Managing Heart Care from Home

Thanks to the CardioMEMS HF System, Charlie Chatman's heart failure can now be monitored remotely, reducing his trips to Kansas City

Andrew Sauer, MD, and Charlie Chatman
Charlie Chatman with Dr. Andrew Sauer

It was not unusual for Charlie Chatman to be in the hospital 3 or 4 times a year due to his heart health. At 66, he was struggling with four separate heart conditions: coronary artery disease, severe aortic stenosis (narrowing of the aortic heart valve), abnormal heart rhythm and heart failure.

Chatman's heart problems were not a complete surprise – heart disease runs in his family. His mother, father, two sisters and son all lost their lives to heart disease. Monitoring his health required several appointments, and he was forced to travel long distances from his home in Poplar Bluff, Missouri.

That changed in 2015 when cardiologist Andrew Sauer, MD, recommended a new technology that could monitor Chatman's heart health from home and minimize his travel time.

High-tech help from home

CardioMEM is about the size of a dime
The CardioMEMS device is no bigger than a dime.

The device Dr. Sauer was referring to is the CardioMEMS™ HF System – an implantable wireless sensor (no bigger than a dime) that monitors pulmonary artery pressure and heart rate in heart failure patients. The device instantly transmits reports to the patient's care team, allowing them to adjust medications as needed and monitor heart function remotely.

"It's like a pressure gauge," Dr. Sauer explains. "You can essentially forecast when someone's about to have symptoms of heart failure by watching the trends. Generally, if you're checking it twice a week, you can prevent hospitalizations of heart failure."

The CardioMEMS heart failure device was approved by the Food and Drug Administration in May 2014, and The University of Kansas Health System was one of the first in the region to adopt the new technology. Now, the health system has the longest track record of using CardioMEMS in the Kansas City metro area. A dedicated team that includes nurse practitioners, physician assistants and heart failure nurses monitors the readings on a regular basis.

"We started using the device almost immediately after it was approved," Dr. Sauer says. "We've now done 15 or more of these cases, and we've been able to see the technology is very safe."

Chatman received the CardioMEMS device in January 2016. The procedure was minimally invasive and allowed him to go home the same day. Since the device was implanted, Chatman has not been hospitalized.

"This really is a game changer for him," Dr. Sauer says. "He was in the hospital 3 or 4 times a year for the last 2 years. It's been 6 months since the device was implanted, and that's the longest he's been able to stay out of the hospital."

Finding the right care

Finding the right heart care had not been easy for Chatman. At one point, while being evaluated with an electrocardiogram, Chatman's heart stopped twice. He was revived and awoke to surprising news: He'd had a pacemaker placed in his chest and was being transferred to a hospital in St. Louis to receive a mechanical heart pump called a left ventricular assist device, or LVAD. Once he arrived in St. Louis, Chatman was prepped for surgery. However, as he was being admitted, he was shocked to learn that his insurance wouldn't cover the procedure.

It was then that Chatman was referred to Dr. Sauer, who was working at Northwestern Memorial Hospital in Chicago. Dr. Sauer performed a minimally invasive aortic valve procedure to correct Chatman's severe aortic stenosis. He also received another lead in his pacemaker to synchronize his heart rhythm. The procedures were successful and, combined with medication, helped resolve Chatman's heart failure symptoms.

"We were able to get him out of heart failure without LVAD surgery," Dr. Sauer says. "As much as we like LVAD technology, it does come with some risk of complications and limitations in lifestyle that you don't want to impose on someone if you don't need to."

When Dr. Sauer made the decision to join the advanced heart failure team at The University of Kansas Health System, he reached out to all his patients, including Chatman, to let them know he would be relocating his practice. A few months after making the move to Kansas City, Dr. Sauer was surprised to see Chatman's name on his schedule.

Staying heart healthy

Chatman continues to enjoy a better quality of life since receiving the CardioMEMS. He is now retired, and spends time with his wife on their farm. Both receive heart care from The University of Kansas Health System and synchronize their appointments to minimize travel time. Although the 6-hour trip is long, Chatman says he appreciates the personal attention he receives at The University of Kansas Health System.

"They're always waiting for me as soon as I get here," he says. "They know me when they see me."

It's possible that heart failure patients like Chatman may need a mechanical heart pump or even heart transplant in the future. But for now, Dr. Sauer sees no need for additional measures.

"His condition is complex," Dr. Sauer says. "But every time we evaluate him, we find something to make him better. He's open to LVAD surgery, but he's obviously hoping he doesn't need it. I'm glad we've given him some years without it."

If Chatman does require future treatments, there's no question where he will turn for help.

"I wouldn't go anywhere else," Chatman says. "Dr. Sauer saved my life. I love him for it too. He's really good."