CardioMEMS™ is the first and only FDA-approved heart failure monitoring solution that provides physicians with vital real-time measurements from inside a person’s body.
CardioMEMS consists of a small sensor that is permanently implanted into a person’s pulmonary artery via a catheter during a minimally-invasive procedure. Once in place, it provides real-time, on-demand access to data like pulmonary artery pressure and heart rate that allows physicians to more effectively manage patients with heart failure.
Patients use a wireless electronics system to transmit the data to a secure website, which can be accessed remotely in a doctor’s office. With access to this data, physicians can make time-sensitive treatment decisions that can help keep patients out of the hospital. In trials, the use of CardioMEMS reduced hospital admissions for heart failure patients by 37 percent.
Paul A Luetmer MD, FACC is here to discuss CardioMEMS™.
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CardioMEMS™ Heart Failure Monitoring Solution
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Learn more about Dr. Luetmer
Paul A Luetmer MD, FACC – Cardiology Aspirus Heart & Vascular
In 1997, Dr. Luetmer relocated from Vermont to join Aspirus Cardiology. He enjoys skiing, biking, hiking, swimming and reading in his free time.Learn more about Dr. Luetmer
Transcription:
CardioMEMS™ Heart Failure Monitoring Solution
Melanie Cole (Host): CardioMEMS is the first and only FDA-approved heart failure monitoring solution that provides physicians with vital, real-time measurements from inside a person’s body. My guest today is Dr. Paul Leutmer. He’s a cardiologist with Aspirus Health. Welcome to the show, Dr. Leutmer. First, start by telling the listeners a little bit about heart failure. What is it? How does it differ from other forms of heart disease?
Dr. Paul Leutmer (Guest): Well, heart failure is not just one disease, but it’s a clinical syndrome in which the person’s heart can’t keep up with the workload that’s demanded of it. And that can happen for many number of things, from diseases of the heart muscle, of the heart valves, or maybe, heart attacks. But the end result is the heart can’t keep up with the needs. And what the patient feels is shortness of breath, weakness, can’t do their daily activities. Their legs may start to swell, and they may lose their appetite, start to lose their muscle mass over time. So it affects, really, every activity of the body because it all depends on the circulation provided by the heart.
Melanie: Typically, what sort of treatments? Is this a chronic condition, something that a person can live with for a little while?
Dr. Leutmer: Yes. People often think when they’re told they have heart failure that they’re going to die immediately. But people live for many years with heart failure. Typically, the symptoms of shortness of breath and leg swelling are due to retention of fluid, which the body does when there is not adequate circulation. The body thinks that it’s not having adequate circulation because there’s not enough fluid for the heart to circulate, so the kidneys respond by retaining fluid instead of excreting it urine. It’s this excess fluid that leads too much of the symptoms, and that’s treated with diuretics. It’s water pills that make you excrete more fluid in your urine. Patients can also have symptoms of weakness and shortness of breath, and those can be helped with medications that help give the heart an easier job to do.
Melanie: So up until recently, if somebody has heart failure, they’re living with heart failure, they’re on medications, they’re keeping in touch with their physician, how do you monitor what’s going on with their heart failure at any given time in the day?
Dr. Leutmer: Well this has been a very difficult problem over the years in trying to monitor heart failure. Typically, we try to use patients’ weight, but as you might imagine, weight is more than the amount of fluid in your body, and it can vary by several pounds a day, even with no change in the amount of fluid present. So it’s a very rough, inaccurate thing to try to follow. We also follow with patient symptoms. But again, this is an inaccurate measure and can be related to a lot of other things. Your symptoms may be worse just because you’re overtired or something else changed that may not be directly their heart failure. So, one of the problems we’ve struggled with is to know exactly what is the status of their heart failure? Do they have too much fluid? Do they have too little fluid? And we need to find this very exact balance because these people can adapt to the fluctuations that the body normally encounters in day-to-day life. So, finding the right thing to monitor has been difficult.
Melanie: So now, what are you doing now that is so exciting that can help predict an impending crisis before it happens?
Dr. Leutmer: Well, the best measurement to know has always been what are the pressures inside the pulmonary arteries of the lungs, and the only way we could measure that in the past -- we can’t put a blood pressure cuff on the lungs to see what the pressure in the lungs might be, like what we do on the arm to see what the blood pressure in the rest of the body is. The only we way could measure that pressure was to put a catheter—that is, a tube—up through the heart, up into the lungs to measure that. That’s something that can be done in the hospital and can be left in place for a few days but certainly not something we could monitor at home over a long period of time. Now, with a cardioMEMS device, we can actually implant this device in the artery, in the lung, in the pulmonary artery, and it stays there permanently. And anytime we need a measurement, which is usually done every morning when the patient first gets up, they can lie on this special pillow that generates an electromagnetic field that powers up this device, which can then give pressure measurement reading which is then transmitted wirelessly to our resource center, and we can look up on the computer and see what the pressure is and see how it changes over time.
Melanie: That is really amazing. What’s the implantation situation like? What’s the procedure? Is it simple?
Dr. Leutmer: It’s quite straightforward. We do what’s called a right heart catheterization. That’s when we put this tube through the vein through the right side of the heart, which pumps blood through the lungs and out into the pulmonary artery. That’s a routine procedure that’s been around for 30 or 40 years. When we put that catheter into the lungs, we can then deposit this device, which is clipped to the side of the catheter and we just release it. The device has a little metal loop on it, very springy, soft metal that then can pop open and hold the device in the center of the pulmonary artery. It’s about a half-an-hour procedure to put this device in place, and then we make measurements to calibrate so that we know that this thing is giving us the accurate readings. So the actual time in the cath lab is only about a half an hour.
Melanie: And how long can this device stay in? Does it wear out like a pacemaker—every 10 years or so it needs to be replaced?
Dr. Leutmer: Well, I think this is an amazing piece of technology. It actually has no internal power source. It stays there permanently. It never comes out. And these have been in place in patients that had them placed for the research trials for quite a few years now, and they don’t really wear out. They’re just a solid-state electronic device, and when we need to get a reading from it and the patient lies on this pillow, the power source is within this pillow that generates an electromagnetic field that induces a current in the device. So there’s no battery or any wiring that needs to be replaced.
Melanie: And what about hospitalization? Does this help keep patients out of the hospital? Does it alert you quick enough if they need to be hospitalized? Where does that come in?
Dr. Leutmer: Well, one of the big concerns with congestive heart failure is the need for people to be admitted to the hospital over and over again. And over half the money spent on caring for heart failure is spent on these hospital admissions. So a big goal has been to reduce the number of hospital admissions, and in fact this device and the research trials have been shown to reduce hospital readmissions by 37 percent, which will be a huge savings for the healthcare system and a great benefit on the quality of life for patients who are at home and doing things rather than being in the hospital, being sick. What the device does is it gives us about a four-week warning that the patient is starting to have trouble. So, long before we see a change in their weight or any change in their symptoms, we can see that these pressures in the lungs are changing, and we know we have to make a change in the patient’s medicines in order to keep that from getting worse and get things back to where they need to be for the patient to be active and healthy. It’s this four-week warning before people would get into the hospital that allows us to keep patients feeling better.
Melanie: It’s absolutely fascinating. And Dr. Leutmer, in just the last few minutes, if you would, give the listeners your best advice about the most exciting new treatments for congestive heart failure and why they should come to Aspirus for their heart care.
Dr. Leutmer: Well, if patients have a diagnosis of congestive heart failure and they find that they’re getting admitted to the hospital more frequently or having trouble with their day-to-day lives and not seeming to be able to get control of the excess fluid retention or their symptoms, I think they really ought to be considering this device to help their physicians and nurse practitioners and other caregivers to be able to make the best adjustments to their medication. Another thing we find is patients often have trouble with their kidney function, and finding that balance between kidney function and excess fluid and other symptoms, where this device can really help us close in on the right dosing of their medicines and how that dosing needs to change over time. Patients feel great, and they probably don’t need this. If they haven’t been admitted to the hospital, they probably don’t need this. But if they’re getting admitted to the hospital again and again and having trouble with their heart failure, I think this is something that may really help them.
Melanie: Thank you so much. You’re listening to Aspirus Health Talk. For more information, you can go to aspirus.org. That’s aspirus.org. This is Melanie Cole. Thank you so much for listening.
CardioMEMS™ Heart Failure Monitoring Solution
Melanie Cole (Host): CardioMEMS is the first and only FDA-approved heart failure monitoring solution that provides physicians with vital, real-time measurements from inside a person’s body. My guest today is Dr. Paul Leutmer. He’s a cardiologist with Aspirus Health. Welcome to the show, Dr. Leutmer. First, start by telling the listeners a little bit about heart failure. What is it? How does it differ from other forms of heart disease?
Dr. Paul Leutmer (Guest): Well, heart failure is not just one disease, but it’s a clinical syndrome in which the person’s heart can’t keep up with the workload that’s demanded of it. And that can happen for many number of things, from diseases of the heart muscle, of the heart valves, or maybe, heart attacks. But the end result is the heart can’t keep up with the needs. And what the patient feels is shortness of breath, weakness, can’t do their daily activities. Their legs may start to swell, and they may lose their appetite, start to lose their muscle mass over time. So it affects, really, every activity of the body because it all depends on the circulation provided by the heart.
Melanie: Typically, what sort of treatments? Is this a chronic condition, something that a person can live with for a little while?
Dr. Leutmer: Yes. People often think when they’re told they have heart failure that they’re going to die immediately. But people live for many years with heart failure. Typically, the symptoms of shortness of breath and leg swelling are due to retention of fluid, which the body does when there is not adequate circulation. The body thinks that it’s not having adequate circulation because there’s not enough fluid for the heart to circulate, so the kidneys respond by retaining fluid instead of excreting it urine. It’s this excess fluid that leads too much of the symptoms, and that’s treated with diuretics. It’s water pills that make you excrete more fluid in your urine. Patients can also have symptoms of weakness and shortness of breath, and those can be helped with medications that help give the heart an easier job to do.
Melanie: So up until recently, if somebody has heart failure, they’re living with heart failure, they’re on medications, they’re keeping in touch with their physician, how do you monitor what’s going on with their heart failure at any given time in the day?
Dr. Leutmer: Well this has been a very difficult problem over the years in trying to monitor heart failure. Typically, we try to use patients’ weight, but as you might imagine, weight is more than the amount of fluid in your body, and it can vary by several pounds a day, even with no change in the amount of fluid present. So it’s a very rough, inaccurate thing to try to follow. We also follow with patient symptoms. But again, this is an inaccurate measure and can be related to a lot of other things. Your symptoms may be worse just because you’re overtired or something else changed that may not be directly their heart failure. So, one of the problems we’ve struggled with is to know exactly what is the status of their heart failure? Do they have too much fluid? Do they have too little fluid? And we need to find this very exact balance because these people can adapt to the fluctuations that the body normally encounters in day-to-day life. So, finding the right thing to monitor has been difficult.
Melanie: So now, what are you doing now that is so exciting that can help predict an impending crisis before it happens?
Dr. Leutmer: Well, the best measurement to know has always been what are the pressures inside the pulmonary arteries of the lungs, and the only way we could measure that in the past -- we can’t put a blood pressure cuff on the lungs to see what the pressure in the lungs might be, like what we do on the arm to see what the blood pressure in the rest of the body is. The only we way could measure that pressure was to put a catheter—that is, a tube—up through the heart, up into the lungs to measure that. That’s something that can be done in the hospital and can be left in place for a few days but certainly not something we could monitor at home over a long period of time. Now, with a cardioMEMS device, we can actually implant this device in the artery, in the lung, in the pulmonary artery, and it stays there permanently. And anytime we need a measurement, which is usually done every morning when the patient first gets up, they can lie on this special pillow that generates an electromagnetic field that powers up this device, which can then give pressure measurement reading which is then transmitted wirelessly to our resource center, and we can look up on the computer and see what the pressure is and see how it changes over time.
Melanie: That is really amazing. What’s the implantation situation like? What’s the procedure? Is it simple?
Dr. Leutmer: It’s quite straightforward. We do what’s called a right heart catheterization. That’s when we put this tube through the vein through the right side of the heart, which pumps blood through the lungs and out into the pulmonary artery. That’s a routine procedure that’s been around for 30 or 40 years. When we put that catheter into the lungs, we can then deposit this device, which is clipped to the side of the catheter and we just release it. The device has a little metal loop on it, very springy, soft metal that then can pop open and hold the device in the center of the pulmonary artery. It’s about a half-an-hour procedure to put this device in place, and then we make measurements to calibrate so that we know that this thing is giving us the accurate readings. So the actual time in the cath lab is only about a half an hour.
Melanie: And how long can this device stay in? Does it wear out like a pacemaker—every 10 years or so it needs to be replaced?
Dr. Leutmer: Well, I think this is an amazing piece of technology. It actually has no internal power source. It stays there permanently. It never comes out. And these have been in place in patients that had them placed for the research trials for quite a few years now, and they don’t really wear out. They’re just a solid-state electronic device, and when we need to get a reading from it and the patient lies on this pillow, the power source is within this pillow that generates an electromagnetic field that induces a current in the device. So there’s no battery or any wiring that needs to be replaced.
Melanie: And what about hospitalization? Does this help keep patients out of the hospital? Does it alert you quick enough if they need to be hospitalized? Where does that come in?
Dr. Leutmer: Well, one of the big concerns with congestive heart failure is the need for people to be admitted to the hospital over and over again. And over half the money spent on caring for heart failure is spent on these hospital admissions. So a big goal has been to reduce the number of hospital admissions, and in fact this device and the research trials have been shown to reduce hospital readmissions by 37 percent, which will be a huge savings for the healthcare system and a great benefit on the quality of life for patients who are at home and doing things rather than being in the hospital, being sick. What the device does is it gives us about a four-week warning that the patient is starting to have trouble. So, long before we see a change in their weight or any change in their symptoms, we can see that these pressures in the lungs are changing, and we know we have to make a change in the patient’s medicines in order to keep that from getting worse and get things back to where they need to be for the patient to be active and healthy. It’s this four-week warning before people would get into the hospital that allows us to keep patients feeling better.
Melanie: It’s absolutely fascinating. And Dr. Leutmer, in just the last few minutes, if you would, give the listeners your best advice about the most exciting new treatments for congestive heart failure and why they should come to Aspirus for their heart care.
Dr. Leutmer: Well, if patients have a diagnosis of congestive heart failure and they find that they’re getting admitted to the hospital more frequently or having trouble with their day-to-day lives and not seeming to be able to get control of the excess fluid retention or their symptoms, I think they really ought to be considering this device to help their physicians and nurse practitioners and other caregivers to be able to make the best adjustments to their medication. Another thing we find is patients often have trouble with their kidney function, and finding that balance between kidney function and excess fluid and other symptoms, where this device can really help us close in on the right dosing of their medicines and how that dosing needs to change over time. Patients feel great, and they probably don’t need this. If they haven’t been admitted to the hospital, they probably don’t need this. But if they’re getting admitted to the hospital again and again and having trouble with their heart failure, I think this is something that may really help them.
Melanie: Thank you so much. You’re listening to Aspirus Health Talk. For more information, you can go to aspirus.org. That’s aspirus.org. This is Melanie Cole. Thank you so much for listening.