Device Deep Dive: Exploring Remote Monitoring Technology-Device Deep Dive: Exploring Remote Monitoring Technology

Video Transcription

Video Summary

Sandeep Zalawadia, a heart failure cardiologist at Vanderbilt, reviews remote monitoring for chronic heart failure, focusing on implantable pulmonary artery (PA) pressure monitors: Abbott’s CardioMEMS and Edwards’ Cordella. He explains the rationale: cardiac filling/PA pressures rise weeks before symptoms (weight gain, dyspnea), enabling proactive treatment to prevent decompensation across both preserved and reduced EF. CardioMEMS uses a dime-sized sensor (left or right PA) and a home “pillow” receiver; clinicians trend supine PA diastolic pressure (goal ~8–20 mmHg) via the Merlin portal. Cordella implants only in the right PA and includes an integrated home platform (reader, tablet, BP cuff, scale, pulse oximeter), transmitting PA pressures (seated or supine) plus vitals; management targets seated mean PA pressure (goal ~5–20 mmHg), noting seated pressures are physiologically lower. Successful use requires closed-loop clinician-patient communication, with an “optimization phase” in the first 90 days where most pressure reduction and interventions occur; achieving lower pressures by 90 days correlates with better survival.

Keywords

remote monitoring

chronic heart failure

implantable pulmonary artery pressure monitor

CardioMEMS

Cordella