Percutaneous implantation of pulmonary artery pressure sensors
Topic Status Complete
Percutaneous implantation of pulmonary artery pressure sensors for monitoring treatment of chronic heart failure.
Outcome of the appraisal
The evidence supports the routine adoption of percutaneously implanted pulmonary artery pressure sensors to monitor the treatment of people with New York Heart Association class III chronic heart failure and/or a hospitalisation for heart failure within the previous 12 months.
The evidence shows that the use of percutaneously implanted pulmonary artery pressure sensors reduces hospitalisations for heart failure and the length of stay in hospital and may improve quality of life.
Expert advice suggests that the baseline rate of hospitalisations in Wales may have been underestimated in the Health Technology Wales cost-utility analysis and it is therefore plausible that percutaneously implanted pulmonary artery pressure sensors are cost effective in NHS Wales.
The use of percutaneously implanted pulmonary artery pressure sensors in NHS Wales should be associated with the gathering of real-world evidence of clinical and cost effectiveness
Why was this topic appraised?
Chronic heart failure is a disabling and often progressive medical condition that results from the heart being unable to pump sufficient blood through the circulation to meet the body’s needs.
People with heart failure have a reduced quality of life and a significant risk of death. Acute heart failure, including acute exacerbations of chronic heart failure, is the most common reason for emergency admission to hospital in Wales in adults over 65 years old and its prevalence is increasing.
People with chronic heart failure need regular monitoring to identify signs of deterioration and to modify treatment. An increase in pulmonary artery pressure is known to be one of the earliest signs of heart failure decompensation so the use of haemodynamic devices that measure pulmonary artery pressure may assist in the monitoring of people with heart failure.
This topic was identified following a search of National Institute for Health and Care Excellence (NICE) interventional procedures guidance. Since NICE interventional procedures guidance is focused only on evidence of safety and efficacy, HTW conducted this appraisal to assess both the clinical and cost effectiveness of the technology
Plain language summary
Chronic heart failure is when the heart can no longer pump blood around the body properly. A person with chronic heart failure needs to be very closely monitored. Regular checks have to be made on the heart’s function and rhythm as well as the person’s general health and other organs, like the kidneys. Checking for early signs that something may be going wrong can be very important. One type of early warning sign is a rise in pulmonary artery pressure, or the pressure that the flow of blood puts on the arteries that carry it to the lungs. If a rise in in pulmonary artery pressure can be detected, then treatment can be introduced or changed to help manage this.
Devices that measure pulmonary artery pressure may therefore help with heart-failure monitoring. A pulmonary artery pressure sensor (PAPS) is one such device. The sensor is placed into the left pulmonary artery. The sensor measures the pressure of the blood flow in the artery. Readings are taken from the sensor by a special pillow. At least once a day, a person with a PAPS lies down on the pillow and a reading of the artery pressure is taken and then sent to the healthcare team.
Health Technology Wales looked for evidence on the use of PAPs to monitor treatment of people with chronic heart failure. The evidence supports the routine adoption of percutaneously implanted pulmonary artery pressure sensors to monitor the treatment of people with New York Heart Association class III chronic heart failure and/or a hospitalisation for heart failure within the previous 12 months.
Topic Exploration Report
TER430 02.2023
Evidence Appraisal Report
EAR052 10.2023
Guidance
GUI052 10.2023
Health Technology Wales Partners
