Wireless implant cuts HF hospitalization rates
MedWire News: Using a wireless implantable hemodynamic monitoring (W-IHM) system in patients with New York Heart Association (NYHA) class III heart failure (HF) may substantially reduce their risk for hospitalization, according to results from the CHAMPION study.
Findings from the study, published in The Lancet, also indicate that W-IHM improves quality of life (QoL) and out-of-hospital survival among such patients.
In the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III HF Patients) study, 270 patients were randomly assigned to receive standard HF care (optimum pharmacological therapy) combined with daily pulmonary artery (PA) pressure measurements obtained from W-IHM, while a control group of 280 patients received standard care only.
Over a mean 15-month follow-up period, all patients underwent assessment of QoL (using the Minnesota Living with HF questionnaire) at 1, 3, and 6 months, and 6-monthly thereafter. Patients in the treatment group also had a weekly PA pressure data review.
William Abraham (Ohio State University, Columbus, USA) and team report that significantly fewer patients with W-IHM had a HF-related hospitalization over the study period than patients in the control group, at 57% versus 90%. This, says the team, is equivalent to a 36% reduction in HF-related hospitalization risk among patients who have W-IHM plus standard care compared with standard care only (p<0.0001).
When QoL data was analyzed, Abraham and team found that patients in the W-IHM group had an average quality-adjusted life years of 2.506 which was higher than that of those in the control group, at 2.200.
The authors used an analytical model to estimate the cost-effectiveness of W-IHM, accounting for the costs for patient care at assessed QoL, including cost of hospitalizations, drugs for outpatients, and end-of-life support. This illustrated a substantial cost saving with W-IHM compared with standard care.
"Thus, the incremental cost-effectiveness ratio of integrating W-IHM into standard care for management of the heart is estimated to be US$13,979 [€10,337] per quality-adjusted life expectancy," report Abraham and team.
In an accompanying commentary, Henry Krum (Monash University, Melbourne, Victoria, Australia) advised that implantation of the W-IHM device should be strongly considered in NYHA III HF patients.
He added: "A key issue is how rapid the uptake of this new device-based approach to HF management might be."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Lauretta Ihonor