional and three modified ICG methods in detecting regional conductivity changes in the simulated human thorax. The theoretical analyses of the measurement sensitivity employ the reciprocity theorem and the lead field theory with a highly detailed, anatomically accurate, three-dimensional computer thorax model. This model is based on the finite-difference element method and the U.S. National Library of Medicine's Visible Human Man anatomy data. The results obtained indicate that the conventional four-band ICG is not specifically sensitive to detect conductivity changes in the region of the heart, aortas, and lungs. Analyzed modified electrode configurations do not reproduce exactly the measurement sensitivity distribution of the conventional four-band ICG. Thus, although the signals measured with modified spot arrangements may appear similar to the four-band configuration, the distribution of the signal origin may not be the same. Changing from band to spot electrodes does not overcome the methodological problems associated with ICG.