Empowering Low-Income Patients with Home Blood Pressure Monitors to Improve Hypertension Control.

INTRODUCTION: Effective management of hypertension (HTN) is a priority in primary care. With telehealth now considered a staple care delivery method, uninsured and low-income patients without home blood pressure (BP) monitors may need additional attention and resources to achieve successful HTN control. METHODS: This prospective study at an underserved community clinic assessed the impact of distributing free BP monitors on patients' HTN control and therapy adherence. Enrollees were randomized into 2 groups, both completing 4 primary care physician (PCP) visits over a 6-month study period. Intervention participants collected home BP readings to report to their PCP and comparison participants completed an equivalent number of visits without having home BP data available for their PCP to review. Both groups completed an initial and final Therapy Adherence Scale (TAS) questionnaire. RESULTS: 263 patients were invited and 200 participants (mean age 50, 60% female, 19% Black, 67% Hispanic) completed the study. Intervention and comparison subjects featured comparable initial BP levels and TAS scores. After adjusting for age, race, ethnicity, sex, presence of diabetes and therapy adherence, intervention participants experienced higher odds of controlled HTN (OR 4.0; 95% Confidence Interval 2.1 to 7.7). A greater proportion of participants achieved BP control in the intervention arm compared with the comparison arm (82% vs 54% of participants, P < .001). TAS scores were higher in the intervention group (Mean = 44.1 vs 41.1; P < .001). DISCUSSION: The provision of free home BP monitors to low-income patients may feasibly and effectively improve BP control and therapy adherence.

Validation of the Raycome model M2 ambulatory blood pressure monitor in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard (ISO 81060-2:2018).

OBJECTIVE: The aim of this study was to evaluate the accuracy of the Raycome model M2 oscillometric upper-arm blood pressure (BP) monitor developed for ambulatory BP measurement in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018) at rest and during dynamic exercise. METHOD: Subjects were recruited to fulfill the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in the general population using the same arm sequential BP measurement method. Three cuffs of the test device were used for arm circumference 18-22 cm (small), 22-32 cm (medium) and 32-42 cm (large). RESULTS: For the general validation study, 106 subjects were recruited and 85 were analyzed. For validation criterion 1, the mean ±â€…SD of the differences between the test device and reference BP readings was 0.5 ±â€…6.2/-0.2 ±â€…5.1 mmHg (systolic/diastolic). For criterion 2, the SD of the mean BP differences between the test device and reference BP per subject was 5.23/4.50 mmHg (systolic/diastolic). In the ambulatory validation study ( N  = 35), the mean difference was 0.4 ±â€…5.9/-1.1 ±â€…5.8 mmHg. The Raycome model M2 performed well against the standard in both the general and ambulatory validations and the Bland-Altman plots did not show any systematic variation in the error. CONCLUSION: These data show that the Raycome model M2 monitor meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) and in the ambulatory setting, indicating its suitability for measuring BP in the general population.

Availability, Cost, and Consumer Ratings of Popular Nonvalidated vs Validated Blood Pressure-Measuring Devices Sold Online in 10 Countries.

This study examines the availability, cost, and consumer ratings of blood pressure­measuring devices relative to validation status across 10 countries.

Monitorização residencial da pressão arterial em adultos com hipertensão arterial sistêmica em tratamento medicamentoso, independentemente da pressão arterial do consultório / Residential monitoring of blood pressure in adults with systemic arterial hypertension in medication treatment, regardless of the blood pressure in the office

INTRODUÇÃO: A HAS é uma condição clínica multifatorial caracterizada por níveis elevados e sustentados de PA. Além de ser causa direta de cardiopatia e nefropatia hipertensivas, a HAS é fator de risco linear e contínuo para doenças decorrentes de aterosclerose e trombose, que se manifestam, predominantemente, por doença isquêmica cardíaca, cerebrovascular, vascular periférica e renal, assim como de morte prematura. No Brasil, a prevalência média é estimada em 32%, e pode chegar a mais de 50% em indivíduos com 60 a 69 anos e 75% em indivíduos com mais de 70 anos. Embora as diretrizes atuais recomendem o uso de monitorização ambulatorial da pressão arterial (MAPA) ou MRPA para monitoramento da resposta ao tratamento; este monitoramento é realizado no SUS apenas pela MAPA e medida da PA de consultório, ainda que o primeiro não esteja acessível para toda a população com indicação e o segundo não seja considerado suficientemente confiável para esse monitoram

Choice of home blood pressure monitoring device: the role of device characteristics among Alaska Native and American Indian peoples.

BACKGROUND: Home blood pressure monitoring (HBPM) is an effective tool in treatment and long-term management of hypertension. HBPM incorporates more data points to help patients and providers with diagnosis and management. The characteristics of HBPM devices matter to patients, but the relative importance of the characteristics in choosing a device remains unclear. METHODS: We used data from a randomized cross-over pilot study with 100 Alaska Native and American Indian (ANAI) people with hypertension to assess the choice of a wrist or arm HBPM device. We use a random utility framework to evaluate the relationship between stated likely use, perceived accuracy, ease of use, comfort, and participant characteristics with choice of device. Additional analyses examined willingness to change to a more accurate device. RESULTS: Participants ranked the wrist device higher compared to the arm on a 5-point Likert scale for likely use, ease of use, and comfort (0.3, 0.5, 0.8 percentage points, respectively). Most participants (66%) choose the wrist device. Likely use (wrist and arm devices) was related to the probability of choosing the wrist (0.7 and - 1.4 percentage points, respectively). Independent of characteristics, 75% of participants would be willing to use the more accurate device. Ease of use (wrist device) and comfort (arm device) were associated with the probability of changing to a more accurate device (- 1.1 and 0.5 percentage points, respectively). CONCLUSION: Usability, including comfort, ease, and likely use, appeared to discount the relative importance of perceived accuracy in the device choice. Our results contribute evidence that ANAI populations value accurate HBPM, but that the devices should also be easy to use and comfortable to facilitate long-term management.

The quality of patients' self-blood pressure measurements: a cross-sectional study.

BACKGROUND: The accurate and independent measurement of blood pressure (BP) by patients is essential for home BP monitoring (HBPM) and determining the quality of hypertension (HTN) control. This study aimed to evaluate the BP self-measurement techniques of hypertensive patients and their accuracy in accordance with established guidelines. We sought to identify the common errors that patients make and suggest improvements that can be implemented in the primary healthcare setting to increase the reliability of HBPM conducted by hypertensive patients. METHODS: One hundred patients diagnosed with HTN completed a questionnaire inquiring about their health and demographic data and BP monitoring practices. Patients were then observed and filmed while measuring their BP on their own devices in five primary healthcare centres in Kraków, Poland. The correctness of their techniques was assessed in accordance with the European Society of Hypertension guidelines on HBPM. RESULTS: Only 3% of patients measured their BP without error; 60% made three or more errors. The most frequent error, made by 76% of subjects, was incorrect sphygmomanometer cuff placement (above or below heart level, or/and the indicator mark was not aligned with the brachial artery). Regarding patients' previous instruction for the correct use of their devices, 36% of patients referred to their monitor's user manual, 22% did not receive any prior assistance, and only 29% were adequately counselled by physicians on how to measure their BP correctly. CONCLUSIONS: Our findings suggest that primary healthcare physicians and their personnel often do not adequately instruct patients on how to measure their BP correctly. Therefore, healthcare systems must provide patients with more adequate training and reference materials on the best practices of BP monitoring.

Pediatric Ambulatory Blood Pressure Classification: The Case for a Change.

In 1997, Soergel et al1 published the first set of normative values for ambulatory blood pressure monitoring (ABPM) in children. Since then, the clinical utility of ABPM has increased dramatically, and now, ABPM is accepted as the standard method to confirm the diagnosis of hypertension in children. Despite significant progress in the field of pediatric ABPM, many important questions remain unanswered. One of the most controversial issues is how to define ambulatory hypertension in children. The purpose of this review is to discuss the limitations of the current pediatric ABPM classification scheme and to provide the justification and rationale for a new classification.

Lack of Acceptance of Digital Healthcare in the Medical Market: Addressing Old Problems Raised by Various Clinical Professionals and Developing Possible Solutions.

Various digital healthcare devices and apps, such as blood glucose meters, blood pressure monitors, and step-trackers are commonly used by patients; however, digital healthcare devices have not been widely accepted in the medical market as of yet. Despite the various legal and privacy issues involved in their use, the main reason for its poor acceptance is that users do not use such devices voluntarily and continuously. Digital healthcare devices generally do not provide valuable information to users except for tracking self-checked glucose or walking. To increase the use of these devices, users must first understand the health data produced in the context of their personal health, and the devices must be easy to use and integrated into everyday life. Thus, users need to know how to manage their own data. Medical staff must teach and encourage users to analyze and manage their patient-generated healthcare data, and users should be able to find medical values from these digital devices. Eventually, a single customized service that can comprehensively analyze various medical data to provide valuable customized services to users, and which can be linked to various heterogeneous digital healthcare devices based on the integration of various health data should be developed. Digital healthcare professionals should have detailed knowledge about a variety of digital healthcare devices and fully understand the advantages and disadvantages of digital healthcare to help patients understand and embrace the use of such devices.

Automated office BP measurement: The new standard in HTN screening.

Obtain greater accuracy in blood pressure measurement with an automated office device.

Detection of Atrial Fibrillation Using a Home Blood Pressure Monitor.

PURPOSE: Atrial fibrillation (AF) is the most common arrhythmia and is associated with an increased risk of complications. A screening test has the potential to prevent AF-related complications. This study investigated the diagnostic accuracy of an automated device for home blood pressure (BP) monitoring, which implements an algorithm for AF detection. PATIENTS AND METHODS: A modified, automated oscillometric device for home BP monitoring (Omron BP785N (HEM-7321-Z), Omron Healthcare) with an AF detector was used to measure the BP in patients. During each BP measurements, the electrocardiogram (ECG) was recorded simultaneously. Simultaneous BP measurements and ECG recordings were obtained from 99 subjects. RESULTS: Twenty out of 20 patients with atrial fibrillation were correctly recognized by the device and the device correctly identified 67 patients with sinus rhythm as "Not-AF". On the other hand, 12 patients with basic rhythm: sinus rhythm were incorrectly referred to as "atrial fibrillation". In summary, the device has a diagnostic accuracy of 87.88% with a sensitivity of 100% and a specificity of 84.8%. On the other hand, in 23 patients, the raw data of the device showed that a body movement occurred during the measurement of the blood pressure. If these subjects were excluded of the analysis, then the diagnostic accuracy of the device would be even better, namely 90.79%. The sensitivity would be 100% and the specificity 89.5%. CONCLUSION: These data suggest that an automated device for home blood pressure has an excellent diagnostic accuracy for detecting an AF and could be used as a reliable screening test for early diagnosis of atrial fibrillation. Body movements have an impact of the accuracy and specificity of a blood pressure monitor.

Home blood pressure monitoring in the diagnosis and treatment of hypertension in pregnancy: a systematic review and meta-analysis.

BACKGROUND: Home blood pressure monitoring is increasingly used for pregnant individuals; however, there are no guidelines on such monitoring in this population. We assessed current practices in the prescription and use of home blood pressure monitoring in pregnancy. METHODS: We conducted a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs). We conducted a structured search through the MEDLINE (from 1946), Embase (from 1974) and CENTRAL (from 2018) databases up to Oct. 19, 2020. We included trials comparing office and home blood pressure monitoring in pregnant people. Outcomes included patient education, home blood pressure device, monitoring schedule, adherence, diagnostic thresholds for home blood pressure, and comparison between home and office measurements of blood pressure. RESULTS: We included in our review 21 articles on 19 individual studies (1 RCT, 18 observational) that assessed home and office blood pressure in pregnant individuals (n = 2843). We observed variation in practice patterns in terms of how home monitoring was prescribed. Eight (42%) of the studies used validated home blood pressure devices. Across all studies, measurements were taken 3 to 36 times per week. Third-trimester home blood pressure corresponding to office blood pressure of 140/90 mm Hg after application of a conversion factor ranged from 118 to 143 mm Hg (systolic) and from 76 to 92 mm Hg (diastolic), depending on the patient population and methodology. Systolic and diastolic blood pressure values measured at home were lower than office values by 4 (95% confidence interval [CI] -6 to -3) mm Hg and 3 (95% CI -4 to -2) mm Hg, respectively. INTERPRETATION: Many issues related to home blood pressure monitoring in pregnancy are currently unresolved, including technique, monitoring schedule and target values. Future studies should prioritize the use of validated home measuring devices and standardized measurement schedules and should establish treatment targets. PROSPERO REGISTRATION: CRD42020147352.

Home Blood Pressure Monitoring Devices: Device Performance in an Alaska Native and American Indian Population.

Objectives: Home blood pressure monitoring (HBPM) is an important component of blood pressure (BP) management. We assessed performance of two HBPM devices among Alaska Native and American Indian people (ANAIs). Methods: We measured BP using Omron BP786 arm cuff, Omron BP654 wrist cuff, and Baum aneroid sphygmomanometer in 100 ANAIs. Performance was assessed with intraclass correlation, paired t-tests, and calibration models. Results: Compared to sphygmomanometer, average BP was higher for wrist cuff (systolic = 4.8 mmHg and diastolic = 3.6 mmHg) and varied for arm cuff (systolic = -1.5 mmHg and diastolic = 2.5 mmHg). Calibration increased performance from grade B to A for arm cuff and from D to B for wrist cuff. Calibration increased false negatives and decreased false positives. Discussion: The arm HBPM device is more accurate than the wrist cuff among ANAIs with hypertension. Most patients are willing to use the arm cuff when accuracy is discussed.

Sociodemographic Characteristics Predicting Digital Health Intervention Use After Acute Myocardial Infarction.

Increasing evidence suggests that digital health interventions (DHIs) are an effective tool to reduce hospital readmissions by improving adherence to guideline-directed therapy. We investigated whether sociodemographic characteristics influence use of a DHI targeting 30-day readmission reduction after acute myocardial infarction (AMI). Covariates included age, sex, race, native versus loaner iPhone, access to a Bluetooth-enabled blood pressure monitor, and disease severity as marked by treatment with CABG. Age, sex, and race were not significantly associated with DHI use before or after covariate adjustment (fully adjusted OR 0.98 (95%CI: 0.95-1.01), 0.6 (95%CI: 0.29-1.25), and 1.22 (95% CI: 0.60-2.48), respectively). Being married was associated with high DHI use (OR 2.12; 95% CI 1.02-4.39). Our findings suggest that DHIs may have a role in achieving equity in cardiovascular health given similar use by age, sex, and race. The presence of a spouse, perhaps a proxy for enhanced caregiver support, may encourage DHI use.

SAFE@HOME: Cost analysis of a new care pathway including a digital health platform for women at increased risk of preeclampsia.

OBJECTIVE: To perform a cost analysis of the use of a new care pathway with a digital health platform for blood pressure telemonitoring for women at risk of preeclampsia. STUDY DESIGN: This is a cost analysis of a case-control study with women with chronic hypertension, history of preeclampsia, maternal cardiac or kidney disease at intake of pregnancy. Antenatal care with a reduced visit schedule and a digital health platform (SAFE@HOME, n = 97) was compared to a retrospective control group (n = 133) with usual care without self-monitoring. MAIN OUTCOME MEASURES: Costs per pregnancy (€) of healthcare consumption of antenatal clinic visits, ultrasound assessments, antenatal admissions, laboratory and other diagnostic tests, and societal costs such as traveling and work absence. RESULTS: Baseline characteristics and perinatal outcomes were similar between both groups. A significant reduction of antenatal visits, ultrasounds and hypertension-related admissions was associated with use of the digital platform. In the SAFE@HOME group, costs of antenatal care, including the costs of the digital platform, were 19.7% lower compared to the control group (median €3616 [IQR 3071 - 5329] vs €4504 [IQR 3515-6923], p = 0.001). Total costs per pregnancy, including societal costs, were also reduced (€7485 [IQR 6338-10,173] vs €9150, [IQR 7546-12,286] p < 0.001). Each euro invested in the platform saved on average €8 of antenatal care resources. CONCLUSION: The use of a digital platform for blood pressure and symptom monitoring in antenatal care for high-risk women is associated with lower costs compared to conventional care, while observed maternal and neonatal outcomes are similar.

The 2020 "WHO Technical Specifications for Automated Non-Invasive Blood Pressure Measuring Devices With Cuff".

High systolic blood pressure (BP) is the single leading modifiable risk factor for death worldwide. Accurate BP measurement is the cornerstone for screening, diagnosis, and management of hypertension. Inaccurate BP measurement is a leading patient safety challenge. A recent World Health Organization report has outlined the technical specifications for automated noninvasive clinical BP measurement with cuff. The report is applicable to ambulatory, home, and office devices used for clinical purposes. The report recommends that for routine clinical purposes, (1) automated devices be used, (2) an upper arm cuff be used, and (3) that only automated devices that have passed accepted international accuracy standards (eg, the International Organization for Standardization 81060-2; 2018 protocol) be used. Accurate measurement also depends on standardized patient preparation and measurement technique and a quiet, comfortable setting. The World Health Organization report provides steps for governments, manufacturers, health care providers, and their organizations that need to be taken to implement the report recommendations and to ensure accurate BP measurement for clinical purposes. Although, health and scientific organizations have had similar recommendations for many years, the World Health Organization as the leading governmental health organization globally provides a potentially synergistic nongovernment government opportunity to enhance the accuracy of clinical BP assessment.

Utilidad del MAPA y bioimpedancia para el tratamiento y control de la HTA en pacientes en hemodiálisis crónica / Usefulness of ABPM and bioimpedance for the treatment and control of hypertension in patients on chronic haemodialysis

INTRODUCCIÓN: La hipertensión arterial (HTA) en los pacientes en hemodiálisis (HD) es muy frecuente y se asocia a un aumento de la morbimortalidad. Los objetivos de nuestro trabajo han sido: 1. Conocer la tensión arterial (TA) en la sesión de HD. 2. Estudiar la TA, en el periodo interdialítico, mediante monitorización ambulatoria de presión arterial (MAPA) de 44 horas. 3. Conocer la concordancia entre la TA en la sesión de HD y MAPA. 4. Valorar los cambios de tratamiento después de la realización del MAPA. 5. Realizar una bioimpedancia espectroscópica (BIS) a todos los pacientes y en los hiperhidratados e hipertensos, según MAPA, valorar cambios en la TA después de ajustar el peso seco (PS). 6. Conocer factores asociados a la TA sistólica (TAS) y TA diastólica (TAD) promedio del MAPA. MATERIAL Y MÉTODOS: Estudio prospectivo observacional, que incluyó a 100 pacientes de nuestra unidad de diálisis. Se han recogido las tensiones pre y post-HD, durante dos semanas y, posteriormente, colocamos a los pacientes un aparato de MAPA a mitad de semana, durante 44 horas. Previo a comenzar la siguiente sesión de diálisis, realizamos una BIS. A aquellos pacientes hiperhidratados e hipertensos, según MAPA, se les realizó un segundo MAPA para valorar cambios en los valores de TA. RESULTADOS: Según MAPA, el 65% de pacientes presentaron una TA diurna > 135/85 mmHg, 90% TA nocturna > 120/70 mmHg y 76% TA promedio > 130/80 mmHg. El 11% presentó un patrón dipper, 51% no dipper y 38% riser. Las TAS y TAD promedio fueron 4,7 mmHg (3,8%) y 1,1 mmHg (1,64%) más altas el segundo día. En el 6% de pacientes fue necesario bajar la dosis de antihipertensivos, 9% suspenderlos, 28% aumentar dosis y 17% añadir un nuevo fármaco. La TAD pre-HD es la que mejor concordancia presenta con el MAPA. Después de realizar BIS y ajustar PS hubo un descenso significativo en todas las cifras de TA. El análisis univariante mostró que la TAS promedio fue más alta en pacientes con baño alto en calcio, mayor cantidad de fármacos antihipertensivos y mayores dosis de eritropoyetina (EPO). El análisis multivariante mostró asociación significativa para EPO y número de fármacos (p < 0,01). La TAD promedio fue más alta en pacientes más jóvenes, con Charlson más bajos, menor índice de masa corporal (IMC), menos diuresis, no diabéticos y con mayores dosis de EPO. El estudio de regresión lineal mostró como variables significativas la edad (p < 0,005), IMC (p < 0,03) y EPO (p < 0,03). CONCLUSIONES: Nuestro estudio muestra: 1. La variabilidad de criterio de HTA, según utilicemos cifras de TA durante la sesión de HD o MAPA. 2. La variabilidad de TA en el periodo interdiálisis. 3. La TAD prediálisis es la que mejor concordancia presenta con el MAPA. 4. La utilización conjunta de la BIS y el MAPA mejora el control de la TA. 5. La dosis de EPO es el factor más importante asociado a la HTA en nuestros pacientes

INTRODUCTION: Hypertension is very common in haemodialysis (HD) patients, and is associated with increased morbidity and mortality rates. The goals of our research were to: 1. Measure blood pressure (BP) during HD sessions; 2. Study BP in between HD sessions with 44-hour Ambulatory Blood Pressure Monitoring (ABPM); 3. Identify differences between the BP recorded during HD and with the ABPM; 4. Evaluate changes in treatment after the ABPM; 5. Perform bioimpedance spectroscopy (BIS) on all patients and, in those hyper-hydrated or hypertensive according to ABPM, assess for changes in BP after adjusting the dry weight; 6. Identify factors associated with average systolic and diastolic BP measured by ABPM. MATERIAL AND METHODS: Prospective observational study, which included 100 patients from our dialysis unit. We measured BP before and after the HD sessions for two weeks and then, mid-week, we attached the ABPM device to the patients for 44 hours. Before starting the following dialysis session, we performed BIS. A second ABPM was performed on hyper-hydrated patients and patients hypertensive according to ABPM to evaluate changes in BP values. RESULTS: According to the ABPM, 65% of patients had daytime BP > 135/85 mmHg, 90% night-time BP > 120/70 mmHg and 76% average BP > 130/80 mmHg; 11% had a dipper pattern, 51% non-dipper and 38% riser. The average systolic and diastolic BP readings were 4.7 mmHg (3.8%) and 1.1 mmHg (1.64%) higher on the second day. The dose of antihypertensive medication had to be lowered in 6% of patients, 9% had to stop taking it, 28% needed increased doses and 17% had to add a new drug. The pre-HD diastolic BP best matched the ABPM. After performing the bioimpedance and adjusting dry weight, there was a statistically significant decrease in all BP values. The univariate analysis showed that the average systolic BP was higher in patients with a high-calcium dialysis bath, more antihypertensive drugs and higher doses of EPO. The multivariate analysis showed significant association for EPO and number of drugs (p < 0.01). The average diastolic BP was higher in younger patients and patients with lower Charlson index, lower body mass index and less diuresis, those on higher doses of EPO and non-diabetics. The linear regression study showed age (p < 0.005), body mass index (p < 0.03) and EPO (p < 0.03) as significant variables. CONCLUSIONS: Our study shows: 1. The variability of hypertension criteria according to use of BP values from during the HD session or ABPM; 2. The variability of BP in the interdialysis period; 3. That the pre-dialysis diastolic BP best corresponds with the ABPM. 4. That the use of both BIS and ABPM improves the control of BP; 5. That the dose of EPO is the most important factor associated with hypertension in our patients

A new option for monitoring heart failure. First experience in Spain with CardioMEMS / Una nueva opción de monitorizar la insuficiencia cardiaca. Primera experiencia en España con CardioMEMS(TM)

INTRODUCTION: The CardioMEMS device is inserted into the pulmonary artery and allows monitorization of pulmonary artery pressure in heart failure patients. Previous studies have shown a reduction in hospitalizations for heart failure and an improvement in quality of life in the group of patients monitored with the device. PATIENTS AND METHODS: Eleven patients managed in a multidisciplinary heart failure clinic implanted with the sensor were consecutively included from June 2019 to February 2020. This is the first experience with a cardioMEMS device published in Spain. RESULTS: The device was successfully implanted in all cases without severe complications or sensor failures, allowing precise adjustment of medical treatment that led to very few heart failure readmissions. DISCUSSION: Wireless pulmonary artery pressure monitoring will probably become an essential component in the management of selected HF patients

INTRODUCCIÓN: El dispositivo CardioMEMS(TM) se inserta en la arteria pulmonar, y permite la monitorización de la presión arterial pulmonar en los pacientes con insuficiencia cardiaca. Los estudios previos han reflejado una reducción de las hospitalizaciones por insuficiencia cardiaca, así como una mejora de la calidad de vida en el grupo de pacientes monitorizados con el dispositivo. Pacientes and métodos: Se incluyó consecutivamente a 11 pacientes tratados en una clínica multidisciplinar para insuficiencia cardiaca, que tuvieron implantado el sensor de junio de 2019 a febrero de 2020. Esta es la primera experiencia con el dispositivo CardioMEMS(TM) que se publica en España. RESULTADOS: Se implantó exitosamente el dispositivo en todos los casos, sin complicaciones graves ni fallos del sensor, lo cual permitió el ajuste preciso del tratamiento médico, que redundó en pocos reingresos por insuficiencia cardiaca. DISCUSIÓN: La monitorización de la presión arterial pulmonar sin cables se convertirá probablemente en un componente esencial del tratamiento de los pacientes de insuficiencia cardiaca seleccionados