A remote readable sensor in the pulmonary artery may offer relief for patients with chronic heart failure. The sensor can halve the number of patients' hospitalisations. It also improves patients' quality of life by allowing doctors to intervene earlier.
In heart failure, the heart cannot pump as much blood around as normal. This can result in a variety of symptoms. For example, patients tire more quickly and run out of breath more often. The symptoms often increase over time. Heart failure is fatal; about 7,500 people die of heart failure every year. This places it sixth in the ranking of causes of death.
38,000 people annually diagnosed with heart failure
Heart failure is relatively common; on an annual basis, 38,000 people are diagnosed with heart failure for the first time. About 31,000 heart failure patients are admitted to hospitals every year. In total, some 250,000 people in the Netherlands live with heart failure. The impact on care due to admissions and check-ups of patients is therefore high.
At the same time, hospital visits are also a major burden for patients. For instance, they have to travel to the hospital regularly and, in some cases, are forced to be hospitalised.
Imaging heart filling pressure
Remote monitoring can offer relief, argues cardiologist Dr Jasper Brugts of the Erasmus MC Heart and Vascular Institute. In a study, 348 heart failure patients from 25 Dutch centres received a small sensor implanted in the pulmonary artery. They were also given a pillow with measuring equipment at home. Does the patient lie on this cushion? Then the cushion measures the lung pressure, which is an indication of the heart's filling pressure. The cushion sends this data via a secure connection to the cardiologist at the hospital.
The system is called CardioMEMS and has been in development for some time. Erasmus MC, for instance, announced in early 2019 that CardioMEMS will be reimbursed in the basic health insurance package for study participants. Brugts reported then, "By actively monitoring the patient, the cardiologist knows whether a change of medication is needed, for example. We expect to be able to drastically reduce the number of hospital admissions."
Earlier intervention
Remote monitoring allows cardiologists to intervene earlier. This can prevent symptoms of heart failure and possible hospitalisation. In the study, the number of hospital admissions decreased by 44% over a period of 1.8 years. At the same time, the quality of life of patients who used the monitoring system improved.
Brugts: "The cardiologist can intervene in time instead of reacting passively to complaints such as fluid accumulation and tightness of the chest. Then it's actually already too late and an admission can no longer be prevented."
Centring care at home
Prof Dr Rudolf de Boer, head of the department of cardiology at Erasmus MC, is also involved in the study. De Boer: "With additional monitoring, you centre the care around the patient at home instead of in the hospital. This is important for the care of the future and fits perfectly into the Integral Care Agreement, for example. We will roll this out in the region."
The sensor only provides information, Brugts stresses. Adjusting treatment based on the information provided is up to the doctor. Is a patient retaining too much fluid? Then a doctor can prescribe urinary tablets. On the contrary, does a patient retain too little fluid? Then the doctor reduces the number of urinary tablets.
'No news is good news'
Brugts: "Patients do not have to keep travelling to the hospital for check-up appointments and admissions. This is important to patients and increases their quality of life. The patient experiences it as safe and familiar when the doctor keeps an eye on him or her, which is true. In this respect, no news is good news, we only intervene when necessary. And so then we are also on time."
Further information on the study is available in The Lancet, where the researchers have published their findings.
Author: Wouter Hoeffnagel
Source photo: orzalaga via Pixabay
