Impedance cardiography: A valuable method of evaluating haemodynamic parameters

Folia Cardiologica

Volumn 14, Issue 2, 2007, Pages 115-126

  Sodolski, Tomasz ^a   Kutarski, Andrzej ^a  

^a MEDICAL UNIVERSITY OF LUBLIN   (Poland)

Author keywords

Cardiac output; Electrical bioimpedance of the chest; Haemodynamics; Impedance cardiography; Non invasive diagnostics; Reocardiography

Indexed keywords

ANTIHYPERTENSIVE AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; NIFEDIPINE; PROPRANOLOL;

ACCELERATION; ACCURACY; ARTIFICIAL HEART PACEMAKER; ATRIOVENTRICULAR CONDUCTION; BLOOD FLOW VELOCITY; CARDIAC RESYNCHRONIZATION THERAPY; CARDIOVASCULAR DISEASE; CARDIOVASCULAR SURGERY; CLINICAL EVALUATION; COMPUTER PROGRAM; DIAGNOSTIC VALUE; DISEASE SEVERITY; DYSPNEA; ECHOCARDIOGRAPHY; HEALTH CARE COST; HEALTH CARE PERSONNEL; HEART AFTERLOAD; HEART FAILURE; HEART LEFT VENTRICLE CONTRACTION; HEART LEFT VENTRICLE EJECTION TIME; HEART MUSCLE CONTRACTILITY; HEART OUTPUT; HEART PREEJECTION PERIOD; HEART PRELOAD; HEART RATE; HEART STROKE VOLUME; HEART TRANSPLANTATION; HEMODIALYSIS; HEMODYNAMIC PARAMETERS; HOSPITAL ADMISSION; HUMAN; HYPERTENSION; IMPEDANCE CARDIOGRAPHY; IMPEDANCE PLETHYSMOGRAPHY; INTENSIVE CARE UNIT; INTERMETHOD COMPARISON; LUNG ARTERY PRESSURE; LUNG CONGESTION; MATHEMATICAL COMPUTING; MEDICAL ASSESSMENT; MEDICAL DECISION MAKING; MUSCLE HYPOTONIA; NON INVASIVE MEASUREMENT; NURSE TRAINING; OPERATING ROOM; PATIENT MONITORING; PLEURA FLUID; PREGNANCY; PREGNANCY TOXEMIA; PROGNOSIS; QUALITY CONTROL; REPRODUCIBILITY; REVIEW; SIGNAL PROCESSING; SODIUM RESTRICTION; SYSTEMIC VASCULAR RESISTANCE; TIME; TREATMENT OUTCOME;

EID: 34247465511     PISSN: 15074145     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (108)

1. Strobeck J, Silver M. Beyond the four quadrants: the critical and emerging role of impedance cardiography in heart failure. Congest Heart Fail, 2004; 10 (suppl. 2): 1-6.
2. Siebert J. Ocena wartości klinicznej badania układu krażenia i płuc za pomoca technik bio-impedancyjnych. Rozprawa habilitacyjna. Wydział Lekarski, AMG, Gdańsk 2000: 1333.
3. Osypka MJ, Bernstein DP. Electrophysiologic principles and theory of stroke volume determination by thoracic electrical bioimpedance. AACN Clin Iss, 1999; 10: 385-395.
4. BioZ ICG Monitor User Manual. CardioDynamics, San Diego, CA 2001.
5. Greenberg BH, Hermann DD, Pranulis MF, Lazio L, Cloutier D. Reproducibility of impedance cardiography hemodynamic measures in clinically stable heart failure patients. Congest Heart Fail, 2000; 6: 19-26.
6. Engoren M, Barbee D. Comparison of cardiac output determined by bioimpedance, thermodilution, and the Fick method. Am J Crit Care, 2005; 14: 40-45.
7. Ito H, Yamakoshi K, Yamada A. Physiological and fluid-dynamic investigation of the thoracic impedance plethysmography method for measuring cardiac output: Part II. Analysis of thoracic impedance wave by perfusing dog. Med Biol Eng, 1976; 14: 373.
8. Thomsen A. Impedance cardiography. Is the output from the right or left ventricle measured? Int Care Med, 1979; 5: 206.
9. Lababidi Z, Ehmke A, Durin R, Leaverton P, Lauer R. The first derivative thoracic impedance cardiogram. Circulation, 1970; 41: 651-658.
10. Hubbard W, Fish D, McBrien D. The use of impedance cardiography in heart failure. Int J Cardiol, 1986; 12: 71-97.
11. Pickett B, Buell J. Usefulness of the impedance cardiogram to reflect left ventricular diastolic function. Am J Cardiol, 1993; 71: 1099-1103.
12. Ramos MU. An abnormal early diastolic impedance waveform: a predictor of poor prognosis in the cardiac patient? Am Heart J, 1977; 94: 274-281.
13. Nyboer J, Bagno S, Bamett A et al. Radiocardiograms: electrical impedance changes of the heart in relation to electrocardiograms and heart sounds. J Clin Invest, 1940; 19: 963.
14. Kubicek WG, Karnegis JN, Patterson RP et al. Development and evaluation of an impedance cardiac output system. Aerosp Med, 1966; 37: 1208-1212.
15. Sramek BB. Cardiac output by electrical impedance. Med Electron, 1982; 13: 93-97.
16. Bernstein DP. A new stroke volume equation for thoracic electrical bioimpedance: theory and rationale. Crit Care Med, 1986; 14: 904-909.
17. Yakimets J, Jensen L. Evaluation of impedance cardiography: comparison of NCCOM3-R7 with Fick and thermodilution methods. Heart Lung, 1995; 24: 194-206.
18. Marik PE, Pendelton JE, Smith R. A comparison of hemodynamic parameters derived from transthoracic electrical bioimpedance with those parameters obtained by thermodilution and ventricular angiography. Crit Care Med, 1997; 25: 1545-1550.
19. De Maria AN, Raisinghani A. Comparative overview of cardiac output measurement methods: has impedance cardiography come of age? Congest Heart Fail, 2000; 6: 7-18.
20. Van De Water JM, Miller TW, Vogel RL, Mount BE, Dalton ML. Impedance cardiography. The next vital sign technology? Chest, 2003; 123: 2028-2033.
21. Strobeck JE, Silver M, Ventura H. Impedance cardiography: Noninvasive measurement of cardiac stroke volume and thoracic fluid content. Congest Heart Fail, 2000; 6: 3-6.
22. Sageman WS, Riffenburgh RH, Spiess BD. Equivalence of bioimpedance and thermodilution in measuring cardiac index after cardiac surgery. J Cardiothorac Vasc Anesth, 2002; 16: 8-14.
23. Drazner MH, Thompson B, Rosenberg PB et al. Comparison of impedance cardiography with invasive hemodynamic measurements in patients with heart failure secondary to ischemic or nonischemic cardiomyopathy. Am J Cardiol, 2002; 89: 993-995.
24. Nollert G, Reichart B. Registration of thoracic electrical bioimpedance for early diagnosis of rejection after heart transplantation. J Heart Lung Transplant, 1993; 12: 832-836.
25. Sherwood A, McFetridge J, Hutcheson JS. Ambulatory impedance cardiography: a feasibility study. J Appl Physiol, 1998; 85: 2365-2369.
26. Yung GL, Fedullo PF, Kinninger K, Johnson W, Channick R. Comparison of impedance cardiography to direct Fick and thermodilution cardiac output determination in pulmonary arterial hypertension. Congest Heart Fail, 2004; 10 (suppl. 2): 7-10.
27. Verhoeve PE, Cadwell CA, Tsadok S. Reproducibility of noninvasive bioimpedance measurements of cardiac function. J Card Fail, 1998; 4 (suppl.): S3 (abstract).
28. Yu CM, Wang L, Chau E et al. Intrathoracic impedance monitoring in patients with heart failure: correlation with fluid status and feasibility of early warning preceding hospitalization. Circulation, 2005; 112: 841-848.
29. Ganion V, Rhodes M, Stadler RW. Intrathoracic impedance to monitor heart failure status: a comparison of two methods in a chronic heart failure dog model. Congest Heart Fail, 2005; 211: 177-181.
30. Forrester JS, Diamond G, Chatterjee K, Swan HJC. Correlative classification of clinical and hemodynamic function after acute myocardial infarction. J Am Cardiol, 1997; 39: 137-145.
31. Milzman D, Hogan C, Han C. Continuous noninvasive cardiac output monitoring quantifies acute congestive heart failure in the emergency department. Crit Care Med, 1997; 25: A47 (abstract).
32. Nawarycz T, Ostrowska-Nawarycz L, Kaczmarek J. Impact of cardiovascular reactions using the impedance cardiography method in borderline hypertension. Ann NY Acad Sci, 1999; 873: 174-181.
33. Sharman DL, Gomes CP, Rutherford JP. Improvement in blood pressure control with impedance cardiography-guided pharmacologic decision making. Congest Heart Fail, 2004; 10: 54-58.
34. Ferrario CM. New approaches to hypertension management: always reasonable but now necessary. Am J Hypertens, 2005; 18: 23S-25S
35. Ventura HO, Taler SJ, Strobeck JE. Hypertension as a hemodynamic disease: the role of impedance cardiography in diagnostic, prognostic, and therapeutic decision making. Am J Hypertens, 2005; 18: 26S-43S.
36. Ramirez MF, Tibayan RT, Marinas CE, Yamamoto ME, Caguioa EV. Prognostic value of hemodynamic findings from impedance cardiography in hypertensive stroke. Am J Hypertens, 2005; 18: 65S-72S.
37. Abdelhammed AI, Smith RD, Levy P, Smits GJ, Ferrario CM. Noninvasive hemodynamic profiles in hypertensive subjects. Am J Hypertens, 2005; 18: 51S-59S.
38. Bhalla V, Isakson S, Bhalla MA et al. Diagnostic ability of B-type natriuretic peptide and impedance cardiography: testing to identify left ventricular dysfunction in hypertensive patients. Am J Hypertens, 2005; 18: 73S-81S.
39. Randall OS, Westerhof N, van den Bos GC, Alexander B. Reliability of stroke volume to pulse pressure ratio for estimating and detecting changes in arterial compliance. J Hypertens, 1986; 4 (suppl. 5): S293-S296.
40. Chemla D, Hebert J-L, Coirault C et al. Total arterial compliance estimated by stroke volume-to-aortic pulse pressure ratio in humans. Am J Physiol, 1998; 274: H500-H505.
41. Ventura HO, Taler SJ, Strobeck JE. Hypertension as a hemodynamic disease: the role of impedance cardiography in diagnostic, prognostic and therapeutic decision making. Am J Hypertens, 2005; 18: 26S-43S.
42. Linb G, Eisenberg BM. Noninvasive techniques for evaluation of heart function and hemodynamics in arterial hypertension. Acta Cardiol, 1990; 45: 133-139.
43. Galarza C, Alfie J, Waisman G et al. Severe systemic hemodynamic impairment in patients with stroke. Am J Hypertens, 1996; 9 (suppl. 1): 172A (abstract).
44. Koga Y, Gillum RF, Kubicek WG. An impedance cardiographic study of the mechanism of blood pressure fall after moderate dietary sodium restriction. Jpn Heart J, 1985; 26: 197-207.
45. Taler SJ, Textor SC, Augustine JE. Resistant hypertension: comparing hemodynamic management to specialist care. Hypertension, 2002; 39: 982-988.
46. Sharman DL, Gomes CP, Rutherford JP. Improvement in blood pressure control with impedance cardiograph-guided pharmacologic decision making. Congest Heart Fail, 2004; 10: 54-58.
47. Sramek BB, Tichy JA, Hojerova M, Cervenka V. Normohemodynamic goal-oriented antihypertensive therapy improves the outcome. Am J Hypertens, 1996; 9: 141A (abstract).
48. Springfield CL, Sebat F, Johnson D, Lengle S, Sebat C. Utility of impedance cardiography to determine cardiac vs. noncardiac cause of dyspnea in the emergency department. Congest Heart Fail. 2004; 10 (suppl. 2): 14-16.
49. Ziegler D, Grotti L, Krucke G. Comparison of cardiac output measurements by TEB vs. intermittent bolus thermodilution in mechanical ventilated patients. Chest, 1999; 116: 281S (abstract).
50. Kokkonen L, Majahalme S, Koobi T et al. Atrial fibrillation in elderly patients after cardiac surgery: postoperative hemodynamics and low postoperative serum triiodothyronine. J Cardiothorac Vasc Anesth, 2005; 19: 182-187.
51. Kaukinen S, Koobi T, Bi Y, Turjanmaa VM. Cardiac output measurement after coronary artery bypass grafting using bolus thermodilution, continuous thermodilution, and whole-body impedance cardiography. J Cardiothorac Vasc Anesth, 2003; 17: 199-203.
52. Neath SX, Lazio L, Guss DA. Utility of impedance cardiography to improve physician estimation of hemodynamic parameters in the emergency department. Congest Heart Fail, 2005; 11: 17-20.
53. Brown CV, Shoemaker WC, Wo CC, Chan L, Demetriades D. Is noninvasive hemodynamic monitoring appropriate for the elderly critically injured patient? J Trauma, 2005; 58: 102-107.
54. Veale WN Jr, Morgan JH, Beatty JS, Sheppard SW, Dalton ML, Van de Water JM. Hemodynamic and pulmonary fluid status in the trauma patient: are we slipping? Am Surg, 2005; 71: 621-562.
55. Neath SX, Lazio L, Guss DA. Utility of impedance cardiography to improve physician estimation of hemodynamic parameters in the emergency department. Congest Heart Fail, 2005; 11: 17-20.
56. Brown CV, Shoemaker WC, Wo CC, Chan L, Demetriades D. Is noninvasive hemodynamic monitoring appropriate for the elderly critically injured patient? J Trauma, 2005; 58: 102-107.
57. Silver MA, Cianci P, Brennan S, Longeran-Thomas H, Ahmad F. Evaluation of impedance cardiography as an alternative to pulmonary artery catheterization in critically ill patients. Congest Heart Fail, 2004; 10 (suppl. 2): 17-21.
58. Wynne JL, Ovadje LO, Akridge CM, Sheppard SW, Vogel RL, Van De Water JM. Impedance cardiography: a potential monitor for hemodialysis. J Surg Res, 2006; 133: 55-60.
59. Yoshii M, Minami J, Ishimitsu T, Yamakoshi K, Matsuoka H. Non-invasive monitoring of hemodynamic changes during hemodialysis by the use of a newly developed admittance cardiograph. Ther Apher Dial, 2005; 9: 154-160.
60. Straver B, De Vries PM, Donker AJ, ter Wee PM. The effect of profiled hemodialysis on intradialytic hemodynamics when a proper sodium balance is applied. Blood Purif, 2002; 20: 364-369.
61. Miltenyi G, Tory K, Stubnya G et al. Monitoring cardiovascular changes during hemodialysis in children. Pediatr Nephrol, 2001; 16: 19-24.
62. Straver B, de Vries PM, ten Voorde BJ, Roggekamp MC, Donker AJ, ter Wee PM. Intradialytic hypotension in relation to pre-existent autonomic dysfunction in hemodialysis patients. Int J Artif Organs, 1998; 21: 794-801.
63. Santos JF, Parreira L, Madeira J et al. Noninvasive hemodynamic monitorization for AV interval optimization in patients with ventricular resynchronization therapy. Rev Port Cardiol, 2003; 22: 1091-1098.
64. Defaye P, Petit L, Vanzetto G, Mansour P, Bertrand B, Denis B. Optimization of dual chamber pacers programming by thoracic electrical bio-impedance (about 34 cases). PACE, 1993; 16: 193 (abstract).
65. Ovsyshcher I, Katz A, Bondy C, Gross J, Furman S. Thoracic impedance measurements as a method for assessement of cardiac output in pacemaker patients. PACE, 1993; 16: 180 (abstract).
66. Kindermann M, Frohlig G, Doerr T, Schieffer H. Optimizing the AV delay in DDD pacemaker patients with high degree AV block: mitral valve Doppler versus impedance cardiography. PACE, 1997; 20: 2453-2462.
67. Schwaab B, Frohlig G, Alexander C et al. Influence of right ventricular stimulation site on left ventricular function in atrial synchronous ventricular pacing. J Am Coll Cardiol, 1999; 33: 317-323.
68. Belott P. Bioimpedance in the pacemaker clinic. AACN Clin Iss, 1999; 10: 414-418.
69. Crystal E, Ovsyshcher IE. Cardiac output-based versus empirically programmed AV interval - how different are they? Europace, 1999; 1: 121-125.
70. Hayes DL, Hayes SN, Hyberger LK et al. Atrioventricular interval optimization after biventricular pacing: echo/doppler vs. impedance pletysmography. Europace, 2000; 1 (suppl. D): 108 (abstract).
71. Adachi H, Hiratsuji T, Sakurai S et al. Impedance cardiography and quantitative tissue Doppler echocardiography for evaluating the effect of cardiac resynchronization therapy: a case report. J Cardiol, 2003; 42: 37-42.
72. Tse H, Yu C, Park E et al. Impedance cardiography for atrioventricular interval optimization during permanent left ventricular pacing. PACE, 2003; 26: 189-191.
73. Braun MU, Schnabel A, Rauwolf T, Schulze M, Strasser RH. Impedance cardiography as a noninvasive technique for atrioventricular interval optimization in cardiac resynchronization therapy. J Interv Card Electrophysiol, 2005; 13: 223-229.
74. Gimbel JR. Method and demonstration of direct confirmation of response to cardiac resynchronization therapy via preimplant temporary biventricular pacing and impedance cardiography. Am J Cardiol, 2005; 96: 874-876.
75. Silver MA, Lazzara D, Slaughter M, Szabo S, Pappas P. Thoracic bioimpedance accurately determines cardiac output in patients with left ventricular assist devices. J Card Fail, 1999; 5 (suppl. 1): 38 (abstract).
76. Thangathurai D, Charbonnet C, Roessler P et al. Continuous intraoperative noninvasive cardiac output monitoring using a new thoracic bioimpedance device. J Cardiothorac Vasc Anesth, 1997; 11: 440-444.
77. Roessler P, Thangathurai D, Wo C. Intraoperative use of continuous noninvasive cardiac output monitoring in high risk patients. Crit Care Med, 1996; 24: A46.
78. Savino J.S. Noninvasive cardiac monitoring. 46th Annual Refresher Course and Clinical Update. Am Soc Anesth, 1995; 223: 1-6.
79. Koerner K, Borzotta A, Lipman G, Wilson J. Screening for coronary artery disease with impedance cardiography. Crit Care Med, 1997; 25: A47 (abstract).
80. Feng S, Okuda N, Fujinami T, Takada K, Nakano S, Ohte N. Detection of impaired left ventricular function in coronary artery disease with acceleration index in the first derivative of the transthoracic impedance change. Clin Cardiol, 1988; 11: 843-847.
81. Scardo JA, Vermillion ST, Hogg BB, Newman RB. Hemodynamic effects of oral nifedipine in preeclamptic hypertensive emergencies. Am J Obstet Gynecol, 1996; 175: 336-340.
82. van Oppen AC, van der Tweel I, Alsbach GP, Heethaar RM, Bruinse HW. A longitudinal study of maternal hemodynamics during normal pregnancy. Obstet Gynecol, 1996; 88: 40-46.
83. Heethaar RM, van Oppen AC, Ottenhoff FA, Brouwer FA, Bruinse HW. Thoracic electrical bioimpedance: suitable for monitoring stroke volume during pregnancy? Eur J Obstet Gynecol Reproduc Biol, 1995; 58: 183-190.
84. Lang D, Hilger F, Binswanger J, Andelfinge G, Hartmann W. Late effects of anthracycline therapy in childhood in relation to the function of the heart at rest and under physical stress. Eur J Pediatr, 1995; 154: 340-345.
85. Albert N, Hail M, Li J et al. Equivalence of bioimpedance and TD in measuring CO/CI in patients with advanced, decompensated chronic heart failure hosp. in critical care. J Am Coll Cardiol, 2003; 41 (suppl. 6): 211A (abstract).
86. Peacock WF, Summers RL, Vogel J, Emerman CE. Impact of impedance cardiography on diagnosis and therapy of emergent dyspnea: the ED-IMPACT trial. Acad Emerg Med, 2006; 13: 365-371.
87. Taler SJ, Augustine JE, Textor Stephen C. A hemodynamic approach to resistant hypertension. Congest Heart Fail, 2000; 6: 36-39.
88. Silver MA, Cianci P, Brennan S, Longeran-Thomas H, Ahmad F. Evaluation of impedance cardiography as an alternative to pulmonary artery catheterization in critically ill patients. Congest Heart Fail, 2004; 10 (suppl. 2): 17-21.
89. Petersen JR, Jensen BV, Drabaeck H, Viskum K, Mehlsen J. Electrical impedance measured changes in thoracic fluid content during thoracentesis. Clin Physiol, 1994; 14: 459-466.
90. Ebert TJ, Smith JJ, Barney JA, Merrill DC, Smith GK. The use of thoracic impedance for determining thoracic blood volume changes in man. Aviat Space Environ Med, 1986; 57: 49-53.
91. Yancy C, Abraham W. Noninvasive hemodynamic monitoring in heart failure: utilization of impedance cardiography. Congest Heart Fail, 2003; 9: 241-250.
92. Vijayaraghavan K, Crum S, Cherukuri S, Barnett-Avery L. Association of impedance cardiography parameters with changes in functional and quality-of-life measures in patients with chronic heart failure. Congest Heart Fail, 2004; 10 (Suppl. 2): 22-27.
93. Peacock WF IV, Albert NM, Kies P, White RD, Emerman CL. Bioimpedance monitoring: better than chest X-ray for predicting abnormal pulmonary fluid? Congest Heart Fail, 2000; 6: 32-35.
94. Lasater M. Managing inotrope therapy noninvasively. AACN Clin Iss, 1999; 10: 406-413.
95. Parrott CW, Kenneth MB, Quale C, Lewis DL. Comparison of changes in ejection fraction to changes in impedance cardiography cardiac index and systolic time ratio. Congest Heart Fail, 2004; 10 (suppl. 2): 11-13.
96. Hoit BD, Rashwan M, Watt C, Sahn DJ, Bhargava V. Calculating cardiac output from transmitral volume flow using Doppler and M-mode echocardiography. Am J Cardiol, 1988; 62: 131-135.
97. Northridge DB, Findlay IN, Wilson J, Henderson E, Dargie HJ. Non-invasive determination of cardiac output by Doppler echocardiography and electrical bioimpedance. Br Heart J, 1990; 63: 93-97.
98. Hendrickson K. Cost-effectiveness of noninvasive hemodynamic monitoring. AACN Clin Iss, 1999; 10: 419-424.
99. Albert NM, Hail MD, Li J, Young JB. Equivalence of the bioimpedance and thermodilution in measuring cardiac output and index in patients with advanced, decompensated chronic heart failure hospitalized in critical care. Am J Crit Care, 2004; 13: 469-479.
100. Clancy TV, Norman K, Reynolds R, Covington D, Maxwell JG. Cardiac output measurement in critical care patients: Thoracic electrical bioimpedance versus thermodilution. J Trauma, 1991; 31: 1116-1119.
101. Ramsay J, Auger W, Dow KL. Impact of continuous cardiac output/mixed venous oximetry on nursing time after cardiac surgery. Crit Care Med, 1996; 24: A46 (abstract).
102. Connors AF Jr, Speroff T, Dawson NV et al. The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA, 1996; 18: 889-897.
103. Sandham JD, Hull RD, Brant RF et al.; Canadian Critical Care Clinical Trials Group. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med, 2003; 348: 5-14.
104. Chittock DR, Dhingra VK, Ronco JJ et al. Severity of illness and risk of death associated with pulmonary artery catheter use. Crit Care Med, 2004; 32: 911-915.
105. Pulmonary Artery Catheter Consensus Conference: Consensus Statement. Crit Care Med, 1997; 25: 910-925.
106. Shah MR, O'Connor CM, Sopko G, Hasselblad V, Califf RM, Stevenson LW. Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE): design and rationale. Am Heart J, 2001; 141: 528-535.
107. Binanay C, Califf RM, Hasselblad V, O'Connor CM et al.; ESCAPE Investigators and ESCAPE Study Coordinators. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial. JAMA, 2005; 294: 1625-1633.
108. Belott P. Bioimpedance in the pacemaker clinic. AACN Clin Iss, 1999; 10: 414-418.