Tiny sensor keeps heart failure patients out of hospital

ATINY sensor the size of a 5p piece could slash the risk of dying from heart failure. Cardiologists have fitted the miniature device into the first two British patients in a breakthrough they hope will herald a revolution in cardiac care.

The device — called the CardioMEMS heart failure system — monitors the flow of blood leaving the heart, warning doctors if it begins to weaken.

If a patient’s heart starts to decline in strength, an automatic alert is sent to their hospital, triggering urgent action.

It is the first time the device, which was implanted in two women in Southampton last month, has been used in the UK outside a clinical trial.

Heart failure is a debilitating and incurable condition in which damaged or weakened heart muscles struggle to pump blood properly around the body.

Up to 900,000 people in the UK suffer from the condition, which is often caused by a heart attack.

In severe cases, people with heart failure are left unable to walk up a flight of stairs and are often breathless, even when resting. A third of patients die within a year of developing the condition — a survival rate that’s worse than many cancers.

But trials in the U.S. have found severe cases can be carefully managed using the CardioMEMS system, because doctors are able to react quickly if someone’s condition deteriorates.

A study published in the Lancet last year found hospitalisation rates could be reduced by 48 per cent using the system.

Dr Andrew Flett, a consultant cardiologist at Southampton General Hospital who fitted the first UK devices, called the technology a ‘game-changer’. ‘The majority of hospital admissions for patients with heart failure occur as a result of a build-up of excess fluid in the body, which causes increased pressure in the pulmonary artery,’ he says.

‘This goes undetected until it is too late to treat and the patient ends up needing to be admitted.’

Until now, heart failure has been monitored by taking blood pressure readings on a patient’s arm and keeping an eye on their weight to make sure they are not accumulating fluid. The new system, which sends readings once a day to a hospital computer, spots problems more quickly.

The device — a tiny sensor and two loops of wire — is inserted through an artery in the groin and pushed up the blood vessel until it nestles in the pulmonary artery leaving the heart.

There the vibrating wires measure blood flow in the artery.

Once a day the patient lies on an ‘electronic pillow’, which receives a radio signal from the sensor containing information from their heart. This is then sent through a wireless internet connection to the hospital server.

The data is checked regularly by a doctor on a secure website, but if the readings fall too low or rise too high, an automatic alert is sent to the patient’s care team.

They would then be monitored and treated with drugs to counteract the problem before it becomes too serious.

‘ Patients who receive this implant can send readings to us every day via the internet from their home so we can monitor them and adjust medications immediately — it is a revolution and a very exciting piece of technology,’ says Dr Flett.

‘Being able to monitor pulmonary artery pressure on a daily basis will undoubtedly reduce hospital admissions, improving patients’ quality of life and relieving pressure on hospitals.’

Jennifer Harvey, 70, the first woman to undergo the procedure last month, said: ‘Last year I suffered a lot of problems associated with heart failure and was in hospital for ten weeks over four months.

‘While I felt fine after coming out of hospital at the end of that time, I did worry if it would happen again.

‘This device will give me the security of knowing the medical team will be informed of my readings on a regular basis and give them the chance to intervene and, if necessary, change my medication to prevent all the problems I faced last year.’

LASTmonth, a second woman, aged 53, underwent the treatment and is said to be recovering well. Professor Sir Nilesh Samani, medical director at the British Heart Foundation, says: ‘A randomised clinical trial has shown this device substantially reduced the need for hospitalisation in people with heart failure, making it extremely relevant for the NHS.

‘Further trials in other settings and groups of patients are needed to confirm these findings.

‘If they demonstrate that these devices also improve patient outcomes beyond hospitalisation, then the use of these devices may become more common.’