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World J Cardiol. Jan 26, 2017; 9(1): 21-26
Published online Jan 26, 2017. doi: 10.4330/wjc.v9.i1.21
Ambulatory pulmonary artery pressure monitoring in advanced heart failure patients
Srikanth Yandrapalli, Anoshia Raza, Sohaib Tariq, Wilbert S Aronow
Srikanth Yandrapalli, Anoshia Raza, Sohaib Tariq, Wilbert S Aronow, Department of Cardiology, New York Medical College at Westchester Medical Center, Valhalla, NY 10595, United States
Author contributions: Yandrapalli S, Raza A, Tariq S and Aronow W identified the current topic, collected relevant literature, and wrote the paper.
Institutional review board statement: Exempt.
Informed consent statement: Not needed due to the non-clinical study design.
Conflict-of-interest statement: None of the authors report any conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wilbert S Aronow, MD, FACC, FAHA, Professor of Medicine, Department of Cardiology, New York Medical College at Westchester Medical Center, Macy Pavilion, Room 141, Valhalla, NY 10595, United States. wsaronow@aol.com
Telephone: +1-914-4935311 Fax: +1-914-2356274
Received: July 7, 2016
Peer-review started: July 14, 2016
First decision: September 12, 2016
Revised: September 18, 2016
Accepted: November 16, 2016
Article in press: November 17, 2016
Published online: January 26, 2017
Processing time: 195 Days and 21.2 Hours
Abstract

Heart failure (HF) is an emerging epidemic associate with significant morbidity, mortality, and health care expenditure. Although there were major advances in pharmacologic and device based therapies for the management of HF, mortality of this condition remains high. Accurate monitoring of HF patients for exacerbations is very important to reduce recurrent hospitalizations and its associated complications. With the failure of clinical signs, tele-monitoring, and laboratory bio-markers to function as early markers of HF exacerbations, more sophisticated techniques were sought to accurately predict the circulatory status in HF patients in order to execute timely pharmacological intervention to reduce frequent hospitalizations. CardioMEMSTM (St. Jude Medical, Inc., Saint Paul, Minnesota) is an implantable, wireless pulmonary arterial pressure (PAP) monitoring system which transmits the patient’s continuous PAPs to the treating health care provider in the ambulatory setting. PAP-guided medical therapy modification has been shown to significantly reduce HF-related hospitalization and overall mortality. In advanced stages of HF, wireless access to hemodynamic information correlated with earlier left ventricular assist device implantation and shorter time to heart transplantation.

Keywords: CardioMEMS; Heart failure; Remote heart failure monitoring; Pulmonary arterial pressure monitoring; Left ventricular assist device

Core tip: Traditional heart failure monitoring methods have failed to accurately and timely identify worsening heart failure. Remote pulmonary artery pressure monitoring via CardioMEMSTM heart failure system identified heart failure exacerbations earlier and more accurately than clinical signs, and timely medical interventions resulted in reduced hospitalizations and mortality. Remote pulmonary artery pressure monitoring appears to have positive clinical implications in patients with mechanical circulatory support.