COMPASS-HF Study: Implantable Hemodynamic Monitor Reduces Heart Failure Hospital Events for Many Heart Failure Patients.ORLANDO, Fla. -- First-of-Its Kind, Investigational Hemodynamic he·mo·dy·nam·ics n. (used with a sing. verb) The study of the forces involved in the circulation of blood. he Monitor from Medtronic Uses Internet-Based Patient Management System Medtronic, Inc. (NYSE NYSE See: New York Stock Exchange :MDT MDT abbr. Mountain Daylight Time MDT (in the US and Canada) Mountain Daylight Time MDT n abbr (US) (= mountain daylight time) → ), the world leader in the device-based treatment of cardiac disease, today announced results of the COMPASS-HF (Chronicle(R) Offers Management to Patients with Advanced Signs and Symptoms of Heart Failure) clinical trial that were presented during a Late-Breaking Clinical Trial session at the American College of Cardiology The American College of Cardiology (ACC) is a nonprofit medical association established in 1949 to educate, research and influence health care public policy. The president for the 2006–2007 year is Steven E. Nissen. [1] The organization has 39 chapters in the U.S. Annual Scientific Session. COMPASS-HF evaluated the use of a new, investigational device, the Chronicle(R) implantable hemodynamic monitor (IHM IHM Immaculate Heart of Mary (Roman Catholic religious order) IHM Interface Homme Machine (man-machine interface) IHM Institute of Healthcare Management (UK) ) that is designed to continuously track intracardiac intracardiac /in·tra·car·di·ac/ (-kahr´de-ak) within the heart. in·tra·car·di·ac adj. Within the heart. intracardiac within the heart. pressure, body temperature, physical activity and heart rate in patients with systolic Systolic The phase of blood circulation in which the heart's pumping chambers (ventricles) are actively pumping blood. The ventricles are squeezing (contracting) forcefully, and the pressure against the walls of the arteries is at its highest. and diastolic heart failure diastolic heart failure Cardiology Heart failure with preserved left ventricular systolic function–LV ejection fraction of ≥ 50%, no segmental wall motion abnormalities, and no evidence of significant coronary, valvular, infiltrative, pericardial, or (NYHA NYHA New York Heart Association Class III and IV). Study results presented by Robert Bourge, M.D., director of the Division of Cardiovascular Disease at the University of Alabama at Birmingham UAB began in 1936 as the Birmingham Extension Center of the University of Alabama. Because of the rapid growth of the Birmingham area, it was decided that an extension program for students who had difficulties which prevented them from studying in Tuscaloosa was needed. , include: --The Chronicle IHM was used safely and reliably in the study population as measured by freedom from system-related complications and sensor lead failure. --There was a 22-percent reduction in combined heart failure-related hospitalizations, emergency department (ED) and urgency care visits among patients whose physicians had regular access to data transmitted from the Chronicle monitor (did not reach statistical significance). --There was a 41-percent reduction in combined heart failure-related hospitalizations, ED and urgency care visits among NYHA Class III patients whose physicians had regular access to data transmitted from the Chronicle monitor (statistically significant). Eighty-five percent of all patients enrolled in the study had NYHA Class III heart failure. --Patient outcomes were improved as demonstrated by a 33 percent reduction in the proportion of patients that experienced worsening heart failure (statistically significant). "These results demonstrate the benefits of remotely monitoring hemodynamics hemodynamics /he·mo·dy·nam·ics/ (-di-nam´iks) the study of the movements of blood and of the forces concerned.hemodynam´ic he·mo·dy·nam·ics n. and congestion The condition of a network when there is not enough bandwidth to support the current traffic load. congestion - When the offered load of a data communication path exceeds the capacity. in many heart failure patients using an implantable monitor," said Dr. Bourge. "Currently, physicians have no reliable, efficient way to measure this information, which presents a significant challenge in managing patients with heart failure and the detrimental cardiovascular effects of chronic fluid overload. We are now aware that with regular access to continuously measured, precise patient data from the Chronicle monitoring system, physicians can make real-time changes to medications, diet and fluid balance - often before patients even feel worsening heart failure symptoms - to reduce the need for hospitalization. This is an exciting technology that I expect will one day change the long-term management of heart failure for many patients." COMPASS-HF, supported by Medtronic, is the first randomized ran·dom·ize tr.v. ran·dom·ized, ran·dom·iz·ing, ran·dom·iz·es To make random in arrangement, especially in order to control the variables in an experiment. , controlled clinical trial controlled clinical trial, n a research strategy that calls for two samples: an experimental sample of patients receiving a pharmaceutical, and a second sample of control patients receiving a placebo. to evaluate the utility of a continuous, ambulatory intracardiac pressure monitor to reduce heart failure hospitalizations and improve heart failure status. The Chronicle IHM, similar in size to a pacemaker, is implanted in the upper chest with a sensor located in the heart's right ventricle. The monitor continuously tracks intra-cardiac pressure, body temperature, patient activity and heart rate. Patients transmit the information from home using a remote monitor via a standard phone line, and clinicians can then view the data on a secure web site. Clinicians then can note any changes in these readings - which may indicate changes in the patient's clinical status - and, as appropriate, make treatment changes. Twenty-eight U.S. clinical sites enrolled a total of 274 patients with NYHA Class III or IV heart failure and with at least one heart failure-related hospitalization or ED visit during the six months prior to baseline evaluation. All patients in the randomized, single-blinded, controlled study received optimal heart failure care (including standard drug and device therapy, daily weight measurements and regular access to experienced heart failure clinicians) and were implanted with the Chronicle IHM. Prior to Chronicle implantation, 40 percent of all patients also had another Medtronic pacemaker, implantable cardioverter-defibrillator or cardiac resynchronization therapy device. Patients were randomized to receive optimal heart failure care alone (140 patients) or optimal heart failure care and therapy guided by the Chronicle IHM (134 patients). All patients were blinded to their randomization randomization (ranˈ·d "Every cardiologist knows the difficulty of keeping hard-to-manage heart failure patients out of the hospital," said Steve Mahle, president of Medtronic Cardiac Rhythm Management Cardiac rhythm management is a field of treatment in cardiology. The purpose is managing cardiac rhythm disorders. Usually it involves artificial pacemakers and/or implantable cardioverter-defibrillator therapy as well as antiarrhythmia drugs. . "Medtronic is dedicated to finding new ways to help improve the management of heart failure, and COMPASS-HF shows that with implantable hemodynamic monitoring clinicians can be alerted to early signs of heart failure deterioration and proactively tailor medical therapy to improve the patient's condition. We are optimistic that the Chronicle device will soon move beyond investigational use for the benefit of many heart failure patients." More than 5 million Americans suffer from heart failure, and 550,000 new cases are diagnosed annually. The estimated direct and indirect cost of heart failure in 2004 was $25.8 billion, two thirds of which is due to hospitalization and home nursing care. Every year more than 1 million hospitalizations occur due to acute heart failure exacerbation, and it is estimated that approximately half of these are for a subset of 200,000 patients that are admitted at least twice per year. These patients are targets for more intense care and specialized follow up to prevent repeated admissions to the hospital. Medtronic, Inc., headquartered in Minneapolis, is the world's leading medical technology company providing lifelong solutions for people with chronic disease. Its Internet address is www.medtronic.com. Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's Annual Report on Form 10-K for the year ended April 30, 2004. Actual results may differ materially from anticipated results. |
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