Nursing-led remote monitoring with Cardiomems in heart failure: impact on clinical stability and hospitalisations in a six-year real-world experience
B Gonzalez Fernandez, A Ros Corchado, P Velayos Martos, A Pulido Altamirano, E Crespo Garcia, M Verges Bellido, D Bares Escute, S Ortiz Sanchez, O Gallardo Barrancos, V Diaz Herrera, J Serra Gregori, E Santiago Vacas, P Codina Verdaguer, J Lupon Roses, T Bayes GenisAbstract
Background
Remote pulmonary artery pressure (PAP) monitoring using CardioMEMS allows early identification of haemodynamic deterioration in patients with heart failure (HF). Its clinical benefit largely depends on structured follow-up, in which specialised HF nurses play a key role. Long-term real-world evidence specifically addressing nursing interventions in this setting is still scarce.
Purpose
To describe the role and impact of nursing-led interventions during long-term remote follow-up of HF patients monitored with CardioMEMS, focusing on clinical stability and prevention of hospital admissions.
Methods
This was a single-centre, observational and retrospective study including all consecutive HF patients implanted with CardioMEMS between June 2019 and March 2025 in a multidisciplinary HF unit. Demographic and clinical characteristics, device-related data, nursing interventions and derived clinical actions were analysed descriptively over a follow-up of up to six years.
Results
Seventy-five patients were analysed (mean age 73 ± 8.5 years), with a median HF duration of 56 months. Mean left ventricular ejection fraction at implantation was 43.8%. Baseline quality of life was impaired (MLWHFQ 28.2; EuroScale 19.2). HF aetiology was mainly ischaemic (31 patients), followed by hypertensive, valvular and dilated cardiomyopathy.
A total of 2,853 nursing interventions were recorded. The most frequent trigger was variation in PAP measurements (64%), followed by lack of transmitted measurements (16.2%), system failures (9.5%), increased heart rate (3.3%), hospital admissions (4.0%), emergency department visits (1.9%), exitus (0.9%) and rhythm disturbances (0.1%).
These interventions led to specific nursing-driven actions, including telephone contacts (50.6%), pharmacological treatment adjustments (31.8%), visits to the HF unit (5.3%), advice on fluid restriction (8.0%), referral to emergency services (1.2%) and other actions (7.2%).
Most deaths were related to HF progression (51.9%), followed by non-cardiovascular causes (37%), sudden death (7.4%) and myocardial infarction (3.7%). The predominance of proactive outpatient interventions and the low proportion associated with hospital admissions support effective prevention of acute decompensation.
Conclusion
In this six-year real-world experience, nursing-led remote monitoring with CardioMEMS was characterised by a high volume of proactive interventions, enabling early detection of haemodynamic changes, treatment optimisation and a reduced need for unplanned hospital care. Specialised HF nursing appears to be a key component of successful long-term telemonitoring programmes.