Abstract
Heart failure (HF) is one of the leading causes of morbidity and mortality and has a large effect on the country’s economy. Although there have been major advances in HF monitoring, including more advanced pharmacological management and device-based therapy, HF-related mortality remains high. It is important to monitor HF so that HF-related hospitalization and mortality can be prevented. Due to the lower sensitivity of clinical features and biochemical markers, as well as the failure of telemonitoring in early detection of HF, more advanced techniques have been sought to more accurately predict impending HF, in order to address timely pharmacological management and prevent heart failure hospitalization (HFH). Device-based therapy has passed through various stages and culminated in the recently introduced CardioMEMSTM (St. Jude Medical, Inc., Saint Paul, Minnesota). CardioMEMSTM is a wireless pulmonary artery pressure (PAP) monitoring device, which continuously monitors PAP and transmits data to a healthcare provider. It rapidly identifies changes in intracardiac pressure and allows timely pharmacological management. CardioMEMSTM showed a higher reduction of HFH compared to any other devices.
Highlights
Heart failure (HF) is a clinical syndrome characterized by the inability of the heart to meet the metabolic demand of the body either by left ventricular dysfunction or right ventricular (RV) dysfunction
The Reducing Decompensation Events Utilizing Intracardiac Pressures in Patients with Chronic Heart Failure (REDUCE HF trial) combines both devices, implantable hemodynamic monitoring device (IHM) and implantable cardioverter defibrillator to check for RV pressure guided medical therapy [31]
There was a 45% reduction of heart failure hospitalization (HFH) observed in this study compared to 28% in
Summary
Heart failure (HF) is a clinical syndrome characterized by the inability of the heart to meet the metabolic demand of the body either by left ventricular dysfunction or right ventricular (RV) dysfunction. The Reducing Decompensation Events Utilizing Intracardiac Pressures in Patients with Chronic Heart Failure (REDUCE HF trial) combines both devices, implantable hemodynamic monitoring device (IHM) and implantable cardioverter defibrillator to check for RV pressure guided medical therapy [31]. This device did not show any satisfactory result on reducing HFH. This discussion continued and in 2010, Hemodynamically Guided Home Self-Therapy in Severe Heart Failure Patients (HOMEOSTASIS) trial demonstrated a reduction of HFH and mortality when treatment was guided on LAP [33] In this trial, they used implantable Heart POD (St. Jude Medical Inc, Minneapolis, Minnesota). The data obtained from treatment group revealed more frequent medication adjustment than the control group
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