CardioMEMS in a Busy Cardiology Practice: Less than Optimal Implementation of a Valuable Tool to Reduce Heart Failure Readmissions

Abstract

Introduction Congestive heart failure is a leading cause of cardiovascular morbidity and mortality that results in a significant financial burden on healthcare expenditure. Though various strategies have been employed to reduce hospital readmissions, one valuable tool that remains greatly underutilized is the CardioMEMS (Abbott), a remote pulmonary artery pressure-monitoring system, which has been shown to help reduce heart failure rehospitalizations in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial. Methods ICD-9/ICD-10 codes for chronic heart failure were used to identify patients who presented with congestive heart failure. Of this group, those eligible for CardioMEMS device placement, as based on the CHAMPION trial definition, were selected. Subsequently, a retrospective review of the electronic medical records was completed. All patients were on ACC/AHA guideline-directed medical therapy and had at least one hospital admission for NYHA class III symptoms. Results 473 patients met the inclusion criteria, of which, 85 patients were found to be eligible for implantation of CardioMEMS device based on the CHAMPION trial definition. Only 18/85 patients received the device, roughly 21%, and the overall CardioMEMS implantation rate was only 4% (18/473) of the total cohort. Conclusion Despite the benefits to patients and reducing healthcare expenditure, there has been a poor adaptation of this groundbreaking technology. Our study revealed that 79% of eligible heart failure patients did not receive the device. Therefore, efforts need to be undertaken to improve physician and patient education of the device to complement the current standard of care for congestive heart failure.

Patients’ Information Needs Related to a Monitoring Implant for Heart Failure: Co-designed Study Based on Affect Stories

“…Among its advantages, it allows trustworthy and automatic measurements. Compared with the CardioMEMS implant [43,44], this subcutaneous implant is less invasive, and once the gateway is installed, data transmission will not require any commitment (a priori) on the part of the patient. It is already known that adherence to self-care is an important issue in the field of chronic conditions [45], including heart failure [46][47][48].…”

Advanced remote care for heart failure in times of COVID-19 using an implantable pulmonary artery pressure sensor: the new normal

“…Singh et al . 23 showed, before the COVID-19 pandemic invaded us, that despite its well-established beneficial clinical outcomes in the management of HF patients, adoption of CardioMEMS was slow and among their patient population only 21% of patients eligible for the device received it.…”

Out-of-Hospital Care of Heart Failure Patients During and After COVID-19 Pandemic: Time for Telemedicine?

“…While invasive solutions such as cardioMEMS have already demonstrated to decrease HF patients' hospitalization ( 6 ), their utilization has been limited mainly due to invasiveness and related adverse events ( 7 ) or lack of penetrance among medical doctors ( 8 ). The spectrum of non-invasive telemedicine is, instead, broad, and the recent positive results achieved by Köhler et al ( 9 ) and confirmed by the meta-analysis of Zhu et al ( 10 ) are encouraging.…”