scholarly journals Invasive Devices and Sensors for Remote Care of Heart Failure Patients

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2014
Author(s):  
Sumant P. Radhoe ◽  
Jesse F. Veenis ◽  
Jasper J. Brugts
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Hospital Admissions ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Decompensated Heart Failure ◽  
Hospital Admission Rate ◽  
Remote Care ◽  
New Sensors ◽  
Near Future

The large and growing burden of chronic heart failure (CHF) on healthcare systems and economies is mainly caused by a high hospital admission rate for acute decompensated heart failure (HF). Several remote monitoring techniques have been developed for early detection of worsening disease, potentially limiting the number of hospitalizations. Over the last years, the scope has been shifting towards the relatively novel invasive sensors capable of measuring intracardiac filling pressures, because it is believed that hemodynamic congestion precedes clinical congestion. Monitoring intracardiac pressures may therefore enable clinicians to intervene and avert hospitalizations in a pre-symptomatic phase. Several techniques have been discussed in this review, and thus far, remote monitoring of pulmonary artery pressures (PAP) by the CardioMEMS (CardioMicroelectromechanical system) HF System is the only technique with proven safety as well as efficacy with regard to the prevention of HF-related hospital admissions. Efforts are currently aimed to further develop existing techniques and new sensors capable of measuring left atrial pressures (LAP). With the growing body of evidence and need for remote care, it is expected that remote monitoring by invasive sensors will play a larger role in HF care in the near future.

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

2021 ◽  
Author(s):  
J Breda
Keyword(s):  
Heart Failure ◽  
Hospital Admission ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Volume Overload ◽  
Decompensated Heart Failure ◽  
Healthcare Systems ◽  
Hospital Admission Rate ◽  
Cardiac Heart Failure

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.

7. Emergency department diuretic dosing in acute decompensated heart failure and its effect on length of stay and re-admission rate

Heart & Lung ◽  
2012 ◽  
Vol 41 (4) ◽  
pp. 414-415 ◽  
Author(s):  
J. Fearon-Clarke ◽  
M. Betty ◽  
B. Vargas ◽  
R. Montesino ◽  
S. Sheris ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Length Of Stay ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Decompensated Heart Failure

scholarly journals Comparison of management and outcomes of ED patients with acute decompensated heart failure between the Canadian and United States’ settings

CJEM ◽  
2015 ◽  
Vol 18 (2) ◽  
pp. 81-89 ◽  
Author(s):  
Anita Lai ◽  
Elliott Tenpenny ◽  
David Nestler ◽  
Erik Hess ◽  
Ian G. Stiell
Keyword(s):  
United States ◽  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Decompensated Heart Failure ◽  
The United States ◽  
Health Records ◽  
Male Sex ◽  
Relapse Rates ◽  
The U.S

AbstractIntroductionThe objective of this study was to compare the emergency department (ED) management and rate of admission of acute decompensated heart failure (ADHF) between two hospitals in Canada and the United States and to compare the outcomes of these patients.MethodsThis was a health records review of adults presenting with ADHF to two EDs in Canada and the United States between January 1 and April 30, 2010. Outcome measures were admission to the hospital, myocardial infarction (MI), and death or relapse rates to the ED. Data were analysed using descriptive, univariate and multivariate analyses.ResultsIn total, 394 cases were reviewed and 73 were excluded. Comparing 156 Canadian to 165 U.S. patients, respectively, mean age was 76.0 and 75.8 years; male sex was 54.5% and 52.1%. Canadian and U.S. ED treatments were noninvasive ventilation 7.7% v. 12.8% (p=0.13); IV diuretics 77.6% v. 36.0% (p<0.001); IV nitrates 4.5% v. 6.7% (p=0.39). There were significant differences in rate of admission (50.6% v. 95.2%, p<0.001) and length of stay in ED (6.7 v. 3.0 hours, p<0.001). Proportion of Canadian and U.S. patients who died within 30 days of the ED visit was 5.1% v. 9.7% (p=0.12); relapsed to the ED within 30 days was 20.8% v. 17.5% (p=0.5); and had MI within 30 days was 2.0% v. 1.9% (p=1.0).ConclusionsThe U.S. and Canadian centres saw ADHF patients with similar characteristics. Although the U.S. site had almost double the admission rate, the outcomes were similar between the sites, which question the necessity of routine admission for patients with ADHF.

Emergency Department Diuretic Dosing in Acute Decompensated Heart Failure and Its Effect on Length of Stay and Re-Admission Rate

2011 ◽  
Vol 17 (8) ◽  
pp. S92
Author(s):  
Jacqueline Fearon-Clarke ◽  
Simarta Brennan ◽  
Rami Bustami ◽  
Betty Merveil-Ceneus ◽  
Bernardo Vargas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Length Of Stay ◽  
Acute Decompensated Heart Failure ◽  
Admission Rate ◽  
Decompensated Heart Failure

Abstract 17319: Management of Advanced Heart Failure Patients With the Combined Use of CardioMEMS™ and Telehealth: A Single Center Experience in a Veteran’s Affairs Population

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nishi Patel ◽  
Amit Alam ◽  
Subash Banerjee ◽  
Nicole Minniefield ◽  
Shelley Hall ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Text Message ◽  
Admission Rate ◽  
Encounter Rate ◽  
Office Visits ◽  
Hospital Admission Rate ◽  
Phone Calls ◽  
Virtual Visits ◽  
Veteran's Affairs

Background: Due to the Coronavirus Disease of 2019 pandemic many clinics began to utilize virtual visits in lieu of traditional office visits. It is unclear what effect this will have on outcomes and admission rates for heart failure (HF). We describe our approach and outcomes in managing HF in a Veteran’s Affairs population with previously implanted CardioMEMS™ during this time. Methods: Starting February 15 th 2020, virtual visits were utilized in patients with CardioMEMS™ during which their symptoms were discussed and medications adjusted. Patients also received weekly phone calls to ensure that they had medications and to adjust diuretics based on pulmonary artery (PA) pressure readings. They received text message reminders if a reading was missed. A nurse was also tasked to follow up on lab results. Data was collected by reviewing the charts of CardioMEMS™ patients followed in our clinic by cardiology fellows and divided into pre pandemic period of July 1 st 2018 to February 14 th 2020 and a post pandemic period of February 15 th 2020 to May 15 th 2020. Data collected included baseline demographics, number of in-office and virtual visits, hospital admissions for HF, PA pressures, and compliance with CardioMEMS™ readings. Phone calls to adjust diuretics or review labs were not counted as virtual visits. Results: In the pre-pandemic period we identified 49 patients with prior CardioMEMS™; baseline demographics are shown in Table 1A. Table 1B shows our results comparing the pre pandemic and post pandemic periods when our telemedicine program was started. Although in the post pandemic period our encounter rate was lower, our virtual program was able to maintain stable PA pressures and a lower overall hospital admission rate. Compliance with CardioMEMS™ also increased though this was not statistically significant. Conclusion: Both CardioMEMS™ and virtual visits may be used effectively to maintain low PA pressures and reduce hospital admissions for in patients with chronic HF.

Inpatient management of acute decompensated heart failure

2019 ◽  
Vol 96 (1131) ◽  
pp. 33-42
Author(s):  
Leah Raj ◽  
Samuel David Maidman ◽  
Bhavin B. Adhyaru
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
American Heart ◽  
Acute Decompensated Heart Failure ◽  
Symptom Relief ◽  
Heart Association ◽  
Decompensated Heart Failure ◽  
Short Term ◽  
Inpatient Management ◽  
Poor Outcomes

Acute decompensated heart failure (ADHF) is the leading cause of hospital admissions in patients older than 65 years. These hospitalisations are highly risky and are associated with poor outcomes, including rehospitalisation and death. The management of ADHF is drastically different from that of chronic heart failure as inpatient treatment consists primarily of haemodynamic stabilisation, symptom relief and prevention of short-term morbidity and mortality. In this review, we will discuss the strategies put forth in the most recent American College of Cardiology/American Heart Association and Heart Failure Society of America guidelines for ADHF as well as the evidence behind these recommendations.

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