Bravo pH Monitoring

The Bravo™ pH Monitoring System from Medtronic is the first catheter-free method of measuring esophageal pH (acidity) levels in patients who have or are suspected of having gastroesophageal reflux disease (GERD). This means there are no tubes or wires for the patient to deal with. With the Bravo system, patients can maintain their usual diet and activities while having their pH levels tested.

pH testing is the gold standard for diagnosing GERD, and the first step in determining appropriate medical or surgical treatment. The Bravo system involves a miniature pH capsule about the size of a gelcap that is attached to the esophagus and transmits pH information to a pager-sized receiver worn by the patient.

The Bravo system is an alternative to the traditional pH testing method, which involves placing a catheter through the nose and down the esophagus. The transnasal catheter is uncomfortable and conspicuous, leading most patients to modify their daily activities and/or diet, or in some cases, to avoid the test altogether.

The catheter-free Bravo system provides data more representative of the patient’s day-to-day activities than traditional pH monitoring methods because patients are able to maintain a normal diet and activity level during testing.

While traditional pH tests are conducted for 24 hours, the Bravo system allows physicians to monitor 24- or 48-hour pH levels. 

The Bravo pH System

The Bravo pH System comprises two main components:

  • A small pH capsule about the size of a gelcap that is attached to the wall of the esophagus and transmits data to the receiver.
  • A pager-sized receiver worn by the patient that receives pH data from the Bravo capsule. After the test is completed, data from the receiver is uploaded to pH analysis software using infrared technology.

Procedure and Follow-Up

  • A gastroenterologist, endoscopist or surgeon places the Bravo pH capsule. The procedure can be performed in a clinic, hospital endoscopy lab or ambulatory surgery center.
  • The Bravo capsule, which contains a miniature pH sensor, is attached to the esophagus using a proprietary delivery system. The physician advances the Bravo capsule to the desired location in the esophagus securely attaching the Bravo capsule to the wall of the esophagus.
  • After placement the capsule transmits pH data via radio telemetry signals that are recorded by the receiver.
  • Within 5-7 days on average, the capsule spontaneously sloughs off the wall of the esophagus and passes through the patient’s gastrointestinal tract.
  • After the study is completed, the patient returns the receiver to the hospital or clinic, and the data is uploaded via an infrared link to a computer, where POLYGRAM NET pH Analysis Software provides a comprehensive report for patient diagnosis.