Royal Brompton & Harefield hospitals have a long history of innovation in remote monitoring of heart failure with skilled multi-disciplinary clinical staff and several research studies in this area. An implanted device is now being rolled out as the next step in remote monitoring for this disease.
The demand for heart failure (HF) care in the UK has been ongoing, with the disease now affecting around 900,000 people in the UK (as of 2017). It is a complex condition requiring many aspects to be addressed in order to be managed properly.
Usually, heart failure patients are monitored via regular follow-up appointments in a clinic or if the patient has noticed any worsening symptoms such as increased breathlessness or fatigue.
However, in July 2015, for the first time ever an innovative device, the CardioMEMS™ HF System, was developed by cardiologists at Royal Brompton Hospital to measure how well a patient’s heart is functioning.
Implanting the device
Patients suffering from chronic heart failure have had a miniature wireless sensor, approximately the size of a paperclip, inserted into their pulmonary artery (the core blood vessel carrying blood from the heart to the lungs). It is implanted during a minimally invasive procedure using a cardiac catheter passed through the vein at the top of the leg.
The device informs doctors of any decline in the patient’s condition, even prior to them experiencing any symptoms. The procedure is performed with the patient fully awake and only takes half an hour. Once the device is successfully in place it allows for remote monitoring of fluctuations in blood pressure in the pulmonary artery which is a key indicator of worsening heart failure.
Readings are provided by a home electronics system that is simple and easy to use. Patients are required to lie on a specially adapted pillow for a few minutes, where the pillow receives data wirelessly from the implanted sensor. This is connected to a monitor which then sends the data directly to the doctor via a secure website. The heart failure team analyse the readings and any potentially life-threatening decline.
Studies from the United States have shown evidence that use of the device can reduce hospital admissions by an average of 30 per cent after six months.
Professor Martin Cowie, consultant cardiologist at Royal Brompton & Harefield Hospitals Specialist Care said:
“This device has the potential to revolutionise the care of heart failure patients. By detecting any deterioration in heart function at a much earlier stage and changing treatment accordingly, we should be able to prevent significant numbers of hospital admissions and improve the quality of life for many thousands of people with the condition.”
What is CardioMEMs?
The CardioMEMS HF System measures and monitors the pulmonary artery pressure and heart rate in heart failure patients. An implantable sensor is permanently placed in the pulmonary artery during a right heart catheterisation procedure.
Together with the home electronics system, the pulmonary artery pressure measurements are read and automatically transmitted to the heart failure team who can monitor the health vital signs and make decisions about potential interventions – such as increasing medications, in real time, without the patient needing to attend a clinic.
Who would benefit from remote monitoring?
Those patients assessed by a cardiologist and on optimal medical treatment, but still with symptoms on minor exertion.
What are the advantages?
Remote monitoring provides another component of care and can help encourage patients to take a more active involvement in their health. Through the provision of regular readings, the heart failure team are able to closely monitor a patient’s health and provide more precise recommendations for treatment and help to decrease the chance of hospitalisation.