Effectiveness and Safety Profile of Remote Pulmonary Artery Hemodynamic Monitoring in a “Real-World” Veterans Affairs Healthcare System

Published:September 29, 2022DOI:
      Ambulatory hemodynamic monitoring has demonstrated the ability to reduce heart failure-related hospitalization, regardless of left ventricular ejection fraction; however, real-world data in a Veterans Affairs patient population are limited. The present study retrospectively reviewed 53 patients with New York Heart Association class III heart failure, regardless of left ventricular ejection fraction, implanted with a pulmonary artery pressure sensor (CardioMEMS) at our single Veterans Affairs institution. Heart failure-related hospitalizations were assessed in patients for 6 and 12 months after the implantation of the device and compared with the 6- and 12- month periods before implantation in the same patient cohort. Pulmonary arterial pressures and medication doses were also recorded at baseline, 6- months, and 12- months and procedural safety data were also assessed. Implantation of a remote pulmonary artery pressure sensor was associated with a 52% (95% confidence interval 30% to 68%, p <0.001) and a 44% (95% confidence interval 24% to 59%, p <0.001) reduction in heart failure-related hospitalization at 6 and 12 months after implant, respectively, compared with the 6- and 12-month preimplant periods. Mean pulmonary arterial pressures also demonstrated significant reductions from baseline to 6 and 12 months after implant. A total of 3 procedure-related adverse events were noted. In conclusion, pulmonary artery pressure sensor implantation is relatively safe and associated with significant reductions in heart failure-related hospitalization and decreased mean pulmonary artery pressures in patients within the Veterans Affairs system with New York Heart Association class III symptoms, regardless of ejection fraction.
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        • Groeneveld PW
        • Medvedeva EL
        • Walker L
        • Segal AG
        • Richardson DM
        • Epstein AJ.
        Outcomes of care for ischemic heart disease and chronic heart failure in the Veterans Health Administration.
        JAMA Cardiol. 2018; 3: 563-571
        • Parizo JT
        • Kohsaka S
        • Sandhu AT
        • Patel J
        • Heidenreich PA.
        Trends in readmission and mortality rates following heart failure hospitalization in the Veterans Affairs Health Care System from 2007 to 2017.
        JAMA Cardiol. 2020; 5: 1042-1047
        • Department of Veterans Affairs, Veterans Health Administration
        2012 VHA facility quality and safety report.
        2022 (Available at:) (Accessed on June 2)
        • Filyo L
        • Hansen K
        • Khazan E
        • Wolf L
        • Milunski M
        • Ingram S.
        Reducing heart failure readmissions through a shared medical appointment.
        J Card Fail. 2020; 26: S6
        • Ogunwole SM
        • Phillips J
        • Gossett A
        • Downs JR.
        Putting veterans with heart failure first improves follow-up and reduces readmissions.
        BMJ Open Qual. 2019; 8e000386
        • Abraham WT
        • Adamson PB
        • Bourge RC
        • Aaron MF
        • Costanzo MR
        • Stevenson LW
        • Strickland W
        • Neelagaru S
        • Raval N
        • Krueger S
        • Weiner S
        • Shavelle D
        • Jeffries B
        • Yadav JS
        • CHAMPION Trial Study Group
        Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial.
        Lancet. 2011; 377 (Published correction appears in Lancet. 2012;379:412): 658-666
        • Alam A
        • Jermyn R
        • Mastoris I
        • Steinkamp L
        • Bhimaraj A
        • Sauer AJ.
        Ambulatory factors influencing pulmonary artery pressure waveforms and implications for clinical practice.
        Heart Fail Rev. 2022;
        • Costanzo MR
        • Stevenson LW
        • Adamson PB
        • Desai AS
        • Heywood JT
        • Bourge RC
        • Bauman J
        • Abraham WT.
        Interventions linked to decreased heart failure hospitalizations during ambulatory pulmonary artery pressure monitoring.
        JACC Heart Fail. 2016; 4: 333-344
        • Desai AS
        • Bhimaraj A
        • Bharmi R
        • Jermyn R
        • Bhatt K
        • Shavelle D
        • Redfield MM
        • Hull R
        • Pelzel J
        • Davis K
        • Dalal N
        • Adamson PB
        • Heywood JT.
        Ambulatory hemodynamic monitoring reduces heart failure hospitalizations in “real-world” clinical practice.
        J Am Coll Cardiol. 2017; 69: 2357-2365
        • Shavelle DM
        • Desai AS
        • Abraham WT
        • Bourge RC
        • Raval N
        • Rathman LD
        • Heywood JT
        • Jermyn RA
        • Pelzel J
        • Jonsson OT
        • Costanzo MR
        • Henderson JD
        • Brett ME
        • Adamson PB
        • Stevenson LW
        CardioMEMS Post-Approval Study Investigators. Lower rates of heart failure and all-cause hospitalizations during pulmonary artery pressure-guided therapy for ambulatory heart failure: one-year outcomes from the CardioMEMS post-approval study.
        Circ Heart Fail. 2020; 13e006863
        • Anand IS
        • Carson P
        • Galle E
        • Song R
        • Boehmer J
        • Ghali JK
        • Jaski B
        • Lindenfeld J
        • O'Connor C
        • Steinberg JS
        • Leigh J
        • Yong P
        • Kosorok MR
        • Feldman AM
        • DeMets D
        • Bristow MR
        Cardiac resynchronization therapy reduces the risk of hospitalizations in patients with advanced heart failure: results from the Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure (COMPANION) trial.
        Circulation. 2009; 119: 969-977
        • Tang AS
        • Wells GA
        • Talajic M
        • MO Arnold
        • Sheldon R
        • Connolly S
        • Hohnloser SH
        • Nichol G
        • Birnie DH
        • Sapp JL
        • Yee R
        • Healey JS
        • Rouleau JL
        Resynchronization-Defibrillation for Ambulatory Heart Failure Trial Investigators. Cardiac-resynchronization therapy for mild-to-moderate heart failure.
        N Engl J Med. 2010; 363: 2385-2395
        • Lindenfeld J
        • Zile MR
        • Desai AS
        • Bhatt K
        • Ducharme A
        • Horstmanshof D
        • Krim SR
        • Maisel A
        • Mehra MR
        • Paul S
        • Sears SF
        • Sauer AJ
        • Smart F
        • Zughaib M
        • Castaneda P
        • Kelly J
        • Johnson N
        • Sood P
        • Ginn G
        • Henderson J
        • Adamson PB
        • Costanzo MR.
        Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial.
        Lancet. 2021; 398: 991-1001
        • Cannatà A
        • Bromage DI
        • Rind IA
        • Gregorio C
        • Bannister C
        • Albarjas M
        • Piper S
        • Shah AM
        • McDonagh TA.
        Temporal trends in decompensated heart failure and outcomes during COVID-19: a multisite report from heart failure referral centres in London.
        Eur J Heart Fail. 2020; 22: 2219-2224
      1. National Center for Veterans Analysis and Statistics. Veteran Population. Available at: Accessed on August 10, 2022.

        • Bahrami H
        • Kronmal R
        • Bluemke DA
        • Olson J
        • Shea S
        • Liu K
        • Burke GL
        • Lima JAC.
        Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis.
        Arch Intern Med. 2008; 168: 2138-2145
        • Rea F
        • Iorio A
        • Barbati G
        • Bessi R
        • Castrichini M
        • Nuzzi V
        • Scagnetto A
        • Senni M
        • Corrao G
        • Sinagra G
        • Di Lenarda A.
        Patient adherence to drug treatment in a community based-sample of patients with chronic heart failure.
        Int J Cardiol. 2022; 349: 144-149