Direct Left Atrial Pressure Monitoring in Severe Heart Failure: Long-Term Sensor Performance

被引：59

作者：

Troughton, Richard W. ^{[1
,2
]}

Ritzema, Jay ^{[2
]}

Eigler, Neal L. ^{[5
]}

Melton, Iain C. ^{[2
]}

Krum, Henry ^{[3
]}

Adamson, Philip B. ^{[4
]}

Kar, Saibal ^{[5
]}

Shah, Prediman K. ^{[5
]}

Whiting, James S. ^{[5
]}

Heywood, J. Thomas ^{[6
]}

Rosero, Spencer ^{[7
]}

Singh, Jagmeet P. ^{[9
]}

Saxon, Leslie ^{[8
]}

Matthews, Ray ^{[8
]}

Crozier, Ian G. ^{[2
]}

Abraham, William T. ^{[10
]}

机构：

[1] Univ Otago, Dept Med, Christchurch 8140, New Zealand

[2] Christchurch Hosp, Dept Cardiol, Christchurch, New Zealand

[3] Alfred Hosp, Melbourne, Australia

[4] Oklahoma Cardiovasc Res Grp, Oklahoma City, OK USA

[5] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA

[6] Scripps Hosp, La Jolla, CA USA

[7] Univ Rochester, Rochester, NY USA

[8] Univ So Calif, Los Angeles, CA USA

[9] Massachusetts Gen Hosp, Boston, MA 02114 USA

[10] Ohio State Univ, Columbus, OH 43210 USA

来源：

JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH | 2011年 / 4卷 / 01期

关键词：

Heart failure; Hemodynamics; Implantable devices; HEMODYNAMIC MONITOR; WEDGE;

D O I：

10.1007/s12265-010-9229-z

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We report the stability, accuracy, and development history of a new left atrial pressure (LAP) sensing system in ambulatory heart failure (HF) patients. A total of 84 patients with advanced HF underwent percutaneous transseptal implantation of the pressure sensor. Quarterly noninvasive calibration by modified Valsalva maneuver was achieved in all patients, and 96.5% of calibration sessions were successful with a reproducibility of 1.2 mmHg. Absolute sensor drift was maximal after 3 months at 4.7 mmHg (95% CI, 3.2-6.2 mmHg) and remained stable through 48 months. LAP was highly correlated with simultaneous pulmonary wedge pressure at 3 and 12 months (r = 0.98, average difference of 0.8 +/- 4.0 mmHg). Freedom from device failure was 95% (n = 37) at 2 years and 88% (n = 12) at 4 years. Causes of failure were identified and mitigated with 100% freedom from device failure and less severe anomalies in the last 41 consecutive patients (p = 0.005). Accurate and reliable LAP measurement using a chronic implanted monitoring system is safe and feasible in patients with advanced heart failure.

引用

页码：3 / 13

页数：11

共 21 条

[1] Ongoing right ventricular hemodynarnics in heart failure -: Clinical value of measurements derived from an implantable monitoring system [J].

Adamson, PB ;

Magalski, A ;

Braunschweig, F ;

Böhm, M ;

Reynolds, D ;

Steinhaus, D ;

Luby, A ;

Linde, C ;

Ryden, L ;

Cremers, B ;

Takle, T ;

Bennett, T .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 41 (04) :565-571

[2] Reducing events in patients with chronic heart failure (REDUCEhf) study design:: Continuous Hemodynamic monitoring with an Implantable defibrillator [J].

Adamson, Philip B. ;

Conti, Jamie B. ;

Smith, Andrew L. ;

Abraham, William T. ;

Aaron, Mark F. ;

Aranda, Juan M., Jr. ;

Baker, James ;

Bourge, Robert C. ;

Warner-Stevenson, Lynne ;

Sparks, Brandon .

CLINICAL CARDIOLOGY, 2007, 30 (11) :567-575

[3] Development of implantable devices for continuous ambulatory monitoring of central hemodynamic values in heart failure patients [J].

Bennett, T ;

Kjellstrom, B ;

Taepke, R ;

Ryden, L .

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 2005, 28 (06) :573-584

[4] Randomized controlled trial of an implantable continuous hemodynamic monitor in patients with advanced heart failure - The COMPASS-HF study [J].

Bourge, Robert C. ;

Abraham, William T. ;

Adamson, Philip B. ;

Aaron, Mark F. ;

Aranda, Juan M., Jr. ;

Magalski, Anthony ;

Zile, Michael R. ;

Smith, Andrew L. ;

Smart, Frank W. ;

O'Shaughnessy, Mark A. ;

Jessup, Mariell L. ;

Sparks, Brandon ;

Naftel, David L. ;

Stevenson, Lynne Warner .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2008, 51 (11) :1073-1079

[5] Relationship between right and left-sided filling pressures in 1000 patients with advanced heart failure [J].

Drazner, MH ;

Hamilton, MA ;

Fonarow, G ;

Creaser, J ;

Flavell, C ;

Stevenson, LW .

JOURNAL OF HEART AND LUNG TRANSPLANTATION, 1999, 18 (11) :1126-1132

[6] EFFECT OF ELEVATED LEFT ATRIAL PRESSURE AND DECREASED PLASMA PROTEIN CONCENTRATION ON THE DEVELOPMENT OF PULMONARY EDEMA [J].

GUYTON, AC ;

LINDSEY, AW .

CIRCULATION RESEARCH, 1959, 7 (04) :649-657

[7] Pulmonary capillary wedge pressure in mitral stenosis accurately reflects mean left atrial pressure but overestimates transmitral gradient [J].

Hildick-Smith, DJR ;

Walsh, JT ;

Shapiro, LM .

AMERICAN JOURNAL OF CARDIOLOGY, 2000, 85 (04) :512-515

[8] EVALUATION OF PULMONARY ARTERIAL END-DIASTOLIC PRESSURE AS AN INDIRECT ESTIMATE OF LEFT ATRIAL MEAN PRESSURE [J].

JENKINS, BS ;

BRADLEY, RD ;

BRANTHWAITE, MA .

CIRCULATION, 1970, 42 (01) :75-+

[9]

LOZMAN J, 1974, ARCH SURG-CHICAGO, V109, P270

[10] Continuous ambulatory right heart pressure measurements with an implantable hemodynamic monitor:: A multicenter, 12-month follow-up study of patients with chronic heart failure [J].

Magalski, A ;

Adamson, P ;

Gadler, F ;

Böehm, M ;

Steinhaus, D ;

Reynolds, D ;

Vlach, K ;

Linde, C ;

Cremers, B ;

Sparks, B ;

Bennett, T .

JOURNAL OF CARDIAC FAILURE, 2002, 8 (02) :63-70

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