Remote Left Ventricular Hemodynamic Monitoring Using a Novel Intracardiac Sensor

Abstract

Our miniaturized wireless pressure sensor placed in the LV (LV-microelectromechanical system) has the potential to become a new telemetric tool to earlier identify patients at risk for HF decompensation and to guide the treatment of patients with HF.

Design and Simulation of an Integrated Wireless Capacitive Sensors Array for Measuring Ventricular Pressure

“…Therefore, if a reliable ventricular pressure sensor can be fabricated and implanted, new diagnostic and therapeutic possibilities could be open, because the LV is the chamber of the heart responsible for pumping the oxygenated blood to the circulatory system [2,29]. As a result, the continuous monitoring of left ventricular pressure, could allow the control of diseases such as: heart failure, hypertrophy in the LV and hypertension; additionally, this will allow the control of secondary diseases such as strokes, renal failure, myocardial infarctions, disease in the coronary artery and aortic aneurysms, placing the sensor permanently in the aneurysmal sac [8,17,19,20,21,30,31,32,33,34,35,36,37,38,39,40,41,42,43]. Figure 1 shows a geometrical approach for the left ventricle, this section is proposed for the sensor implantation, with an inner available area of 2 × 2 cm 2 [44].…”

Lv-Mems

“…In this issue of Circulation: Cardiovascular Interventions , Mondritzki et al 4 report the potential use of MEMS pressure sensor in the left ventricle (LV) for monitoring heart failure. They implanted their newly developed LV-MEMS, a lead-less, battery-less device with a size of 13.9 mm × 1.6 mm, in the LV apex of beagle dogs and induced heart failure by well-established rapid pacing method 5 .…”

“…Specifically, whether the contractility and relaxation parameters derived from LV pressure sensors can provide incremental information that leads to prevention of HF admission and death remains uncertain. In the study of Mondritzki et al 4 , even though significant changes in LV contractility and relaxation parameters were demonstrated, the animal model used was a rapidly progressing heart failure model, which is clearly different from chronic stable heart failure patients who often decompensate from hypervolemia. Additionally, although gradual increases in LV end-diastolic pressure and Tau during the heart failure development were successfully captured with the LV- MEMS, LV +dP/dt and −dP/dt showed rapid initial decrease as the pacing was initiated and remained similar during the course of disease development.…”

“…As the authors indicated in the article 4 , the benefit-risk-ratio also needs careful consideration. Given that CardioMEMS is already approved for its use in the clinic, LV-MEMS needs to show at least non-inferiority against the CardioMEMS to be used in the chronic heart failure management.…”

“…In addition, implantation of LV-MEMS can also have higher risks. In the manuscript by Mondritzki et al 4 , a 6Fr inner diameter guiding sheath was used to implant the LV-MEMS from the carotid artery, which is a relatively straight access to the apex. To implant the device through brachial or femoral access in patients, larger diameter guide catheter is likely required to manipulate the device position and implant the device accurately.…”