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A Non-invasive Test to Detect Coronary Artery Disease of 21st Century

Dr. Rajendra Kumar

Realistic Geometry Cartographic Coronary Imaging (RGCI) is a technique based on impedance Cardiography. It is a scientific technique to estimate cardio-haemodynamic status without even a single cut to the body.


Last century has seen much advancement in the field of medical technology. One such technique that has recently been discovered is Impedance Cardiography.

In the early 60's NASA had discovered this technique to evaluate astronomy in Space for zero-gravity effect. Earlier, the data gathered by ICG was huge and the earlier computer technology was unable to calculate the changes/ reading simultaneously. Now with the help of latest information technology we are able to use and calculate data, which is collected by ICG through computers.

Realistic Geometry Cartographic Coronary Imaging (RGCI) is a technique based on impedance Cardiography. It is a scientific technique to estimate cardio-haemodynamic status without even a single cut to the body. In clinical trial ICG data collection and invasive data collection is found to be at par with each other. Moreover, since it is non-invasive, it is 100% risk free and cost effective.

According to old paradigm, coronary angiography has been the gold standard for the diagnosis of CAD and revascularisation, its main stay of treatment. However, according to the new paradigm, CAG does not identify and consequently revascularisation procedure do not treat the lesion that leads to myocardial infarction. This conclusion is based on increasing realisation that ''small lipid rich vulnerable plaques'' that are angiographically unimpressive and haemodynamically insignificant are responsible for most cases of fatal and non-fatal myocardial infarction. Where as large stable plaques that produce angiographically severe stenosis generally result in stable angina but rarely result in myocardial infarction. The majority of acute myocardial infarction occur due to sudden total occlusion with mild to moderate stenosis (with an average pre-infarct stenosis of less than 50% on a previous CAG and more than 75% stenosis prior to the rupture). Lesions that cause 75% stenosis are effectively stabilised by lipid lowering therapy. - Excerpt taken from JIMA. December 2000.

RGCI
A non-invasive technique to assess the haemodynamic status by the virtue of flow, time and pressure of fluid in thoracic cavity. Once the data is gathered for 1024 heart beats, it is computed and anatomy of coronaries are generated showing the most probable severity, site and extent of obstruction in the coronary arteries.

Procedure: This test is performed in supine position. Patient's chest is cleaned with spirit and disposable electrode is applied as shown in the illustration. Blood pressure, height, weight is fed into the patient's information box and patient box which has 12 electrodes buttoned with the electrodes. Then vertical acceleration detection is put on chest where II heart sound is most audible.

Usefulness of RGCI over Angiography

  • Non-invasive test, so 100% risk free
  • No hospitalisation
  • Requires only 30 minutes to complete the test
  • Patient can go home immediately after test
  • It is cost effective and costs approximately 1/4 of CAG
  • Gives such data about the heart that was not possible to collect earlier
  • Can predict life threatening changes prior to its occurrence
  • Helpful in management of patient's drug intake and general health
  • A complete comprehensive test, which gives the finding of different tests under one test only.
Once all the information is fed into the computer all connections are made. The time of the test depends upon the patient's heart rate. After 1024 heartbeats, data is collected by the computer. It processes all the data and generates haemodynamic reports (which includes left ventricular functions, all systolic and diastolic time interval), cartograph, DSR, Coronary angiogram and myocardial blood flow pictures.

Accuracy: The accuracy for detecting CAD is 92%.

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