IABP: Early Inflation

This shows the arterial tracing of Early Inflation of an IABP

Early Inflation with the IABP inflating during systole is very dangerous. The acute increase in afterload can result in cardiac arrest due to abrupt and great increase in myocardial wall stress, and always results in a marked decrease in cardiac output.

Early inflation may also increase the possibility of left to right shunting in the event of an existing defect, such as a PFO (present in up to 33%), or other physical wall defect, due to the increase in LV intracavitary pressure and volume.

Note here the early rise in arterial pressure which starts well before the position of the dicrotic notch. You will recall that the dicrotic notch marks aortic valve leaflet closure, and thus defines the end of mechanical systole.

A normal IABP pressure trace is shown in the inset to the right.