Letter to editor regarding the article ‘Prediction of heart failure events based on physiologic sensor data’

We would like to comment on ‘Associations between COVID-19 therapies and outcomes in rural and urban America: A multisite, temporal analysis from the Alpha to Omicron SARS-CoV-2 variants’.¹ The HeartLogic algorithm's sensitivity in foretelling patients with implanted cardiac devices' worsening heart failure episodes (HFEs) was assessed in this study. A cohort of 144 individuals, followed for a total of 244 years, was included in the research; 73 HFEs were noted throughout that time. With an alarm rate of 1.27 alerts per patient-year, it was discovered that the HeartLogic alerts had an 80.8% sensitivity in identifying HFEs. Additionally, the study showed that when patients were in an awake state as opposed to when they were not, the HFE rate was much greater, suggesting that the algorithm may be more effective in monitoring patients during their working hours, potentially allowing for timely interventions and improved management of heart failure episodes.

The retroactive simulation of HeartLogic alerts using sensor data, which could include bias or inconsistencies in the results, is one potential drawback in the study. Furthermore, the study omitted details regarding the particular causes or symptoms of the HFEs, which would have shed light on the algorithm's capacity for prediction. Furthermore, the study did not address how other factors, which could affect the algorithm's sensitivity and false positive rates, including co-morbidities or medication modifications, might affect how accurate the alerts are.

Given that the study included patients with both types of implanted devices—ICD and CRT-D—one question that one may pose to the authors is whether the HeartLogic algorithm was equally effective in predicting HFEs in these individuals. Future studies may examine the advantages of modifying the HeartLogic algorithm's alert threshold in order to maximize its sensitivity and specificity across a range of patient demographics. More research might look into the long-term effects and financial viability of using the HeartLogic algorithm in clinical settings to lower hospital stays and enhance patient outcomes for heart failure treatment.

None.