BACKGROUND: Heart failure affects more than five million people in the United States, a figure that's expected to double in the next 30 years. In 2007, an estimated $33 billion was spent on management of the disease. Heart failure is often a result of damage from a heart attack or other conditions, including coronary artery disease, high blood pressure and diabetes. The heart of patients suffering from heart failure does not pump well and fails to deliver essential oxygen-rich blood to the body. Congestive heart failure involves an accumulation of fluid in the lungs and other body tissues. When it occurs, patients are usually hospitalized. Patients are sometimes hospitalized various times throughout the year for the condition. Heart failure is the most frequent reason people older than 65 are hospitalized.

With adequate treatment involving lifestyle changes, medications and sometimes surgery, heart failure can be managed; but it is a progressive disease and 10 percent of cases lead to death. "Heart failure is the biggest clinical problem emerging in heart disease," Nicholas Chronos, M.D., an interventional cardiologist and President and CEO of the St. Joseph’s Translational Research Institute in Atlanta, Ga., told Ivanhoe.

MONITORING THE HEART: A device smaller than a grain of rice is being tested as a way to manage heart failure. The CardioMEMS Heart Failure Pressure Measurement System is a wireless sensor implanted in a patient's pulmonary artery via a catheter-based procedure that requires one overnight stay in the hospital. Every day, the sensor wirelessly transmits information about the amount of pressure in the lungs to a central monitoring system. The database can be reviewed by doctors over the web. A trial on the device is being performed to find out whether physicians can use the data to monitor a patient's heart, tailor medications when necessary, and see if those actions will reduce the number of times a heart failure patient is hospitalized.

For each patient, doctors establish parameters for what level the pressure in the lungs needs to remain. If the pressure in patients like George Marra errs outside that level either up or down, doctors know immediately. "We can much more finely tune George’s cardiovascular status than we could ever before," Dr. Chronos explained. "Before we’d wait for George to get sick. He would turn up in an ER [and] get admitted. Now we can phone him up everyday and tell him, 'Hey, you are doing very well. Just stay where you are,' or, 'You need to take some more diuretic.'"

CHAMPION: The phase 2 CHAMPION clinical trial is enrolling 550 patients across the nation. Patients must be 18 years or older and have relatively severe heart failure: class III or IV. The study began in August 2007 and is expected to be completed by August 2011.