305 - Heart Failure and All Cause Hospitalization Prior to and Following Implantation of the CardioMEMS Heart Failure System

Abstract

Introduction: Over the past 25 years, the annual number of hospitalizations has increased from 800,000 to over 1 million for heart failure (HF) as a primary diagnosis. According to the Medicare Payment Advisory Commission, the estimated annual cost of unplanned readmissions for HF is $17.4 billion. A much debated and heavily looked at field is prevention of HF readmissions. The CHAMPION trial suggests that a wireless pulmonary hemodynamic monitoring device (CardioMEMS) can reduce the number of hospitalizations for patients with New York Heart Association (NYHA) class III heart failure. Hypothesis: Implantation of the CardioMEMS device in the appropriate patient population can reduce the number of hospitalizations secondary to heart failure. In addition, a reduction in the number of hospital admissions will lead to a reduction in days spent in the hospital. Methods: All 17 patients with an implanted CardioMEMS device at Lankenau Medical Center, a large community hospital, underwent retrospective chart review of one year pre and one year post implantation. The population included 8 males and 9 females. The average age was 77 years (range 53–92). All admissions, primary diagnosis, length of stay, and total days spent in hospital were recorded. Comparisons were analyzed on an individual and group basis using two tail t-tests. Results: CardioMEMS devices were implanted in patients with NYHA class III HF, irrespective of left ventricular ejection fraction, a previous admission within one year for HF and were diuretic responsive. The patients implanted were followed exclusively by the Lankenau Cardiovascular Institute with hemodynamic pressure monitoring of the CardioMEMS device by the heart failure team. The 17 patient cohort had an average of 2.23 (standard deviation 1.79) and 0.41 (standard deviation 0.77) admissions per year due to heart failure pre and post-implantation respectively (P < .00005). Average days in the hospital due to heart failure the year prior to implantation was 12.94 (standard deviation 10.1) compared to 2.17 (standard deviation 4.6) one year post implantation (P < .0006). When comparing non-heart failure related length of stay pre and post implantation averages of 6.05 versus 12.2 days per year (P = .3) were observed. Conclusion: There is a significant decrease in the number of HF admissions post implantation using the CardioMEMS device. In addition, the total days spent in the hospital due to HF was significantly reduced. Non-heart failure related length of stay showed no significant difference with implantation of the device.