Impedance Cardiography: A Bridge Between Research and Clinical Practice in the Treatment of Heart Failure
This paper proposes that impedance cardiography could narrow the gap between heart failure clinical research and the appropriate and timely application of new knowledge and technology in the care of patients with heart failure. Research variables and measurement strategies, identified in the heart failure scientific literature between 1994-1999, are compared to measures that can be obtained through a cost effective, noninvasive technology--impedance cardiography. Emphasis is placed on case reports that illustrate how "real time" evaluation and trending of key hemodynamic variables through impedance cardiography monitoring has been used to apply state of the science knowledge and technology to improve the inpatient and outpatient management of care for patients with severe heart failure. (c)2000 by CHF, Inc.
30 Day Hospital Readmissions
Literature that supports the efficacy of MyNICaS™ to detect and monitor Congestive Heart Failure (CHF) at par with Swan Ganz device and that will substantially lower 30-Day Hospital Readmissions.
Rethinking the Focus of Heart Failure Quality Measures
Grandin EW, Jessup M. 2015 Oct 6;132(14):1307-10. doi: 10.1161/CIRCULATIONAHA.115.018692. Epub 2015 Aug 27. PubMed PMID: 26316617.
This study is an important step toward quantifying the magnitude of the problem faced by providers and patients to achieve an optimal HF medical regimen. A central question raised by this study is whether clinicians should attempt to maximize the dose of each medication class in a stepwise, hierarchical fashion versus maximizing the total number of evidence-based therapies for each patient.
There was also no ability to account for the titration of medications already prescribed on admission, and some patients may have had substantial augmentation of their medical regimen without starting new drugs.
The increasing complexity of medical regimens for HF poses substantial logistical and financial challenges to patients and threatens to erode compliance.
Given the burden of new medications required to comply with performance measures like GWTG-HF and the attendant logistical, financial, and safety concerns for patients, we must critically assess whether there is evidence to support continued focus on an inpatient strategy alone.
Structured Telephone Support or Telemonitoring Programs for Patients with Chronic Heart Failure
S. I. Chaudhry, J. A. Mattera, J. P. Curtis et al., New England Journal of Medicine, vol. 363, no. 24, pp. 2301–2309, 2010.
By monitoring symptoms that reflect a patient’s physiological struggle to remain euvolemic, telemonitoring holds promise in reducing hospital readmissions and significantly improves patient morbidity and mortality, as well as quality of life.