CardioExchange Archive

Heart Failure Monitoring Finds a CHAMPION: Results of the phase III CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) Trial were presented by William Abraham at the Heart Failure Congress 2010 earlier this week in Berlin, Germany. Some 550 NYHA Class III HF patients were randomized to receive either traditional therapy or the new device, which is about the size of a paper clip and monitors pulmonary artery pressure. At 6 months, there were 83 HF hospitalizations in the device group versus 120 in the control group (31% vs. 44%, P<0.001). “This study represents the first major breakthrough in the management of heart failure in nearly a decade,” said Abraham, in a press release issued by the European Society of Cardiology. “For the first time instead of managing symptoms or weight gain the device allows us to directly manage patient’s pulmonary pressures.”

Oxygen After Cardiac Arrest — More May Not Be Better: Kilgannon and colleagues studied  6,326 patients who had undergone cardiopulmonary resuscitation following cardiac arrest and who were enrolled in the Project IMPACT critical care database. They found that 18% of the population had hyperoxia upon first arterial blood gas determination, and these patients had significantly higher in-hospital mortality (63%) compared to the normoxia group (45%) and the hypoxia group (57%). The study appears in JAMA. In an accompanying editorial, Patrick Kochanek and Hulya Bayir write: “Given the rather conservative definition of hyperoxia (PaO2 ≥300 mm Hg), the true incidence of more moderate levels of hyperoxia is likely to be quite high…. this finding underscores the possibility that further meaningful improvements in outcome might result from careful attention to appropriately titrating basic aspects of extracerebral physiology at the bedside, such as prevention of hyperoxia.”