Nir Ayalon

Area of research

Agronomy and Crop Science · Cardiology and Cardiovascular Medicine

Research interest

The CardioMEMS is a recent FDA-approved device that is comprised of a dime-sized sensor that is placed (permanently) in a distal pulmonary artery (PA) branch. This device connects remotely (via a special electronic system in the shape of a pillow, that is given to the patient) and generates PA pressure waveforms that can be accessed via a web-based portal by the patient’s cardiology providers. This device is innovative as it allows instantaneous hemodynamic monitoring in our HF patients, often our most difficult patients to treat at BMC. It enables a precise hemodynamic information to detect volume overload 2-4 weeks prior to weight gain and initiation of symptoms and once placed, obviates any need for right heart catheterizations. The CardioMEMS has been shown in randomized-controlled trials to decrease HF hospitalizations. Early identification of volume overload enables the treating clinicians to escalate therapies and diuretics in the outpatient setting and prevents HF hospitalizations. It is placed as an outpatient or an inpatient procedure, with a minimal risk to our patients. Lastly, this device has a variety of clinical conditions that it can be applied: all HF patient with recent admission (both HFpEF and HFrEF), hemodialysis patients to help guide ultrafiltration goals, and individuals with mixed cardiac and pulmonary disease with narrow therapeutic windows of fluid management. This device is placed by Dr. Ayalon in the catheterization lab. The remote monitoring platform is established within the Cardiology clinic and is led by the Cardiomyopathy/HF NPs, with the support of the Cardiology clinic nurses, and the HF attendings. This program provides the Cardiomyopathy/HF NPs with an enhanced toolset to manage our most challenging patients, in a completely remote fashion, with high fidelity and accuracy in their home on a day-to-day manner. This program has already shown a significant reduction in HF hospitalization among the treated patients at BMC. All patie

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