Abstract 1820: First Clinical Experience with the Chronicle® Implantable Hemodynamic Monitor in Patients on the Heart Transplant Waiting List
Background: The vast majority of heart transplants is currently performed in patients who need intensive care for hemodynamic compromise. Consequently waiting time on the elective list has increased. Close monitoring of patients waiting at home now becomes a pivotal task in order to identify those who deteriorate.
Methods Since October 2005 we implanted a Chronicle® implantable hemodynamic monitor in 10 patients waiting for a heart transplant (all male, 54.7±7.8 years, NYHA 3.3 ± 0.3, LVEF 20.3±7.7%). The device is implanted like a pacemaker and includes a pressure sensor lead which is positioned in the right ventricular outflow tract. This allows the continuous measurement of intracardiac pressure, heart rate and activity. The data are transmitted weekly by the patient with a remote monitor device to a central computer which delivers the data to the clinician via internet.
Results There were no perioperative complications. Weekly transmissions by the patients could be performed in all cases. Medication was adjusted according to a pressure increase in 3 patients. During follow-up (maximum 7 months) one patient showed two episodes of cardiac decompensation and one episode of ventricular tachycardia with a critical decrease of ventricular pressures. He was consequently admitted to the hospital for intensive care and accepted for high urgent listing.
Conclusion The Chronicle® is easy to implant and allows a remote but close invasive monitoring of patients on the heart transplant waiting list. It appears to be an ideal tool to identify patients who are at risk of acute hemodynamic decompensation.