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Published on September 01, 2018

Wireless Device Remotely Monitors HF Patients, Reduces Hospitalizations

CardioMEMS device

CardioMEMS, a 15 mm wide by 2 mm deep sealed monitoring sensor,
is implanted in the pulmonary artery during a right heart catheterization.

Patients with heart failure tend to be difficult to treat. They often have multiple comorbidities, such as chronic obstructive pulmonary disease, diabetes, hypertension, kidney disease, obesity and sleep apnea, which often lead to hospitalization.

North Kansas City Hospital is the only hospital in the Northland using the CardioMEMS™ HF System, an implanted monitoring device for people with HF. The device has been shown to reduce hospital admissions and improve quality of life.

“The CardioMEMS pinpoints pressure levels in the pulmonary artery, so we get a direct heart pressure assessment, which allows us to more accurately treat our patients,” said David M. Hahn, MD, FACC, an interventional cardiologist with Meritas Health Cardiology.

Pressure Detection

cardioMems pillow

Each morning at home, patients recline on a special pillow and wirelessly
transmit their fluid retention and heart pressure readings to the North
Kansas City Hospital Heart Care Clinic.

CardioMEMS, a 15 mm wide by 2 mm deep sealed monitoring sensor, is implanted in the pulmonary artery during a right heart catheterization. Designed to last a lifetime, the sensor does not require a battery or leads. It is powered by radio frequency energy and anchored in the artery wall by two nickel titanium loops.

Patients recline on a companion home unit the size of a queen-size pillow to wirelessly transmit their fluid retention and heart pressure readings each morning.

The CardioMEMS HF System is indicated for patients with Class III heart failure who have been hospitalized for HF in the past 12 months, based on New York Heart Association Class guidelines. The device is contraindicated for patients who cannot take dual antiplatelets or anticoagulants for one month after implantation.

Dr. Hahn and Ann Palmer, FNP-BC, review the information on a secure website and contact patients if medication and treatment changes are needed. Automated alerts to the Heart Care Clinic are triggered if pressure readings fall outside prespecified ranges. NKCH also has CardioMEMS systems in the Catheterization Lab and the 6th floor Progressive Care Unit.

By measuring subtle PA pressure changes, the team can spot fluid volume increases seven to 10 days before a patient experiences the signs or symptoms. “We have a greater ability to preemptively intervene in HF by treating volume retention with medication changes before it becomes clinically apparent and without admitting patients to the hospital because their condition has worsened,” said Dr. Hahn, who is board certified in advanced HF and transplant cardiology, cardiovascular disease and interventional cardiology. (See article about U.S. News & World Report’s recognition of NKCH’s heart failure program.)

Clinical Trials

A May 2017 Journal of the American College of Cardiology Heart Failure article reported that more than 20% of patients with HF are readmitted within 30 days of hospitalization, and up to 50% return by within six months.

The 2010 CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressures to Improve Outcomes with New York Heart Association Class III Heart Failure Patient) Trial generated several retrospective studies.

  • In the “Wireless Pulmonary Artery Hemodynamic Monitoring in Chronic Heart Failure: Randomized Controlled Trial,” PA-pressure guided HF management reduced HF-related hospitalizations by 37% during the entire follow-up (mean 15 months). The study was published in The Lancet in February 21, 2011.
  • In “Pulmonary Artery Pressure-guided Heart Failure Management Reduces 30-day Readmissions,” researchers found that such HF management in Medicare-eligible patients led to a 49% reduction in total HF hospitalizations and a 58% reduction in all-cause 30-day readmissions. The findings were published in Circulation: Heart Failure in June 2016.

David M. Hahn, MD, FACC

David M Hahn, MDDr. Hahn received his medical degree from the Roy J. and Lucille Carver College of Medicine, Iowa City. After his residency at Vanderbilt University Hospital, Nashville, he was a fellow at the University of Iowa Hospitals and Clinics, Iowa City.