Concurrent Assessment of the CardioMEMS HF System and HeartLogic HF Diagnostic: A Retrospective Case Series.

BACKGROUND: Heart failure (HF) causes high morbidity and mortality despite advances in medical therapy. Remote patient monitoring for HF allows for the optimization of medical therapy and prevention of HF hospitalizations. This study is the first to assess pulmonary artery diastolic pressures (PADP) using the CardioMEMS HF System (CMEMS) and cardiac implantable electronic device-based multisensor indexes (HeartLogic index [HLI]) using the HeartLogic HF Diagnostic (HL) in a small, retrospective cohort of patients with HF at a single center. METHODS AND RESULTS: Any hospitalization, HF hospitalization, HF-related outpatient visit, and pulmonary artery pressure action were recorded in 7 patients with concurrent CMEMS and HL measurements for at least 1 year. The median time before both platforms were implanted and present in the same participant was 3.12 months. The median study period was 1.44 years per participant. Data availability for HL was significantly higher at 99.6% compared with 64.1% adherence for CMEMS (P = .016). Overall, PADP was only weakly correlated to HLI (r = 0.098), but there was a 2.87 mm Hg (P = .014) estimated increase in PADP during HLI alert periods versus nonalert periods. Similarly, the estimated odds of being above a PADP goal was 4.7 times higher (95% confidence interval 3.0-7.2, P < .001) in HLI alert vs nonalert periods. CONCLUSIONS: Concurrent analysis of patients with CMEMS and HL showed an association between PADP and HLI, but the correlation was weak. However, there was a significant increase in PADP during HLI alert periods versus nonalert periods.

Development and implementation of a remote patient monitoring program for heart failure: a single-centre experience.

AIMS: Remote patient monitoring (RPM) in the management of heart failure (HF), including telemonitoring, thoracic impedance, implantable pulmonary artery pressure (PAP) monitors, and cardiac implantable electronic device (CIED)-based sensors, has had varying outcomes in single platform studies. Uncertainty remains regarding the development of single-centre RPM programs; additionally, no studies examine the effectiveness of dual platform RPM programs for HF. This study describes the implementation and outcomes of a dual platform RPM program for HF at a single centre. METHODS AND RESULTS: An RPM program was developed to include two platforms (e.g. CardioMEMS™ HF System and HeartLogic™ HF Diagnostic). To examine changes within each participant over time, study-related outcomes including total hospitalizations (TH), total length of stay (TLOS), cardiac hospitalizations (CH), cardiac LOS (CLOS), and cardiac-related emergency department (ED) visits were compared in two timeframes: 12 months pre-enrolment and post-enrolment into RPM. For 141 participants enrolled, there was a significant reduction in the likelihood of experiencing a CH by 19% (0.77 vs. 0.61 events/patient-year; HR: 0.81, 95% CI: 0.67-0.97, P = 0.03) and a cardiac-related ED visit by 28% (0.48 vs. 0.34 events/patient-year; HR: 0.72, 95% CI: 0.55-0.93, P = 0.01). There was also a 51% decrease (SE = 1.41, 95% CI: 2.79-8.38 days, P < 0.001) and 62% decrease (SE = 1.24, 95% CI: 3.35-8.22 days, P < 0.001) in TLOS and CLOS, respectively. CONCLUSIONS: A dual platform RPM program for HF using structured education, RPM-capable devices, and alert-specific medication titration reduces the likelihood of experiencing a cardiac hospitalization and cardiac-related ED visit in this single-centre study.