{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T15:11:44Z","timestamp":1794496304089,"version":"4.9.1"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S104795112510927X_as1\"><jats:title>Background:<\/jats:title><jats:p>Implantable haemodynamic monitors allow remote monitoring of Fontan circulation. We report unique opportunities and challenges related to device use in rural, high-altitude regions.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112510927X_as2\"><jats:title>Objectives:<\/jats:title><jats:p>Assess the performance of implantable haemodynamic monitor in Fontan circulation and identify potential sources of measurement discrepancy defined as non-physiological, negative, or significantly lower reading than baseline.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112510927X_as3\"><jats:title>Methods:<\/jats:title><jats:p>We performed a retrospective review of patients who underwent implantable haemodynamic monitor implantation from September 2021 to April 2024 (<jats:italic>n<\/jats:italic> = 17) at our centre (\u223c1,000 feet above sea level; ASL) and identified those with sensor discrepancies.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112510927X_as4\"><jats:title>Results:<\/jats:title><jats:p>During a mean follow-up duration of 26 months (range 13\u201344 months), there were no procedure-related complications, thromboembolism, or device displacement. Ten patients lived in rural, higher-altitude regions (average altitude 5100 feet above sea level, average distance from centre \u223c160 miles, range = 100\u2013400 miles). Challenges in remote monitoring included unreliable home-internet connection, non-compliance, and difficulty performing device recalibration at patient\u2019s home altitude. Sensor discrepancies were noted in 7 patients (41%), of whom 6 (86%) lived remotely. Manual review of the waveforms identified sources of discrepancy, including misinterpretation of the non-pulsatile pressure waveform (<jats:italic>n<\/jats:italic> = 3), offset due to change in hospital-interrogation unit (<jats:italic>n<\/jats:italic> = 4), and sensor drift (<jats:italic>n<\/jats:italic> = 1). Altitude change did not directly affect sensor performance. We were able to apply corrective interventions in 4\/7 sensors, including Fontan-specific settings (overriding pulsatility), and back-end recalibration, which were effective in improving device accuracy.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112510927X_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Implantable haemodynamic monitors are a promising tool for monitoring Fontan circulation but may require modified settings and careful attention to potential interpretation errors. Home monitoring remains challenging for rural, high-altitude residents with limited resources.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s104795112510927x","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:03:59Z","timestamp":1756458239000},"page":"1815-1823","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Opportunities and challenges surrounding the use of implantable haemodynamic monitor in paediatric Fontan patients living in high-altitude, rural settings"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8733-8415","authenticated-orcid":false,"given":"Deepti Pagare","family":"Bhat","sequence":"first","affiliation":[{"name":"Phoenix Children\u2019s\u2019 Hospital"},{"name":"University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8146-6819","authenticated-orcid":false,"given":"Arash A.","family":"Sabati","sequence":"additional","affiliation":[{"name":"Phoenix Children\u2019s\u2019 Hospital"},{"name":"University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleem","family":"Almasarweh","sequence":"additional","affiliation":[{"name":"Phoenix Children\u2019s\u2019 Hospital"},{"name":"University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph N.","family":"Graziano","sequence":"additional","affiliation":[{"name":"Phoenix Children\u2019s\u2019 Hospital"},{"name":"University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"S104795112510927X_ref17","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.067601"},{"key":"S104795112510927X_ref21","unstructured":"21. User\u2019s manual. Abbott. CardioMEMSTM HF system PA sensor and delivery system, March 31, 2023, https:\/\/manuals.eifu.abbott\/en\/search-results.html."},{"key":"S104795112510927X_ref23","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.650796"},{"key":"S104795112510927X_ref16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.751784"},{"key":"S104795112510927X_ref18","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.922857"},{"key":"S104795112510927X_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951101000166"},{"key":"S104795112510927X_ref8","first-page":"270","article-title":"Implantable pulmonary artery pressure monitoring device in patients with palliated congenital heart disease: technical considerations and procedural outcomes","volume":"95","author":"Salavitabar","year":"2020","journal-title":"Catheter Cardiovasc Interv"},{"key":"S104795112510927X_ref11","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-1-31"},{"key":"S104795112510927X_ref20","unstructured":"20. Boltz, E Divisional Vice President, Quality Abbott Heart Failure. https:\/\/www.cardiovascular.abbott\/content\/dam\/cv\/cardiovascular\/pdf\/reports\/CardioMEMS-PA-Sensors-Device-Correction-HCP-Letter-Feb-2023.pdf."},{"key":"S104795112510927X_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)90388-3"},{"key":"S104795112510927X_ref9","doi-asserted-by":"publisher","DOI":"10.35534\/cvs.2024.10002"},{"key":"S104795112510927X_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2022.08.012"},{"key":"S104795112510927X_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.10.081"},{"key":"S104795112510927X_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.01.2010"},{"key":"S104795112510927X_ref2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951123003797"},{"key":"S104795112510927X_ref7","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.031836"},{"key":"S104795112510927X_ref3","first-page":"1","article-title":"Accuracy of elastography versus biopsy in assessing severity of liver fibrosis in young Fontan patients","volume":"28","author":"Bulut","year":"2024","journal-title":"Cardiol Young"},{"key":"S104795112510927X_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951109990357"},{"key":"S104795112510927X_ref24","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.3791"},{"key":"S104795112510927X_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2023.10.264"},{"key":"S104795112510927X_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307467"},{"key":"S104795112510927X_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytad422"},{"key":"S104795112510927X_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60101-3"},{"key":"S104795112510927X_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.12.073"},{"key":"S104795112510927X_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.008"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S104795112510927X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T11:56:42Z","timestamp":1759492602000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S104795112510927X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["S104795112510927X"],"URL":"https:\/\/doi.org\/10.1017\/s104795112510927x","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,29]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. 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