Ambulatory pulmonary artery pressure monitoring in advanced heart failure patients

Abstract

Heart failure (HF) is an emerging epidemic associate with significant morbidity, mortality, and health care expenditure. Although there were major advances in pharmacologic and device based therapies for the management of HF, mortality of this condition remains high. Accurate monitoring of HF patients for exacerbations is very important to reduce recurrent hospitalizations and its associated complications. With the failure of clinical signs, tele-monitoring, and laboratory bio-markers to function as early markers of HF exacerbations, more sophisticated techniques were sought to accurately predict the circulatory status in HF patients in order to execute timely pharmacological intervention to reduce frequent hospitalizations. CardioMEMSTM (St. Jude Medical, Inc., Saint Paul, Minnesota) is an implantable, wireless pulmonary arterial pressure (PAP) monitoring system which transmits the patient’s continuous PAPs to the treating health care provider in the ambulatory setting. PAP-guided medical therapy modification has been shown to significantly reduce HF-related hospitalization and overall mortality. In advanced stages of HF, wireless access to hemodynamic information correlated with earlier left ventricular assist device implantation and shorter time to heart transplantation.

A Machine Learning Methodology for Identification and Triage of Heart Failure Exacerbations

“…At present, technological solutions have generated a great deal of interest in the management of HF and HF-related conditions. Examples include the early detection of atrial fibrillation from smartphone sensors [ 12 ], ambulatory pulmonary artery pressure monitoring that can detect worsening HF signs [ 13 ], and ECG monitoring from iPads to detect atrial fibrillation [ 14 , 15 ]. Telehealth applications also exist and have grown in use in the wake of the 2020 Covid-19 pandemic [ 16 – 18 ], but they require patient self-identification of health deterioration before initiation, and long-term adoption is still uncertain in the current healthcare reimbursement and regulatory landscapes [ 4 , 19 – 21 ].…”

The Utility of CardioMEMS, a Wireless Hemodynamic Monitoring System in Reducing Heart Failure Related Hospital Readmissions

“…This wireless system correlates well with a Swan-Ganz catheter and echocardiographic PA pressure measurements. 19 Elevations in PA pressures can occur days or sometimes weeks before the onset of clinical HF symptoms. 20 This system provides the opportunity for timely intervention to mitigate an acute HF decompensation and hospital admission.…”