This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Steinhaus, D. M. Articles by Levine, R. Search for Related Content PubMed PubMed Citation Articles by Steinhaus, D. M. Articles by Levine, R. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB OXYGEN

(Circulation. 1996;93:745-752.)
© 1996 American Heart Association, Inc.

Articles

Initial Experience With an Implantable Hemodynamic Monitor

David M. Steinhaus, MD; Robert Lemery, MD; Dennis R. Bresnahan, Jr, MD; Larry Handlin, DO; Tom Bennett, PhD; Alan Moore, PhD; Debbie Cardinal, RN; Laura Foley, RN; Richard Levine

From the Department of Cardiology (D.M.S., R.L., D.R.B., Jr, L.H., D.C., L.F., R.L.), Mid America Heart Institute, University of Missouri-Kansas City School of Medicine; and Medtronic, Inc (A.M., T.B.), Minneapolis, Minn.

Background Measurement of intracardiac hemodynamic parameters has been limited to brief periods in the acute care setting. We developed and evaluated an implantable hemodynamic monitor that is capable of measuring chronic right ventricular oxygen saturation and pulmonary artery pressure.

Methods and Results The device consists of an electronic controller placed subcutaneously and two transvenous leads placed in the right ventricle (reflectance oximeter) and pulmonary artery (variable capacitance pressure sensor). Implantation was performed in 10 patients with severe left ventricular dysfunction. Average implant pulmonary artery pressures were systolic, 52±16 mm Hg; diastolic, 29±11 mm Hg; and mean, 40±12 mm Hg. The mean right ventricular oxygen saturation at implant was 51%. Provocative maneuvers, including postural changes, sublingual nitroglycerin, and bicycle exercise, demonstrated expected changes in measured oxygen saturation and pulmonary artery pressures over time. At follow-up of 0.5 to 15.5 months, there were no significant differences between pulmonary artery pressures or oxygen saturation values transmitted from the device and simultaneous measurement with balloon flotation catheters. Four of the pulmonary artery leads dislodged and three demonstrated sensor drift, whereas two of the oxygen saturation sensors failed. Four patients died and four received transplants. Pathological study did not demonstrate injury to the right ventricular outflow tract or pulmonic valve.

Conclusions Chronic measurement of hemodynamic parameters in the outpatient setting with implantable sensor technology appears to be feasible. The devices are well tolerated without significant untoward effects, and the sensors generally function well over time, providing reliable information. Clinical usefulness remains to be established.

Key Words: monitors, hemodynamic • heart failure • devices, implantable

This article has been cited by other articles:

				M. R. Zile, T. D. Bennett, M. St. John Sutton, Y. K. Cho, P. B. Adamson, M. F. Aaron, J. M. Aranda Jr, W. T. Abraham, F. W. Smart, L. W. Stevenson, et al. Transition From Chronic Compensated to Acute Decompensated Heart Failure: Pathophysiological Insights Obtained From Continuous Monitoring of Intracardiac Pressures Circulation, September 30, 2008; 118(14): 1433 - 1441. [Abstract] [Full Text] [PDF]

				R. C. Bourge, W. T. Abraham, P. B. Adamson, M. F. Aaron, J. M. Aranda Jr, A. Magalski, M. R. Zile, A. L. Smith, F. W. Smart, M. A. O'Shaughnessy, et al. Randomized controlled trial of an implantable continuous hemodynamic monitor in patients with advanced heart failure: the COMPASS-HF study. J. Am. Coll. Cardiol., March 18, 2008; 51(11): 1073 - 1079. [Abstract] [Full Text] [PDF]

				T. M. Wadas The Implantable Hemodynamic Monitoring System Crit. Care Nurse, October 1, 2005; 25(5): 14 - 26. [Full Text] [PDF]

				P. B. Adamson, A. Magalski, F. Braunschweig, M. Bohm, D. Reynolds, D. Steinhaus, A. Luby, C. Linde, L. Ryden, B. Cremers, et al. Ongoing right ventricular hemodynamics in heart failure: clinical value of measurements derived from an implantable monitoring system J. Am. Coll. Cardiol., February 19, 2003; 41(4): 565 - 571. [Abstract] [Full Text] [PDF]

				F. Braunschweig, C. Linde, M.J. Eriksson, C. Hofman-Bang, and L. Ryden Continous haemodynamic monitoring during withdrawal of diuretics in patients with congestive heart failure Eur. Heart J., January 1, 2002; 23(1): 59 - 69. [Abstract] [Full Text] [PDF]

				A Ohlsson, S.H Kubo, D Steinhaus, D.T Connelly, S Adler, C Bitkover, R Nordlander, L Ryden, and T Bennett Continuous ambulatory monitoring of absolute right ventricular pressure and mixed venous oxygen saturation in patients with heart failure using an implantable haemodynamic monitor: results of a 1 year multicentre feasibility study Eur. Heart J., June 1, 2001; 22(11): 942 - 954. [Abstract] [PDF]

				M. H. Gollob and J. J. Seger Current Status of the Implantable Cardioverter-Defibrillator Chest, April 1, 2001; 119(4): 1210 - 1221. [Abstract] [Full Text] [PDF]