Handheld Device for Early Warning of Heart Failure

Published in Insight - July/August 2017

Heart failure is one of the most common causes of death in the United States, causing nearly one in nine deaths in Americans, according to the CDC.

Fluid congestion due to heart failure is the most common cause of hospital admissions, and the readmission rate is high—up to 25 percent by 30 days after hospital discharge. Now, a Johns Hopkins team led by cardiologist Harry Silber is working to help combat that problem by creating a device that noninvasively detects increased filling pressure in the heart—the condition that leads to fluid congestion in heart failure.

“This device could have an impact on the management of heart failure by identifying elevated filling pressure before symptoms appear,” says Silber.

The Indicor records a pulse oximeter signal from a patient’s index finger while the patient blows into a small tube. The change in the signal during the effort reflects the invasive measure of cardiac filling pressure, left ventricular end-diastolic pressure (LVEDP).

The result is displayed on an iPad screen and transmitted wirelessly to doctors’ offices. The device is portable and can be used in homes, physicians’ offices, nursing homes, emergency vehicles and hospitals. The assessment takes only a few minutes and is low risk, according to Silber.

Currently, the only common way of noninvasively detecting worsening congestion at home before symptoms appear is by measuring changes in a person’s weight. However, weight fluctuations cannot always be attributed to a heart condition, which makes it difficult to gauge the cause of the fluctuation.

Research using the Indicor has been conducted on 300 patients to date, and so far, shows promise not just for cardiac applications, but also for managing fluid removal in dialysis.

Currently being developed under the company Vixiar Medical, Indicor is targeted for a late 2017 pilot launch.

Under a licensing agreement between Vixiar Medical, Inc. and the Johns Hopkins University, Dr. Silber and the University are entitled to royalties on the invention described in this article. Dr. Silber is a founder of Vixiar Medical, Inc., owns shares of the company's stock, and is the company's Chief Scientific Officer. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.