Key result
Implantable hemodynamic monitoring and PA pressure-guided management reduce HF hospitalizations.
Why the study?
Rates of heart failure hospitalization remain unacceptably high, and randomized controlled trials of noninvasive telemedical systems have failed to demonstrate reduced hospitalization rates.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“CardioMEMS represents a promising tool and should be considered a cornerstone in the continuous monitoring of patients with HF and those assisted with an LVAD.”
“This is the first real suggestion that managing patients by monitoring pulmonary artery pressures improves mortality in heart failure with reduced ejection fraction. It does appear that it takes longer than a year to begin to see mortality differences.”
“The real-world benefits of IHMs will likely improve with increasing experience as individual sites become more familiar with the technology and progressively refine algorithms that better align with specific patient populations, team members, and practice workflow.”
Supports implantable hemodynamic monitoring in heart failure care; extends randomized evidence for outcome-guided management.
Rates of heart failure hospitalization remain unacceptably high. Such hospitalizations are associated with substantial patient, caregiver, and economic costs. Randomized controlled trials of noninvasive telemedical systems have failed to demonstrate reduced rates of hospitalization. The failure of these technologies may be due to the limitations of the signals measured. Intracardiac and pulmonary artery pressure-guided management has become a focus of hospitalization reduction in heart failure. Early studies using implantable hemodynamic monitors demonstrated the potential of pressure-based heart failure management, whereas subsequent studies confirmed the clinical utility of this approach. One large pivotal trial proved the safety and efficacy of pulmonary artery pressure-guided heart failure management, showing a marked reduction in heart failure hospitalizations in patients randomized to active pressure-guided management. "Next-generation" implantable hemodynamic monitors are in development, and novel approaches for the use of this data promise to expand the use of pressure-guided heart failure management.
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Abraham et al. (2017) conducted a review in Heart failure. Implantable hemodynamic monitoring was evaluated on Heart failure hospitalizations. Implantable hemodynamic monitoring and pulmonary artery pressure-guided management reduce heart failure hospitalizations.
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