Download Heart Failure Devices: Staying Connected

Heart Failure Devices: Staying
Connected
Lisa D. Rathman, MSN, CRNP, CCRN, CHFN
The Heart Group of Lancaster General Health
Lancaster, PA
Cardiac Resynchronization Therapy (CRT)
• Restores appropriate
electrical timing and
contraction in the heart
• Improves pumping
efficiency
– ↓ Oxygen use by the
heart muscle
– ↓ Pressures in the heart
– ↓ Leakiness of the mitral
valve
• Can lead to improved
heart function and
reverse remodeling
Who Qualifies for CRT?
• Patient with weak heart - EF < 35% on guideline
directed medical therapy > 3 months and > 40
days after MI
• Other data obtained
– General health
– Symptoms and functional status
– EKG characteristics
– Need for pacemaker or defibrillator
Important Things to Know after CRT
• CRT does not replace your medications.
• Important to keep follow-up with your heart
failure and device provider
• Timing of device may need to be adjusted
• Continue with lifestyle measures (daily
weights, exercise)
Implantable Cardiac Defibrillators (ICD)
• ICDs treat dangerous heart rhythms
• ICDs reduce mortality (prevent sudden cardiac
death)
Who Qualifies for an ICD?
• Patient with weak heart - EF < 35% on optimal
medical therapy
• Other data obtained
– New HF diagnosis?
– Recent heart attack or need for stents, bypass
surgery
– HF symptoms
– Recent medical history
– General health
Important Things to Know after ICD
• ICDs prevent premature death from
dangerous heart rhythms
• ICD will not make you feel better
• Important to continue heart medications and
lifestyle recommendations
• Important to keep follow-up with you heart
failure and device provider
Staying Connected
Heart Failure Data in Devices
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Abnormal heart rhythm
Day/night heart rate
Amount of pacing
Activity
Measurements of possible fluid retention
Weights/blood pressure
Heart Pressure Monitoring System
PA Pressure Sensor on Catheter Delivery System
4.5c
m
Patient Home
Electronics
Unit
Received FDA approval on May 28, 2014
120cm
PA Pressure Database
Physician Access Via Secure Website
Who Qualifies for an Heart Pressure Monitor?
• Heart Failure symptoms (NYHA class 3)
• Hospitalization with heart failure in the last 12
month
• HF with preserved EF and HF with reduced EF
• Other considerations
Final Thoughts
• Devices provide important therapies
– CRT is a treatment for heart failure
– ICDs to prevent death from dangerous heart rhythms
• Devices also allow for monitoring heart failure