CardioMEMS Sensor Detects Atrial Arrhythmias before Clinical Decompensation

Abstract

Background: The CardioMEMS sensor is approved for CHF management. Although a resting heart rate is recorded via the sensor at the time of pressure transmission, to our knowledge there are no published reports of this heart rate data leading to a change in patient management or outcomes. Methods: A retrospective chart analysis of 35 consecutive CardioMEMS implants since March 2015 was performed, identifying patients in whom heart rhythm issues were noted. Results: Of our 35 implanted patients with the CardioMEMS sensor, three patients have demonstrated elevated heart rates or irregular waveforms. When a patient's waveform was irregular, patients were brought into our office for EKGs to confirm their arrhythmia. Patient #1 is a 51 year old male with a severe ICM s/p LVAD (sensor was implanted pre-LVAD), noted to have persistently elevated PADs on routine monitoring and heart rates elevated on CardioMEMS readings. An EKG revealed rapid atrial flutter. The patient went on to atrial flutter ablation with a subsequent downtrend in the PAD by about 5-10 mmHg. Patient #2 was noted to have irregular PA pressure waveforms and occasional heart rates greater than 100 bpm during routine home CardioMEMS readings, found to have controlled atrial fibrillation and flutter by EKG. The patient underwent an atrial flutter ablation, cardioversion of atrial fibrillation, and antiarrhythmic load. Patient #3 was noted to have asymptomatic elevated heart rates and irregular PA waveforms on CardioMEMS readings only two weeks post sensor implantation. Sinus rhythm was restored, resulting in reduction in his PA pressures. Pressures in atrial fibrillation were 56/26 mmHg (systolic/diastolic), now 34/8 mmHg in sinus rhythm. Conclusion: Detection of atrial arrhythmias via the CardioMEMS sensor lead to intervention and a trend towards improved PA pressures in sinus rhythm.