IMPACT OF INTRODUCTION OF PULMONARY ARTERY PRESSURE MONITORING FOR HEART FAILURE MANAGEMENT: LONGITUDINAL RESULTS FROM THE CHAMPION TRIAL

Simultaneous piezoelectric noninvasive detection of multiple vital signs

The monitoring of vital signs plays a key role in the diagnosis of several diseases. Piezoelectric sensors have been utilized to collect a corresponding representative signal from the chest surface. The subject typically needs to hold his or her breath to eliminate the respiration effect. This work further contributes to the extraction of the corresponding representative vital signs directly from the measured respiration signal. The contraction and expansion of the heart muscles, as well as the respiration activities, will induce a mechanical vibration across the chest wall. The induced vibration is then captured by the piezoelectric sensor placed at the chest surface, which produces an electrical output voltage signal conformally mapped with the respiration-cardiac activities. During breathing, the measured voltage signal is composed of the cardiac cycle activities modulated along with the respiratory cycle activity. A representative model that incorporates the cardiac and respiratory activities is developed and adopted. The piezoelectric and the convolution theories along with Fourier transformation are applied to extract the corresponding cardiac activity signal from the respiration signal. All the results were validated step by step by a conventional apparatus, with good agreement observed.

Health Economic Impact of a Pulmonary Artery Pressure Sensor for Heart Failure Telemonitoring: A Dynamic Simulation

AIMS

Recently, a permanently implantable wireless system, designed to monitor and manage pulmonary artery (PA) pressures remotely, demonstrated significant reductions in heart failure (HF) hospitalizations in high-risk symptomatic patients, regardless of ejection fraction. The objectives of this study were to simulate the estimated clinical and economic impact in Germany of generalized use of this PA pressure monitoring system considering reductions of HF hospitalizations and the improvement in Quality of Life.

MATERIALS AND METHODS

Based on the Prospective Health Technology Assessment approach, we simulated the potential of the widespread application of PA pressure monitoring on the German healthcare system for the period 2009-2021.

RESULTS

This healthcare economic simulation formulated input assumptions based on results from the CHAMPION Trial, a multicenter, prospective, randomized controlled U.S. trial that demonstrated a 37% reduction of hospitalizations in persistently symptomatic previous HF patients. Based on these results, an estimated 114,800 hospitalizations would expected to be avoided. This effect would potentially save an estimated €522 million, an equivalent of $575 million, during the entire simulation period.

CONCLUSION

This healthcare economic modeling of the PA pressure monitoring system's impact demonstrates substantial clinical and economic benefits in the German healthcare system.