Heart Failure Devices: Staying Connected

Lisa D. Rathman, MSN, CRNP, CCRN, CHFNThe Heart Group of Lancaster General HealthLancaster, 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

• Abnormal heart rhythm • Day/night heart rate• Amount of pacing• Activity• Measurements of possible fluid retention• Weights/blood pressure

PA Pressure Sensor on Catheter Delivery System

PA Pressure Database

Physician Access Via Secure Website

Patient Home Electronics Unit

120cm4.5cm

Heart Pressure Monitoring System

Received FDA approval on May 28, 2014

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