Left Atrial Pressure Monitoring With an Implantable Wireless Pressure Sensor After Implantation of a Left Ventricular Assist Device.
After implantation of a continuous-flow left ventricular assist device (LVAD), left atrial pressure (LAP) monitoring allows for the precise management of intravascular volume, inotropic therapy, and pump speed. In this case series of 4 LVAD recipients, we report the first clinical use of this wireless pressure sensor for the long-term monitoring of LAP during LVAD support. A wireless microelectromechanical system pressure sensor (Titan, ISS Inc., Ypsilanti, MI) was placed in the left atrium in four patients at the time of LVAD implantation. Titan sensor LAP was measured in all four patients on the intensive care unit and in three patients at home. Ramped speed tests were performed using LAP and echocardiography in three patients. The left ventricular end-diastolic diameter (cm), flow (L/min), power consumption (W), and blood pressure (mm Hg) were measured at each step. Measurements were performed over 36, 84, 137, and 180 days, respectively. The three discharged patients had equipment at home and were able to perform daily recordings. There were significant correlations between sensor pressure and pump speed, LV and LA size and pulmonary capillary wedge pressure, respectively (r = 0.92-0.99, p < 0.05). There was no device failure, and there were no adverse consequences of its use.
From the *Departments of Cardiology and Medicine and Health Sciences, Linkoping University, Linkoping, Sweden; †Departments of Clinical Physiology and Medicine and Health Sciences, Linkoping University, Linkoping, Sweden; and ‡Departments of Thoracic and Vascular Surgery and Medicine and Health Sciences, Linkoping University, Linkoping, Sweden.
Laila
L
Hubbert
Jacek
J
Baranowski
Baz
B
Delshad
Henrik
H
Ahn
D000328:Adult; D016279:Atrial Function, Left; D062185:Atrial Pressure / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*
N Engl J Med. 2009 Dec 3;361(23):2241-51
19920051
Circulation. 2012 Aug 14;126(7):866-74
22891167
J Heart Lung Transplant. 2013 Jul;32(7):675-83
23796152
J Heart Lung Transplant. 2012 Jul;31(7):729-34
22425235
ASAIO J. 2012 Jan-Feb;58(1):83-7
22210654
J Am Coll Cardiol. 2009 Jul 21;54(4):312-21
19608028
J Am Coll Cardiol. 2012 Oct 30;60(18):1764-75
23040584
J Heart Lung Transplant. 2009 Apr;28(4):352-9
19332262
Crit Care Med. 2014 Jan;42(1):158-68
24240731
J Heart Lung Transplant. 2015 Oct;34(10):1292-304
26111595
Biomed Microdevices. 2004 Mar;6(1):61-5
15307446
J Heart Lung Transplant. 2007 Aug;26(8):815-8
17692785