CardioMEMS Device

Name the Device • Xray of the Week

Routine CXR for cough demonstrates metallic device. Name the cardiac implant.

Fig. 1. The circled device is a CardioMEMS HF System used to measure and monitor pulmonary artery (PA) pressure and heart rate. The patient also has a biventricular pacemaker. (Image courtesy of Mark Beller, MD.)

Fig. 2 Video Explaining percutaneous placement technique for the CardioMEMS.

Fig 3. The CardioMEMS HF System. A. Implantable monitoring device. B. RemoteCare external electronics unit.

The CardioMEMS™ HF System is indicated for wirelessly measuring and monitoring pulmonary artery (PA) pressure and heart rate in New York Heart Association (NYHA) Class III heart failure patients who have been hospitalized for heart failure in the previous year. Using a percutaneous approach (Fig. 2), the sensor (Fig. 3A) is implanted in the pulmonary artery. Once the device is implanted, daily pressure readings are obtained with the external electronics unit (Fig. 3B) and wirelessly transmitted to the patient's physician for continuous monitoring.

Fig 4. Magnified views of the CXR and CT Scan of a second patient with the CardioMEMS HF System in the right lower lobe pulmonary artery.

References:

1. Abbott CardioMEMS Website

2. Chaudhry SI, Mattera JA, CurtisJP, et al., (2010). Telemonitoring in patients with heart failure. NEJM, 363(24), 2301-2309. http://dx.doi.org/10.1056/NEJMoa1010029

3. Kohler F, Winker S, Schieber M, et al. (2010, November). Telemedical interventional monitoring in heart failure (TIM-HF), a randomized, controlled, intervention trial investigating the impact of telemedicine on mortality in ambulatory patients with chronic heart failure. Presented at the meeting of the American Heart Association, Chicago, IL. http://dx.doi.org/10.1161/CIR.0b013e318200c0b5

4. van Veldhuisen DJ, Braunschweig F, Conraads V, et al, for the DOT-HF Investigators. (2011). Intrathoracic impedance monitoring, audible patient alerts, and outcome in patients with heart failure. Circulation, 124(16), 1719-1726. http://dx.doi.org/10.1161/circulationaha.111.043042

5. Adamson PB, Abraham WT, Bourge RC, et al. (2014). Wireless pulmonary artery pressure monitoring guides management to reduce decompensation in heart failure with preserved ejection fraction.Circulation: Heart Failure, 7(6), 935- 944. http://dx.doi.org/10.1161/circheartfailure.113.001229

6. Abraham WT, Stevenson L, Bourge RC, et al. (2016). Sustained efficacy of pulmonary artery pressure to guide to adjustment of chronic heart failure therapy: Complete follow-up results from the CHAMPION randomized trial. The Lancet, 387(10017), 453-461. http://dx.doi.org/10.1016/S0140-6736(15)007233-0

7. Adamson PB, Abraham WT, Bourge RC, et al. (2010). CardioMEMS heart sensor allows monitoring of pressures to improve outcomes in NYHA class III heart failure patients (CHAMPION) Trial: Impact of hemodynamic guided care on patients with preserved ejection fraction. Journal of Cardiac Failure, 16(11), 913. http://dx.doi.org/10.1016/j.cardfail.2010.09.012

8. Weiner S, Abraham WT, Adamson PB, et al. (2011). Effect of CRT on heart failure related hospitalizations in patients with reduced EF utilizing remote pulmonary artery pressures in the CHAMPION Trial. Heart Rhythm, 8(5S), S437. http://dx.doi.org/10.1016/j.hrthm.2011.03.033

9. Conyers JM, Rajiah P, Ahn R, Abbara S, et al. Imaging features of leadless cardiovascular devices. Diagn Interv Radiol. 2018 Jul; 24(4): 203–208. doi: 10.5152/dir.2018.17462

10. How to Implant the CardioMEMS Heart Failure SensorA step-by-step review of the sensor implantation procedure, including pre- and postprocedural assessment.By David M. Shavelle, MD, FACC, FSCAI. https://citoday.com/2018/02/how-to-implant-the-cardiomems-heart-failure-sensor/

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Kevin M. Rice, MD is the president of Global Radiology CME

Dr. Rice serves as the Chair of the Radiology Department of Valley Presbyterian Hospital in Los Angeles, California and is a radiologist with Renaissance Imaging Medical Associates. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015, Dr. Rice and Natalie Rice founded Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field.

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