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Implantable Haemodynamic Monitoring — EECC MCQ

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HardHeart FailureImplantable Haemodynamic MonitoringEECC

A 65-year-old man with HFrEF (LVEF 25%) is reviewed in clinic. He has been stable on GDMT for 12 months. His NT-proBNP is 450 pg/mL (down from 3,200 at diagnosis). The cardiology team considers implantable pulmonary artery pressure monitoring (CardioMEMS). What is the main clinical indication for this device?

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Correct answer: C — Reduction in HF hospitalisations by enabling proactive haemodynamic-guided diuretic adjustment in NYHA class III patients with prior HF hospitalisation

The CardioMEMS HF System is an implantable pulmonary artery pressure monitor that wirelessly transmits daily haemodynamic data. The CHAMPION and MONITOR-HF trials demonstrated that PA pressure-guided management significantly reduces HF hospitalisations (by 28-44%) in NYHA class III patients with a prior HF hospitalisation, across all EF ranges. The 2023 ESC HF Guidelines include haemodynamic monitoring as a Class IIb recommendation. The device allows early detection of rising filling pressures (before symptoms or weight change) and proactive diuretic dose adjustment. It does not measure LVEF, detect arrhythmias, or monitor medication adherence.

Reference: ESC (2023): Focused Update on Heart Failure; CHAMPION/MONITOR-HF Trials