{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T19:34:33Z","timestamp":1773862473291,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T00:00:00Z","timestamp":1489968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004092","name":"Kuopio University Hospital","doi-asserted-by":"publisher","award":["5070209"],"award-info":[{"award-number":["5070209"]}],"id":[{"id":"10.13039\/501100004092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Entropy"],"abstract":"<jats:p>The time-frequency balanced spectral entropy of the EEG is a monitoring technique measuring the level of hypnosis during general anesthesia. Two components of spectral entropy are calculated: state entropy (SE) and response entropy (RE). Transcatheter aortic valve implantation (TAVI) is a less invasive treatment for patients suffering from symptomatic aortic stenosis with contraindications for open heart surgery. The goal of hemodynamic management during the procedure is to achieve hemodynamic stability with exact blood pressure control and use of rapid ventricular pacing (RVP) that result in severe hypotension. The objective of this study was to examine how the spectral entropy values respond to RVP and other critical events during the TAVI procedure. Twenty one patients undergoing general anesthesia for TAVI were evaluated. The RVP was used twice during the procedure at a rate of 185 \u00b1 9\/min with durations of 16 \u00b1 4 s (range 8\u201322 s) and 24 \u00b1 6 s (range 18\u201339 s). The systolic blood pressure during RVP was under 50 \u00b1 5 mmHg. Spectral entropy values SE were significantly declined during the RVP procedure, from 28 \u00b1 13 to 23 \u00b1 13 (p &lt; 0.003) and from 29 \u00b1 12 to 24 \u00b1 10 (p &lt; 0.001). The corresponding values for RE were 29 \u00b1 13 vs. 24 \u00b1 13 (p &lt; 0.006) and 30 \u00b1 12 vs. 25 \u00b1 10 (p &lt; 0.001). Both SE and RE values returned to the pre-RVP values after 1 min. Ultra-short hypotension during RVP changed the spectral entropy parameters, however these indices reverted rapidly to the same value before application of RVP.<\/jats:p>","DOI":"10.3390\/e19030133","type":"journal-article","created":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T11:39:09Z","timestamp":1490009949000},"page":"133","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Spectral Entropy Parameters during Rapid Ventricular Pacing for Transcatheter Aortic Valve Implantation"],"prefix":"10.3390","volume":"19","author":[{"given":"Tadeusz","family":"Musialowicz","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Operative Services, Kuopio University Hospital, Kuopio FI-70029, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antti","family":"Valtola","sequence":"additional","affiliation":[{"name":"Heart Centre Department, Kuopio University Hospital, Kuopio FI-70029, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko","family":"Hippel\u00e4inen","sequence":"additional","affiliation":[{"name":"Heart Centre Department, Kuopio University Hospital, Kuopio FI-70029, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jari","family":"Halonen","sequence":"additional","affiliation":[{"name":"Heart Centre Department, Kuopio University Hospital, Kuopio FI-70029, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasi","family":"Lahtinen","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Operative Services, Kuopio University Hospital, Kuopio FI-70029, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1111\/j.1399-6576.1990.tb03149.x","article-title":"The effect of nitrous oxide on EEG spectral power during halothane and isoflurane anaesthesia","volume":"34","year":"1990","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s10877-006-9044-x","article-title":"Using EEG to monitor anesthesia drug effects during surgery","volume":"20","author":"Jameson","year":"2006","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_3","first-page":"CD010135","article-title":"Spectral entropy monitoring for adults and children undergoing general anaesthesia","volume":"3","author":"Chhabra","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s40140-014-0061-x","article-title":"Current Status of EEG-Based Depth-of-Consciousness Monitoring during General Anesthesia","volume":"4","author":"Musialowicz","year":"2014","journal-title":"Curr. Anesthesiol. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/BF01618421","article-title":"An introduction to bispectral analysis for the electroencephalogram","volume":"10","author":"Sigl","year":"1994","journal-title":"J. Clin. Monit."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/00000542-200508000-00010","article-title":"Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia","volume":"103","author":"Vakkuri","year":"2005","journal-title":"Anesthesiology"},{"key":"ref_7","first-page":"404","article-title":"Spectral entropy: A new method for anesthetic adequacy","volume":"54","author":"Nunes","year":"2004","journal-title":"Rev. Bras. Anestesiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/j.0001-5172.2004.00322.x","article-title":"Description of The Entropy\u2122 algorithm as applied in the Datex-Ohmeda S\/5\u2122 Entropy Module","volume":"48","author":"Maja","year":"2004","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3458","DOI":"10.3390\/e15093458","article-title":"Analysis of EEG via Multivariate Empirical Mode Decomposition for Depth of Anesthesia Based on Sample Entropy","volume":"15","author":"Wei","year":"2013","journal-title":"Entropy"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Valencia, J.F., Melia, U.S.P., Vallverd\u00fa, M., Borrat, X., Jospin, M., Jensen, E.W., Porta, A., Gamb\u00fas, P.L., and Caminal, P. (2016). Assessment of Nociceptive Responsiveness Levels during Sedation-Analgesia by Entropy Analysis of EEG. Entropy, 18.","DOI":"10.3390\/e18030103"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ijpsycho.2006.07.010","article-title":"Entropy changes in brain function","volume":"64","author":"Rosso","year":"2007","journal-title":"Int. J. Psychophysiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.0001-5172.2004.00323.x","article-title":"Time\u2013frequency balanced spectral entropy as a measure of anesthetic drug effect in central nervous system during sevoflurane, propofol, and thiopental anesthesia","volume":"48","author":"Vakkuri","year":"2004","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1023\/A:1016393904439","article-title":"Automatic analysis and monitoring of burst suppression in anesthesia","volume":"17","author":"Mustola","year":"2002","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1097\/01.ana.0000151408.62650.b5","article-title":"Response entropy increases during painful stimulation","volume":"17","author":"Wheeler","year":"2005","journal-title":"J. Neurosurg. Anesthesiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s10877-011-9280-6","article-title":"Comparison of spectral entropy and BIS VISTA\u2122 monitor during general anesthesia for cardiac surgery","volume":"25","author":"Musialowicz","year":"2011","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/eurheartj\/ehq427","article-title":"One year follow-up of the multi-centre European PARTNER transcatheter heart valve study","volume":"32","author":"Lefevre","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1056\/NEJMoa1103510","article-title":"PARTNER Trial Investigators. Transcatheter versus surgical aortic-valve replacement in high-risk patients","volume":"364","author":"Smith","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.ijcard.2016.09.018","article-title":"Transcatheter aortic valve implantation versus surgical aortic valve replacement: A meta-analysis of randomized controlled trials","volume":"224","author":"Indraratna","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1007\/s40140-015-0134-5","article-title":"Perioperative Management of Transcatheter Aortic Valve Replacement: Current Advancements and Controversies","volume":"5","author":"Kratzert","year":"2015","journal-title":"Curr. Anesthesiol. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1002\/ccd.20829","article-title":"Rapid pacing to facilitate transcatheter prosthetic heart valve implantation","volume":"68","author":"Webb","year":"2006","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1213\/01.ane.0000167269.62966.af","article-title":"Different conditions that could result in the bispectral index indicating an incorrect hypnotic state","volume":"101","author":"Dahaba","year":"2005","journal-title":"Anesth. Analg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1093\/bja\/aen289","article-title":"Unusual case of low bispectral index values due to electrocardiographic interferences","volume":"101","author":"Hemmerling","year":"2008","journal-title":"Br. J. Anaesth."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.1097\/00000542-199912000-00050","article-title":"The Changes in Bispectral Index during a Hypovolemic Cardiac Arrest","volume":"91","author":"England","year":"1999","journal-title":"Anesthesiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/S1053-0770(03)00160-5","article-title":"Bispectral index is an indicator of adequate cerebral perfusion during cardiopulmonary resuscitation","volume":"17","author":"Chakravarthy","year":"2003","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1097\/00000542-200604000-00031","article-title":"American Society of Anesthesiologists Task Force on Intraoperative Awareness. Practice advisory for intraoperative awareness and brain function monitoring: A report by the American Society of Anesthesiologists task force on intraoperative awareness","volume":"104","author":"Apfelbaum","year":"2006","journal-title":"Anesthesiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/j.1365-2044.2004.03736.x","article-title":"The use of bispectral index during a cardiopulmonary arrest: A potential predictor of cerebral perfusion","volume":"59","author":"Azim","year":"2004","journal-title":"Anaesthesia"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1213\/01.ANE.0000140245.44494.12","article-title":"Bispectral index as an indicator of cerebral hypoperfusion during off-pump coronary artery bypass grafting","volume":"100","author":"Hemmerling","year":"2005","journal-title":"Anesth. Analg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.jclinane.2009.01.014","article-title":"Predicting ischemic brain injury after intraoperative cardiac arrest during cardiac surgery using the BIS monitor","volume":"21","author":"Goodman","year":"2009","journal-title":"J. Clin. Anesth."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1097\/00000542-199011000-00004","article-title":"Electroencephalographic Changes during Brief Cardiac Arrest in Humans","volume":"11","author":"Clute","year":"1990","journal-title":"Anesthesiology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/S0896-6273(02)01061-9","article-title":"Sustained negative BOLD, blood flow and oxygen consumption response and its coupling to the positive response in the human brain","volume":"36","author":"Shmuel","year":"2002","journal-title":"Neuron"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1093\/bja\/aei096","article-title":"Recovery of N100 component of auditory event-related potentials and EEG after cardiac arrest during propofol sedation","volume":"94","author":"Musialowicz","year":"2005","journal-title":"Br. J. Anaesth."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s10877-014-9657-4","article-title":"Cerebral oxygenation and processed EEG response to clamping and shunting during carotid endarterectomy under general anesthesia","volume":"6","author":"Perez","year":"2015","journal-title":"J. Clin. Monit. Comput."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4935","DOI":"10.1523\/JNEUROSCI.4962-11.2012","article-title":"Returning from oblivion: Imaging the neural core of consciousness","volume":"32","author":"Alkire","year":"2012","journal-title":"J. Neurosci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1093\/bja\/aen356","article-title":"Facial muscle activity, Response Entropy, and State Entropy indices during noxious stimuli in propofol-nitrous oxide or propofol-nitrous oxide-remifentanil anaesthesia without neuromuscular block","volume":"102","author":"Aho","year":"2009","journal-title":"Br. J. Anaesth."}],"container-title":["Entropy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1099-4300\/19\/3\/133\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:30:49Z","timestamp":1760207449000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1099-4300\/19\/3\/133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,20]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,3]]}},"alternative-id":["e19030133"],"URL":"https:\/\/doi.org\/10.3390\/e19030133","relation":{},"ISSN":["1099-4300"],"issn-type":[{"value":"1099-4300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,20]]}}}