Remote haemodynamic monitoring of heart failure

Despite improvements in therapy, hospitalisations for heart failure have risen over the past three decades.  More recently, implantable systems for monitoring of intracardiac and pulmonary artery pressures have been developed.

In the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial, patients were implanted with a wireless haemodynamic monitoring system, or were assigned to a control group, for at least six months.  The primary endpoint was the rate of heart-failure-related hospitalisations at six months, however two safety endpoints were also designated: freedom from device-related complications and freedom from pressure-sensor failures.

The treatment group consisted of 270 patients and in 6 months 83 heart-failure-related hospitalisations were noted, compared to 120 in the control group consisting of 280 patients (p<0.0001).  This later translated into a 39% reduction in heart-failure-related hospitalisations in the treatment group when compared to the control group over a mean of 15 months follow-up in the study (p<0.0001, figure).  There were no pressure-sensor failures, but eight patients had device- or system-related compliactions.

Conclusions:

This study demonstrates a reduction in hospitalisations in patients with NYHA III heart failure who were fitted with a wireless implantable haemodynamic monitoring system, suggesting that these devices can provide additional information that can be used to improve heart failure management.

  • Abraham WT, Adamson PB, Bourge RC et al.  Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial.  Lancet 2011; 377:658-66.

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