This requires continuous monitoring, which impairs battery longevity. A subtler limitation is that changes in posture, spontaneous biological variations, and movement artifacts can lead to changes in the signal that have no clinical meaning but can be difficult to distinguish from changes caused by arrhythmia. The second approach is the oscillatory height approach, which quantifies the amplitude of peak-to-trough variation in the hemodynamic signal, as this reduces or eliminates the problem of gradual baseline drift that plagues the running mean approach (13–15). However, in patients, there are always small movements and disturbances whose frequency and amplitude can overlap those elicited by cardiac function and therefore cannot be reliably removed using standard filtering of the hemodynamic signal alone.
As a result, although carefully designed animal experiments showed good discrimination (13–15), imperfect rapid reliability in humans has prevented clinical application.
Patients were continuously monitored using beat-by-beat blood pressure. Where invasive monitoring was not clinically indicated, this was done noninvasively (Finapres Nova, Finapres Medical Systems, Enschede, the Netherlands).
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