Abstract 3278: Noninvasive Home Monitoring of Pulmonary Artery Pressure by the RemonCHF Device: First Multicenter Experience
Objectives: A reliable method for home monitoring of the pulmonary artery (PA) pressure might be useful to improve the management of patients with CHF. We describe the feasibility, safety and clinical utility of CHF monitoring using acoustic wireless communication with a miniature implant in the PA.
Methods: Thirty-eight patients with NYHA class III-IV CHF (age 62.2±2.5 years) were included in a multicenter study. The device was implanted in the right PA using right heart catheterization in 33 suitable patients (due to instability of the implant it was retrieved after implantation in 2 patients). Ultrasonic energy was used for wireless communication and a complete PA pressure curve was recorded daily by patients using a simple, hand-held, home-unit. Home-unit for self monitoring was supplied to 25 patients. Seven patients underwent right heart catheterization at 6 months to assess long term accuracy of pressure measurement.
Results: There were no major adverse events related to the implant / implantation procedure (follow-up duration 173±54 days). A total of 3094 home measurement were successfully performed by patients (mean±SD, 124±98). Compliance with daily monitoring was 93±16%. Pressure tracings at 6 months were almost identical to those obtained by Millar catheter (mean difference ± SD, 0.4±3.3mmHg). Variations of PA diastolic pressure were observed in relation to posture (sitting 5.5±4.0 mmHg lower than supine, p<0.001), time of the day and medication schedule. Time trends of PA diastolic pressure documented improved hemodynamics following cardiac resynchronization therapy, detected pressure increase earlier than weight gain, and were helpful to adjust medical therapy. Two admissions for CHF decompensation were associated with a transient increase in PA pressure.
Conclusions: Home monitoring of PA pressure using wireless acoustic communication with a miniature implant in the PA is feasible and safe. Patient’s compliance with self monitoring is very good, and reliable accurate data is easily obtained. Data demonstrated the physiological response to therapeutic interventions (medical and device). Daily monitoring might thus be helpful to optimize therapy of CHF, to improve quality of life and to prevent decompensations.