• Raymond L Benza, Mark Doyle, David Lasorda, Kishan S Parikh, Priscilla Correa-Jaque, Nima Badie, Greg Ginn, Sophia Airhart, Veronica Franco, Manreet K Kanwar, Srinivas Murali, Amresh Raina, Rahul Agarwal, Sudarshan Rajagopal, Jason White, and Robert Biederman.
• Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, PA. Electronic address: rbenza@wpahs.org.
• Chest. 2019 Dec 1; 156 (6): 1176-1186.

BackgroundPulmonary arterial hypertension (PAH) is a chronic disease that ultimately progresses to right-sided heart failure (HF) and death. Close monitoring of pulmonary artery pressure (PAP) and right ventricular (RV) function allows clinicians to appropriately guide therapy. However, the burden of commonly used methods to assess RV hemodynamics, such as right heart catheterization, precludes frequent monitoring. The CardioMEMS HF System (Abbott) is an ambulatory implantable hemodynamic monitor, previously only used in patients with New York Heart Association (NYHA) class III HF. In this study, we evaluate the feasibility and early safety of monitoring patients with PAH and right-sided HF using the CardioMEMS HF System.MethodsThe CardioMEMS HF sensors were implanted in 26 patients with PAH with NYHA class III or IV right-sided HF (51.3 ± 18.3 years of age, 92% women, 81% NYHA class III). PAH therapy was tracked using a minimum of weekly reviews of CardioMEMS HF daily hemodynamic measurements. Safety, functional response, and hemodynamic response were tracked up to 4 years with in-clinic follow-ups.ResultsThe CardioMEMS HF System was safely used to monitor PAH therapy, with no device-related serious adverse events observed and a single preimplant serious adverse event. Significant PAP reduction and cardiac output elevation were observed as early as 1 month postimplant using trends of CardioMEMS HF data, coupled with significant NYHA class and quality of life improvements within 1 year.ConclusionsThe CardioMEMS HF System provided useful information to monitor PAH therapy, and demonstrated short- and long-term safety. Larger clinical trials are needed before its widespread use to guide therapy in patients with severe PAH with right-sided HF.Copyright © 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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