Physician-Directed Patient Self-Management of Left Atrial Pressure in Advanced Chronic Heart Failure

摘要: Background— Previous studies suggest that management of ambulatory hemodynamics may improve outcomes in chronic heart failure. We conducted a prospective, observational, first-in-human study physician-directed patient self-management system targeting left atrial pressure. Methods and Results— Forty patients with reduced or preserved ventricular ejection fraction history New York Heart Association class III IV failure acute decompensation were implanted an investigational pressure monitor, readings acquired twice daily. For the first 3 months, clinicians blinded as to these readings, treatment continued per usual clinical assessment. Thereafter, individualized therapy instructions guided by pressures disclosed patient. Event-free survival was determined over median follow-up 25 months (range 38 months). Survival without 61% at years, events tended ...