An implantable sensor reduced the rate of hospitalization for HF, but the difference in out-of-hospital time was slight.
Intense interest surrounds the development of implantable hemodynamic monitoring systems, designed to improve outcomes and reduce hospitalization rates in patients with heart failure (HF) by enabling management of derangements in physiologic parameters before they become clinically apparent. In a manufacturer-sponsored trial, researchers tested the effects of the Champion heart sensor on HF-related hospitalizations. Eligible patients had New York Heart Association class III HF of 3 months’ duration and a hospitalization for HF within the past year. A wireless pulmonary artery sensor was placed in all patients. Sensor data were available only to physicians caring for patients randomized to treatment; control patients received usual care.
About one third of the 550 participants (average age, 61; approximately 70% men) had a cardiac resynchronization therapy device. At 6 months, the rate of HF-related hospitalizations was significantly lower in the treatment group than in the control group (31% vs. 43%; P<0.001). The number of days alive outside the hospital was similar in the two groups (174 vs. 172), although the difference was statistically significant (P=0.02). During a total mean follow-up of 15 months, 15 sensor- or procedure-related complications occurred.
Comment: Despite the demonstrated benefit of this device with regard to HF-related hospitalization, the total number of days alive outside the hospital was not much different in the two groups, which may dampen the enthusiasm for this technology. All hospitalizations, not just those related to HF, constitute the endpoint of greatest interest to patients and policymakers.
— Harlan M. Krumholz, MD, SM
Dr. William T. Abraham, the senior author of this study and a founder of the sponsoring manufacturer, is a Contributing Editor for Journal Watch Cardiology. Dr. Abraham had no role in the selection of this article for summarization or in its review.
Published in Journal Watch Cardiology March 9, 2011