Skip to main content
Erschienen in: Journal of Cardiovascular Translational Research 4/2019

02.01.2019 | Original Article

A Novel Wireless Left Atrial Pressure Monitoring System for Patients with Heart Failure, First Ex-Vivo and Animal Experience

verfasst von: Leor Perl, Elina Soifer, Jozef Bartunek, Dedi Erdheim, Friedrich Köhler, William T. Abraham, David Meerkin

Erschienen in: Journal of Cardiovascular Translational Research | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

The V-LAP™ measures left atrial pressure (LAP) and enables bi-directional communications with an external unit, designed to monitor heart failure patients. We hereby describe the pre-clinical experience. Following an ex vivo phase, the system was implanted at the interatrial septum of 10 ovine subjects. LAP readouts were compared with pulmonary capillary wedge pressure (PCWP) at index procedure and 1, 2 and 3–6 months after the implantation, at rest and after volume loading. Histopathology assessment (n = 8) was performed up to 50 weeks post procedure. Procedural success was 100%. Measurements showed a mean difference of 0.19 ± 2.51 mmHg. During this period, correlation of V-LAP™ with PCWP was excellent (R2 = 0.95, for 119 total measurements). There were no major adverse events related to the V-LAP™ system. In an animal model, the implantation of the novel wireless left atrial pressure sensor V-LAP™ was feasible, safe, and showed good accuracy and precision.
Literatur
2.
Zurück zum Zitat Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., …, & American Heart Association Statistics Committee and Stroke Statistics Subcommittee. (2014). Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation, 129(3), e28–e292. https://doi.org/10.1161/01.cir.0000441139.02102.80. Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., …, & American Heart Association Statistics Committee and Stroke Statistics Subcommittee. (2014). Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation, 129(3), e28–e292. https://​doi.​org/​10.​1161/​01.​cir.​0000441139.​02102.​80.
3.
Zurück zum Zitat Kociol, R. D., Hammill, B. G., Fonarow, G. C., Klaskala, W., Mills, R. M., Hernandez, A. F., & Curtis, L. H. (2010). Generalizability and longitudinal outcomes of a national heart failure clinical registry: Comparison of Acute Decompensated Heart Failure National Registry (ADHERE) and non-ADHERE Medicare beneficiaries. American Heart Journal, 160(5), 885–892. https://doi.org/10.1016/j.ahj.2010.07.020.CrossRefPubMed Kociol, R. D., Hammill, B. G., Fonarow, G. C., Klaskala, W., Mills, R. M., Hernandez, A. F., & Curtis, L. H. (2010). Generalizability and longitudinal outcomes of a national heart failure clinical registry: Comparison of Acute Decompensated Heart Failure National Registry (ADHERE) and non-ADHERE Medicare beneficiaries. American Heart Journal, 160(5), 885–892. https://​doi.​org/​10.​1016/​j.​ahj.​2010.​07.​020.CrossRefPubMed
10.
Zurück zum Zitat Adamson, P. B. (2009). Pathophysiology of the transition from chronic compensated and acute decompensated heart failure: new insights from continuous monitoring devices. Current Heart Failure Reports, 6(4), 287–292.CrossRefPubMed Adamson, P. B. (2009). Pathophysiology of the transition from chronic compensated and acute decompensated heart failure: new insights from continuous monitoring devices. Current Heart Failure Reports, 6(4), 287–292.CrossRefPubMed
12.
Zurück zum Zitat Davenport, C., Cheng, E. Y. L., Kwok, Y. T. T., Lai, A. H. O., Wakabayashi, T., Hyde, C., & Connock, M. (2006). Assessing the diagnostic test accuracy of natriuretic peptides and ECG in the diagnosis of left ventricular systolic dysfunction: a systematic review and meta-analysis. The British Journal of General Practice, 56(522), 48–56.PubMedPubMedCentral Davenport, C., Cheng, E. Y. L., Kwok, Y. T. T., Lai, A. H. O., Wakabayashi, T., Hyde, C., & Connock, M. (2006). Assessing the diagnostic test accuracy of natriuretic peptides and ECG in the diagnosis of left ventricular systolic dysfunction: a systematic review and meta-analysis. The British Journal of General Practice, 56(522), 48–56.PubMedPubMedCentral
13.
Zurück zum Zitat Chaudhry, S. I., Mattera, J. A., Curtis, J. P., Spertus, J. A., Herrin, J., Lin, Z., …, & Krumholz, H. M. (2010). Telemonitoring in patients with heart failure. New England Journal of Medicine, 363(24), 2301–2309. https://doi.org/10.1056/NEJMoa1010029. Chaudhry, S. I., Mattera, J. A., Curtis, J. P., Spertus, J. A., Herrin, J., Lin, Z., …, & Krumholz, H. M. (2010). Telemonitoring in patients with heart failure. New England Journal of Medicine, 363(24), 2301–2309. https://​doi.​org/​10.​1056/​NEJMoa1010029.
14.
Zurück zum Zitat Koehler, F., Winkler, S., Schieber, M., Sechtem, U., Stangl, K., Bohm, M., …, & on behalf of the Telemedical Interventional Monitoring in Heart Failure Investigators. (2011). Impact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: the telemedical interventional monitoring in heart failure study. Circulation, 123(17), 1873–1880. https://doi.org/10.1161/CIRCULATIONAHA.111.018473. Koehler, F., Winkler, S., Schieber, M., Sechtem, U., Stangl, K., Bohm, M., …, & on behalf of the Telemedical Interventional Monitoring in Heart Failure Investigators. (2011). Impact of remote telemedical management on mortality and hospitalizations in ambulatory patients with chronic heart failure: the telemedical interventional monitoring in heart failure study. Circulation, 123(17), 1873–1880. https://​doi.​org/​10.​1161/​CIRCULATIONAHA.​111.​018473.
18.
Zurück zum Zitat Abraham, W. T., Stevenson, L. W., Bourge, R. C., Lindenfeld, J. A., Bauman, J. G., & Adamson, P. B. (2016). Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial. The Lancet, 387(10017), 453–461. https://doi.org/10.1016/S0140-6736(15)00723-0.CrossRef Abraham, W. T., Stevenson, L. W., Bourge, R. C., Lindenfeld, J. A., Bauman, J. G., & Adamson, P. B. (2016). Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial. The Lancet, 387(10017), 453–461. https://​doi.​org/​10.​1016/​S0140-6736(15)00723-0.CrossRef
19.
Zurück zum Zitat Desai, A. S., Bhimaraj, A., Bharmi, R., Jermyn, R., Bhatt, K., Shavelle, D., …, & Heywood, J. T. (2017). Ambulatory hemodynamic monitoring reduces heart failure hospitalizations in “real-world” clinical practice. Journal of the American College of Cardiology, 69(19), 2357–2365. https://doi.org/10.1016/j.jacc.2017.03.009. Desai, A. S., Bhimaraj, A., Bharmi, R., Jermyn, R., Bhatt, K., Shavelle, D., …, & Heywood, J. T. (2017). Ambulatory hemodynamic monitoring reduces heart failure hospitalizations in “real-world” clinical practice. Journal of the American College of Cardiology, 69(19), 2357–2365. https://​doi.​org/​10.​1016/​j.​jacc.​2017.​03.​009.
22.
Zurück zum Zitat Troughton, R. W., Ritzema, J., Eigler, N. L., Melton, I. C., Krum, H., Adamson, P. B., …, & Abraham, W. T. (2011). Direct left atrial pressure monitoring in severe heart failure: long-term sensor performance. Journal of Cardiovascular Translational Research, 4(1), 3–13. https://doi.org/10.1007/s12265-010-9229-z. Troughton, R. W., Ritzema, J., Eigler, N. L., Melton, I. C., Krum, H., Adamson, P. B., …, & Abraham, W. T. (2011). Direct left atrial pressure monitoring in severe heart failure: long-term sensor performance. Journal of Cardiovascular Translational Research, 4(1), 3–13. https://​doi.​org/​10.​1007/​s12265-010-9229-z.
24.
26.
Zurück zum Zitat Klein, A. L., Stewart, W. J., Bartlett, J., Cohen, G. I., Kahan, F., Pearce, G., …, & Cosgrove, D. M. (1992). Effects of mitral regurgitation on pulmonary venous flow and left atrial pressure: an intraoperative transesophageal echocardiographic study. Journal of the American College of Cardiology, 20(6), 1345–1352. https://doi.org/10.1016/0735-1097(92)90247-K. Klein, A. L., Stewart, W. J., Bartlett, J., Cohen, G. I., Kahan, F., Pearce, G., …, & Cosgrove, D. M. (1992). Effects of mitral regurgitation on pulmonary venous flow and left atrial pressure: an intraoperative transesophageal echocardiographic study. Journal of the American College of Cardiology, 20(6), 1345–1352. https://​doi.​org/​10.​1016/​0735-1097(92)90247-K.
27.
Zurück zum Zitat Ritzema-Carter, J. L. T., Smyth, D., Troughton, R. W., Crozier, I. G., Melton, I. C., Richards, A. M., …, & Abraham, W. T. (2006). Dynamic myocardial ischemia caused by circumflex artery stenosis detected by a new implantable left atrial pressure monitoring device. Circulation, 113(15), e705–e706. https://doi.org/10.1161/CIRCULATIONAHA.105.572040. Ritzema-Carter, J. L. T., Smyth, D., Troughton, R. W., Crozier, I. G., Melton, I. C., Richards, A. M., …, & Abraham, W. T. (2006). Dynamic myocardial ischemia caused by circumflex artery stenosis detected by a new implantable left atrial pressure monitoring device. Circulation, 113(15), e705–e706. https://​doi.​org/​10.​1161/​CIRCULATIONAHA.​105.​572040.
29.
Zurück zum Zitat Maurer, M. S., Adamson, P. B., Costanzo, M. R., Eigler, N., Gilbert, J., Gold, M. R., …, & Abraham, W. T. (2015). Rationale and design of the Left Atrial Pressure Monitoring to Optimize Heart Failure Therapy Study (LAPTOP-HF). Journal of Cardiac Failure, 21(6), 479–488. https://doi.org/10.1016/j.cardfail.2015.04.012. Maurer, M. S., Adamson, P. B., Costanzo, M. R., Eigler, N., Gilbert, J., Gold, M. R., …, & Abraham, W. T. (2015). Rationale and design of the Left Atrial Pressure Monitoring to Optimize Heart Failure Therapy Study (LAPTOP-HF). Journal of Cardiac Failure, 21(6), 479–488. https://​doi.​org/​10.​1016/​j.​cardfail.​2015.​04.​012.
31.
Zurück zum Zitat Vinayakumar, D., Bijilesh, U., Sajeev, C. G., Rajesh, G. N., Bastion, C., Kadermuneer, P., …, & Krishnan, M. N. (2016). Correlation of pulmonary capillary wedge pressure with left atrial pressure in patients with mitral stenosis undergoing balloon valvotomy. Indian Heart Journal, 68(2), 143–146. https://doi.org/10.1016/j.ihj.2015.07.050. Vinayakumar, D., Bijilesh, U., Sajeev, C. G., Rajesh, G. N., Bastion, C., Kadermuneer, P., …, & Krishnan, M. N. (2016). Correlation of pulmonary capillary wedge pressure with left atrial pressure in patients with mitral stenosis undergoing balloon valvotomy. Indian Heart Journal, 68(2), 143–146. https://​doi.​org/​10.​1016/​j.​ihj.​2015.​07.​050.
Metadaten
Titel
A Novel Wireless Left Atrial Pressure Monitoring System for Patients with Heart Failure, First Ex-Vivo and Animal Experience
verfasst von
Leor Perl
Elina Soifer
Jozef Bartunek
Dedi Erdheim
Friedrich Köhler
William T. Abraham
David Meerkin
Publikationsdatum
02.01.2019
Verlag
Springer US
Erschienen in
Journal of Cardiovascular Translational Research / Ausgabe 4/2019
Print ISSN: 1937-5387
Elektronische ISSN: 1937-5395
DOI
https://doi.org/10.1007/s12265-018-9856-3

Weitere Artikel der Ausgabe 4/2019

Journal of Cardiovascular Translational Research 4/2019 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.