Invasive Devices and Sensors for Remote Care of Heart Failure Patients

Radhoe, Sumant P; Veenis, Jesse F.; Brugts, Jasper J.

doi:10.3390/s21062014

Cited by 29 publications

(23 citation statements)

References 46 publications

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“…Radhoe et al . 30 conducted a review of invasive remote haemodynamic sensors that monitor haemodynamic changes in HF patients and showed that CardioMEMS was the most effective device.…”

Section: Discussionmentioning

confidence: 99%

“…Although CardioMEMS 9 was recently approved for guided treatment in HF patients and has been shown to be effective in reducing readmissions in HF patients 9 as well as a cost-effective monitoring method, 9,28,29 we did not include this in our review as CardioMEMS is an invasive technique, not broadly applicable to the majority of frail, elderly patients. Radhoe et al 30 conducted a review of invasive remote haemodynamic sensors that monitor haemodynamic changes in HF patients and showed that CardioMEMS was the most effective device.…”

Section: Interventionsmentioning

confidence: 99%

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Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

et al. 2021

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Aims Fluid congestion is a leading cause of hospital admission, readmission, and mortality in heart failure (HF). We performed a systematic review and meta-analysis to determine the effectiveness of an advanced fluid management programme (AFMP). The AFMP was defined as an intervention providing tailored diuretic therapy guided by intravascular volume assessment, in hospitalized patients or after discharge. The AFMP group was compared with patients who received standard care treatment. The aim of this systematic review and meta-analysis was to determine the effectiveness of an AFMP in improving patient outcomes. Methods and results A systematic review of randomized controlled trials, case-control studies, and crossover studies using the terms 'heart failure', 'fluid management', and 'readmission' was conducted in PubMed, CINAHL, and Scopus up until November 2020. Studies reporting the association of an AFMP on readmission and/or mortality were included in our metaanalyses. Risk of bias was assessed in non-randomized studies using the Newcastle-Ottawa Scale. From 232 retrieved studies, 12 were included in the data synthesis. The 6040 patients in the included studies had a mean age of 72 ± 4 years and mean left ventricular ejection fraction of 39 ± 8%, there were slightly more men (n = 3022) than women, and the follow-up period was a mean of 4.8 ± 3.1 months. Readmission data were available in 5362 patients; of these, 1629 were readmitted. Mortality data were available in 5787 patients; of these, 584 died. HF patients who had an AFMP in hospital and/or after discharge had lower odds of all-cause readmission (odds ratio-OR 0.64 [95% confidence interval-CI 0.44, 0.92], P = 0.02) with moderate heterogeneity (I 2 = 46.5) and lower odds of all-cause mortality (OR 0.82 [95% CI 0.69, 0.98], P = 0.03) with low heterogeneity (I 2 = 0). The use of an AFMP was equally effective in reducing readmission and mortality regardless of age and follow-up duration. Effective pre-discharge diuresis was associated with significantly lower readmission odds (OR 0.43 [95% CI 0.26, 0.71], P = 0.001) compared with a fluid management plan as part of post-discharge follow-up. Conclusions An effective AFMP is associated with improving readmission and mortality in HF. Our results encourage attainment of optimal volume status at discharge and prescription of optimal diuretic dose. Ongoing support to maintain euvolaemia and effective collaboration between healthcare teams, along with effective patient education and engagement, may help to reduce adverse outcomes in HF patients.

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“…Radhoe et al . 30 conducted a review of invasive remote haemodynamic sensors that monitor haemodynamic changes in HF patients and showed that CardioMEMS was the most effective device.…”

Section: Discussionmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

et al. 2021

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“…Many non-COVID patients may benefit from remote monitoring and management as well, in particular cancer patients treated by chemotherapy, patients discharged from hospital after a major surgery, and patients with chronic disease at high risk of hospital re-admission. In patients with congestive heart failure, the remote monitoring of pulmonary artery pressure with an implantable micro-electromechanical system (aka MEMS) has been shown to be useful to adjust therapy and prevent hospital readmissions [ 12 ]. Whether similar benefits could be reported with non-invasive bioimpedance necklaces able to detect early changes in thoracic fluid content remains to be determined [ 13 ].…”

Section: Home Monitoringmentioning

confidence: 99%

One small wearable, one giant leap for patient safety?

Michard¹,

Thiele²,

Guen³

2021

J Clin Monit Comput

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“…Finally, we can still remember the great importance of ways of remote monitoring of patients, especially at times like the one we faced during the Covid-19 pandemic. (3)…”

Section: Comment On: Safety and Feasibility Of Hemodynamic Pulmonary Artery Pressure Monitoring Using The Cardiomems Device In Lvad Managmentioning

confidence: 99%

Comment on: Safety and feasibility of hemodynamic pulmonary artery pressure monitoring using the CardioMEMS device in LVAD management

Breda

2021

Preprint

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The called burden of cardiac heart failure (CHF) on healthcare systems and economies remains large and a major factor contributing to this burden is the high hospital admission rate for acute decompensated heart failure. These repeated heart failure hospitalizations (HFH) not only exert a high burden on healthcare systems, but also impact patient quality of life and have been associated with impaired prognosis and reduced life expectancy. The need for remote monitoring has become extremely important, mainly based on devices capable of measuring intracardiac filling pressures. If we assume that hemodynamic congestion precedes clinical congestion, the hemodynamic monitoring could be able to detect early signs of congestion and enables clinicians to intervene in a pre-symptomatic phase avoiding hospital admission. Dr. Veenis JF and colleagues present the results of implanting the CardioMEMS device in 10 patients who underwent heartmate 3 implantation. The authors describe the study design based on an earlier publication by the same author. The authors argue that the use of this device will allow the monitoring of patients pre, during hospitalization and after implantation, with a possible reduction in the number of readmissions for allowing the diagnosis and treatment of complications related to ventricular failure and volume overload.

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Invasive Devices and Sensors for Remote Care of Heart Failure Patients

Cited by 29 publications

References 46 publications

Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

Use of novel non‐invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta‐analysis

One small wearable, one giant leap for patient safety?

Comment on: Safety and feasibility of hemodynamic pulmonary artery pressure monitoring using the CardioMEMS device in LVAD management

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