Evaluation of real-world application of cardiac implantable electronic device-based multi-sensor algorithm for heart failure management.

Abstract

Aims: Remote monitoring of cardiac implantable electronic devices enables pre-emptive management of heart failure (HF) without additional patient engagement. The HeartLogic™ algorithm in implantable cardioverter defibrillators (ICDs) combines physiological parameters to predict HF events, facilitating earlier interventions. This study evaluated its diagnostic performance and resource implications within an HF management service.

Methods and results: In a single-centre study, 212 patients with cardiac resynchronization therapy ICDs (CRT-Ds) were monitored for 12-months. During follow-up, 18 (8%) patients died, and 15 HF hospitalizations occurred in 13 (6%) patients. Outpatient visits totalled 37 in 34 (16%) patients. HeartLogic™ alerts occurred in 58% of patients, with 100% sensitivity for HF-related hospitalizations. The positive predictive value was 29% including only alerts associated with HF events, while it was 51% including HF events and explained alerts. Unexplained alert rate was 0.46 per patient-year. Clinical interventions, mainly medication adjustments, followed 82 alerts. Total management time was 257 h/year, equivalent to 0.57 full-time equivalents for managing 1000 CRT-D patients.

Conclusion: The integration of HeartLogic™ into routine care demonstrated its utility in optimizing HF management, improving healthcare resource allocation. The algorithm can enhance proactive patient management and provide holistic care within the existing healthcare infrastructure.