Implementing CardioMEMS Monitoring and Interventions into Clinical Practice

Heart failure is a complex clinical syndrome and its management can be challenging. Recurrent hospitalizations cannot always be avoided and the mortality and morbidity rates in this population are higher with each hospital admission. Current technological advances have focused on exploring intra-vascular or intra-cardiac devices as an option to monitor hemodynamics remotely in patients with heart failure to guide and optimize their medical therapy. This review discusses the implementation of the CardioMEMS monitoring system and its use into clinical practice in patients with heart failure.

Over time, several devices have been studied to monitor hemodynamics in heart failure patients. The CardioMEMS is the only monitoring technology that has demonstrated the ability to significantly reduce heart failure hospitalizations approved by the FDA. Research has showed that it could potentially lead to improved outcomes through hemodynamic guidance of medical therapy in this population. Data collected by the device includes pulmonary artery (PA) pressure values (systolic, diastolic, and mean), PA pressure wave forms, and heart rate. Information is sent remotely to physicians via a secure web-based site. After a provider analyzes the information, medication titration can be done according to the different PA readings. This approach has been very convenient for patients and physicians since patients do not need to undergo repeat invasive hemodynamic testing in order to obtain intracardiac pressures. The CardioMEMS system has showed promising results in heart failure patients and there are encouraging signs that it might be of benefit in special populations such as patient with ventricular assist devices and pulmonary hypertension.

Heart failure is a major public health issue generating increasing annual costs in the United States health care system every year. Pulmonary artery pressure monitoring with the CardioMEMS monitoring system can help physicians tailor medical therapy in patients with heart failure remotely. Monitoring patients in the outpatient setting could reduce the need for hospitalizations for acute decompensated heart failure; and hence, reduce the mortality and morbidity rates in this population.