The intra- and interobserver variability of impedance cardiography in patients at rest and during exercise

We studied the intra- and interobserver variability in the calculation of stroke volume by the impedance technique, using the recently proposed refinements in the electrode configuration and signal processing. Three groups of patients were included in this study: ten stable cardiac patients who underwent a diagnostic heart catheterization, ten patients 24-26 h after coronary artery bypass surgery and ten patients with severe chronic obstructive pulmonary disease (COPD). The first two groups were studied at rest and the COPD group during sub-maximal exercise. The intra-observer variability was 4.2%, 3.9-4.0% and 6.0-6.9% for the catheterized, surgical and CORD groups, respectively. The interobserver variability was 4.3%, 2.6% and 2.4%, respectively. It is concluded that highly reproducible data can be obtained with the newly proposed impedance technique in patients at rest and exercise which may be comparable or superior to other techniques used in clinical settings.