title: [Implantable hemodynamic monitoring devices].
abstract: Heart failure is one of the most frequent diagnoses in hospital admissions in Germany. In the majority of these admissions acute decompensation of an already existing chronic heart failure is responsible. New mostly wireless and remote strategies for monitoring, titration, adaptation and optimization are the focus for improvement of the treatment of heart failure patients and the poor prognosis. The implantation of hemodynamic monitoring devices follows the hypothesis that significant changes in hemodynamic parameters occur before the occurrence of acute decompensation requiring readmission. Three different hemodynamic monitoring devices have so far been investigated in clinical trials employing right ventricular pressure, left atrial pressure and pulmonary artery pressure monitoring. Only one of these systems, the CardioMENS™ HF monitoring system, demonstrated a significant reduction of hospitalization due to heart failure over 6 months in the CHAMPION trial. The systematic adaptation of medication in the CHAMPION trial significantly differed from the usual care of the control arm over 6 months. This direct day to day management of diuretics is currently under intensive investigation; however, further studies demonstrating a positive effect on mortality are needed before translation of this approach into guidelines. Without this evidence a further implementation of pressure monitoring into currently used devices and justification of the substantial technical and personnel demands are not warranted.
authors.affiliation: Abteilung für Kardiologie, Herzzentrum Brandenburg und Immanuel Klinikum Bernau, Ladeburger Str. 17, 16321, Bernau bei Berlin, Deutschland. m.seifert@immanuel.de.
authors.forename: M
authors.initials: M
authors.lastname: Seifert
authors.affiliation: Abteilung für Kardiologie, Herzzentrum Brandenburg und Immanuel Klinikum Bernau, Ladeburger Str. 17, 16321, Bernau bei Berlin, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Butter
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation* / Q000379:methods*; D002908:Chronic Disease; D004867:Equipment Design; D019544:Equipment Failure Analysis; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D006801:Humans; D013673:Technology Assessment, Biomedical; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control
keywords: Heart decompensation; Heart failure; Hemodynamics; Hospitalization; Monitoring devices