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Ryan Davey, Amresh Raina
Hemodynamic monitoring has long formed the cornerstone of heart failure (HF) and pulmonary hypertension diagnosis and management. We review the long history of invasive hemodynamic monitors initially using pulmonary artery (PA) pressure catheters in the hospital setting, to evaluating the utility of a number of implantable devices that can allow for ambulatory determination of intracardiac pressures. Although the use of indwelling PA catheters has fallen out of favor in a number of settings, implantable devices have afforded clinicians an opportunity for objective determination of a patient's volume status and pulmonary pressures...
September 24, 2016: World Journal of Transplantation
Melissa Martinson, Rupinder Bharmi, Nirav Dalal, William T Abraham, Philip B Adamson
AIMS: Haemodynamic-guided heart failure (HF) management effectively reduces decompensation events and need for hospitalizations. The economic benefit of clinical improvement requires further study. METHODS AND RESULTS: An estimate of the cost-effectiveness of haemodynamic-guided HF management was made based on observations published in the randomized, prospective single-blinded CHAMPION trial. A comprehensive analysis was performed including healthcare utilization event rates, survival, and quality of life demonstrated in the randomized portion of the trial (18 months)...
September 19, 2016: European Journal of Heart Failure
Daniel A Ollendorf, Alexander T Sandhu, Steven D Pearson
No abstract text is available yet for this article.
October 1, 2016: JAMA Internal Medicine
Jennifer T Wang, William H Frishman
Heart failure (HF) affects over 5.8 million patients in the United States, and can be very costly due to the number of hospitalizations and re-hospitalizations during the final years of life. Due to the large number of hospitalizations for HF exacerbations, effective methods for preventing these occurrences are necessary. Improvements in the outpatient treatment of HF, aided by non-invasive and invasive home monitoring methods, can reduce the number of hospitalizations. Pulmonary pressure monitoring through the CardioMEMS system provides one method of hemodynamic assessment of patients...
July 25, 2016: Cardiology in Review
David Shavelle, Rita Jermyn
The CardioMEMS heart failure system is a recent Food and Drug Administration approved device that can be implanted in patients with New York Heart Association class III heart failure and allows remote monitoring of pulmonary artery pressures. There is limited published information regarding the implantation procedure. Successful use of the CardioMEMS heart failure system requires an understanding of the technical issues surrounding the implantation procedure. The goal of the present review is to provide a summary of the implantation procedure, discuss the required imaging steps, review procedural supplies, and present a series of case studies to illustrate clinically relevant issues that may arise during sensor implantation...
July 2016: Journal of Invasive Cardiology
Philip B Adamson, William T Abraham, Lynne Warner Stevenson, Akshay S Desai, JoAnn Lindenfeld, Robert C Bourge, Jordan Bauman
BACKGROUND: This study examines the impact of pulmonary artery pressure-guided heart failure (HF) care on 30-day readmissions in Medicare-eligible patients. METHODS AND RESULTS: The CardioMicroelectromechanical system (CardioMEMS) Heart Sensor Allows Monitoring of Pressures to Improve Outcomes in New York Heart Association Class III Heart Failure Patients (CHAMPION) Trial included 550 patients implanted with a permanent MEMS-based pressure sensor in the pulmonary artery...
June 2016: Circulation. Heart Failure
Emilio Vanoli, Emilia D'Elia, Maria T La Rovere, Edoardo Gronda
Heart failure is a pandemic condition that is challenging cardiology today. The primary economical and social burden of this syndrome is hospitalization rate whose costs represent the highest ones within the entire healthcare management. Remote monitoring of physiological data, obtained through self-reporting via telephone calls or, automatically, using external devices is a potential novel approach to implement management of patients with heart failure and reduce hospitalization rates. Relatively large but, sometimes, contradicting information exists about the efficacy of remote monitoring via different noninvasive approaches to reduce the economical and social burden of heart failure management...
July 2016: Journal of Cardiovascular Medicine
Maria R Costanzo, Lynne W Stevenson, Philip B Adamson, Akshay S Desai, J Thomas Heywood, Robert C Bourge, Jordan Bauman, William T Abraham
OBJECTIVES: This study sought to analyze medical therapy data from the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in Class III Heart Failure) trial to determine which interventions were linked to decreases in heart failure (HF) hospitalizations during ambulatory pulmonary artery (PA) pressure-guided management. BACKGROUND: Elevated cardiac filling pressures, which increase the risk of hospitalizations and mortality, can be detected using an ambulatory PA pressure monitoring system before onset of symptomatic congestion allowing earlier intervention to prevent HF hospitalizations...
May 2016: JACC. Heart Failure
Alexander T Sandhu, Jeremy D Goldhaber-Fiebert, Douglas K Owens, Mintu P Turakhia, Daniel W Kaiser, Paul A Heidenreich
OBJECTIVES: This study aimed to evaluate the cost-effectiveness of the CardioMEMS (CardioMEMS Heart Failure System, St Jude Medical Inc, Atlanta, Georgia) device in patients with chronic heart failure. BACKGROUND: The CardioMEMS device, an implantable pulmonary artery pressure monitor, was shown to reduce hospitalizations for heart failure and improve quality of life in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial...
May 2016: JACC. Heart Failure
William T Abraham
Heart failure represents a major public health concern, associated with high rates of morbidity and mortality. A particular focus of contemporary heart failure management is reduction of hospital admission and readmission rates. While optimal medical therapy favourably impacts the natural history of the disease, devices such as cardiac resynchronization therapy devices and implantable cardioverter defibrillators have added incremental value in improving heart failure outcomes. These devices also enable remote patient monitoring via device-based diagnostics...
June 2013: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Joshua P Loh, Israel M Barbash, Ron Waksman
The CardioMEMS Champion Heart Failure Monitoring System (CardioMEMS, Atlanta, Georgia) is a permanently implantable pressure measurement system designed to wirelessly measure and monitor pulmonary artery (PA) pressure and heart rate in heart failure (HF) patients to guide ambulatory HF management and to reduce HF hospital stays. On December 8, 2011, the Food and Drug Administration (FDA) Circulatory System Device Panel reviewed the CardioMEMS Champion HF Monitoring System premarket approval (PMA) application...
April 16, 2013: Journal of the American College of Cardiology
Ian Crozier, Warren Smith
Implantable cardiac devices for arrhythmias and related conditions are a rapidly evolving field, with a constant stream of technologies being developed. There are a number of novel devices, other than conventional pacemakers and implantable defibrillators, currently being developed that have the potential to greatly improve patient outcomes. This paper reviews the important recent technologies, the subcutaneous defibrillator, cardiac contraction modulation, the HeartPOD and CardioMEMS heart failure monitors, left atrial appendage closure devices and leadless cardiac pacing...
June 2012: Heart, Lung & Circulation
William T Abraham, Philip B Adamson, Robert C Bourge, Mark F Aaron, Maria Rosa Costanzo, Lynne W Stevenson, Warren Strickland, Suresh Neelagaru, Nirav Raval, Steven Krueger, Stanislav Weiner, David Shavelle, Bradley Jeffries, Jay S Yadav
BACKGROUND: Results of previous studies support the hypothesis that implantable haemodynamic monitoring systems might reduce rates of hospitalisation in patients with heart failure. We undertook a single-blind trial to assess this approach. METHODS: Patients with New York Heart Association (NYHA) class III heart failure, irrespective of the left ventricular ejection fraction, and a previous hospital admission for heart failure were enrolled in 64 centres in the USA...
February 19, 2011: Lancet
Cyrus J Parsa, Judson B Williams, Syamal D Bhattacharya, Walter G Wolfe, Mani A Daneshmand, Richard L McCann, G Chad Hughes
OBJECTIVE: Thoracic endovascular aortic repair for chronic type B aortic dissection with associated descending thoracic aneurysm remains controversial. Concerns include potential ischemic complications due to branch vessel origin from the chronic false lumen and continued retrograde false lumen/aneurysm sac pressurization via fenestrations distal to implanted endografts. The present study examines midterm results with thoracic endovascular aortic repair for chronic (>2 weeks) type B aortic dissection with associated aneurysm to better understand the potential role of thoracic endovascular aortic repair for this condition...
February 2011: Journal of Thoracic and Cardiovascular Surgery
Philip B Adamson, William T Abraham, Mark Aaron, Juan M Aranda, Robert C Bourge, Andrew Smith, Lynne W Stevenson, Jordan G Bauman, Jay S Yadav
BACKGROUND: Decompensated heart failure (HF) is associated with unacceptable morbidity and mortality risks. Recent implantable technology advancements allow frequent filling pressure monitoring and provide insight into HF pathophysiology and a new tool for HF management. METHODS: The CHAMPION trial is a prospective, multicenter, randomized, single-blind clinical trial testing the hypothesis that HF management guided by frequently assessed pulmonary artery pressures is superior to traditional methods...
January 2011: Journal of Cardiac Failure
Cyrus J Parsa, Mani A Daneshmand, Brian Lima, Keki Balsara, Richard L McCann, G Chad Hughes
BACKGROUND: The goal of thoracic endovascular aneurysm repair (TEVAR) is to exclude and depressurize the aneurysm sac. Type I and III endovascular leaks (EL) transmit systemic pressure and represent treatment failures. The significance of type II EL is more controversial. Remote pressure sensing is a novel nonradiographic technology for EL detection and monitoring. However, little experience exists with regard to use in the thoracic aorta. We present our experience with the EndoSure wireless pressure measurement system (CardioMEMS, Atlanta, GA) for monitoring aneurysm sac pulse pressure (ASP) after TEVAR...
February 2010: Annals of Thoracic Surgery
Yuji Kanaoka, Takao Ohki, Joe Huang, Amit Shah
OBJECTIVES: Low intra-aneurysm sac pressure has been shown to correlate with sac shrinkage following endovascular aneurysm repair (EVAR) whereas high pressure results in sac enlargement. The Resilient AneuRx (RSA) has higher density Dacron compared with the standard AneuRx (STA) and was developed in an attempt to reduce type 4 and 5 endoleaks, thereby more effectively reducing sac pressure. The purpose of this study is to compare the ability of RSA and STA in reducing sac pressure in a chronic canine aneurysm model...
April 2009: Journal of Vascular Surgery
Hugo E Verdejo, Pablo F Castro, Roberto Concepción, Marcela A Ferrada, Mario A Alfaro, Milton E Alcaíno, Carlos C Deck, Robert C Bourge
OBJECTIVES: The goal of this work was to evaluate the accuracy of a new heart failure (HF) sensor (HFS) (Heart Failure Sensor, CardioMEMS Inc., Atlanta, Georgia) pulmonary artery pressure (PAP) monitoring compared with Swan-Ganz (SG) (Hospira, Inc., Lake Forest, Illinois) catheterization and echocardiography (ECHO) in ambulatory HF patients. BACKGROUND: There is an increasing interest in the development of ambulatory monitoring devices aiming to adjust therapy and prevent hospitalizations in HF patients...
December 18, 2007: Journal of the American College of Cardiology
Takao Ohki, Kenneth Ouriel, Pierre Galvagni Silveira, Barry Katzen, Rodney White, Frank Criado, Edward Diethrich
OBJECTIVE: Complete exclusion and depressurization of the aneurysm sac is the prime goal of endovascular repair (EVAR) of abdominal aortic aneurysms. Thus, any EVAR that results in a type I or III endoleak has been classified as a technical failure. The current method to detect endoleaks uses intraoperative aortography. However, aortography is limited by its subjective nature, inability to quantify the significance of the endoleak, and artifacts such as bowel gas that may mimic an endoleak...
February 2007: Journal of Vascular Surgery
Rabih A Chaer, Susan Trocciola, Brian DeRubertis, Robert Hynecek, Qiang Xu, Russell Lam, K Craig Kent, Peter L Faries
BACKGROUND: The utility of intra-aneurysmal pressure determination is dependent on the ability to measure pressure in the presence of endoleak and thrombosis. In this study, the accuracy of a CardioMEMS wireless pressure sensor (CardioMEMS, Atlanta, Ga) transducer in the presence of thrombus associated with type II endoleak was measured. METHODS: Type II endoleaks were created in four mongrel dogs by implanting four collateral arterial side branches (lumbar and caudal mesenteric arteries) as a Carrel patch onto a 3-cm prosthetic polytetrafluoroethylene abdominal aortic aneurysm (AAA)...
December 2006: Journal of Vascular Surgery
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