Ongoing right ventricular hemodynamics in XXXX : clinical value of measurements derived from an implantable monitoring system.

@entity1 @entity712 @entity1284
OBJECTIVES: This study examined the characteristics of continuously measured right ventricular (RV) hemodynamic information derived from an implantable hemodynamic monitor (IHM) in @entity712 @entity1 . BACKGROUND: Hemodynamic monitoring might improve the day-to-day management of @entity1 with @entity712 ( @entity712 ). Little is known about the characteristics of long-term hemodynamic information in @entity1 with @entity712 or how such information relates to meaningful clinical events. METHODS: Thirty-two @entity1 with @entity712 received a permanent RV IHM system similar to a single-lead pacemaker. Right ventricular systolic and diastolic pressures, heart rate, and pressure derivatives were continuously measured for nine months without using the data for clinical decision-making or management of @entity1 . Data were then made available to clinical providers, and the @entity1 were followed up for 17 months. Pressure characteristics during optimal volume, clinically determined @entity1284 exacerbations, and volume depletion events were examined. The effect of IHM on hospitalizations was examined using the @entity1 ' historical controls. RESULTS: Long-term RV pressure measurements had either marked variability or minimal time-related changes. During 36 @entity1284 events, RV systolic pressures increased by 25 +/- 4% (p < 0.05) and heart rate increased by 11 +/- 2% (p < 0.05). Pressure increases occurred in 9 of 12 events 4 +/- 2 days before the exacerbations requiring hospitalization. Hospitalizations before using IHM data for clinical management averaged 1.08 per @entity1 year and decreased to 0.47 per @entity1 -year (57% reduction, p < 0.01) after hemodynamic data were used. CONCLUSIONS: Long-term ambulatory pressure measurements from an IHM may be helpful in guiding day-to-day clinical management, with a potentially favorable impact on @entity712 hospitalizations.
