A novel method—the activity log index—for monitoring physical activity of patients with heart failure

Kadhiresan, V.; Pastore, Joseph; Auricchio, Angelo; Sack, Stefan; Doelger, A.; Girouard, Steven D.; Spinelli, Julio

doi:10.1016/s0002-9149(02)02364-0

Cited by 50 publications

(47 citation statements)

References 4 publications

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“…The ability of implantable devices to continuously monitor variables such as heart rate, 2,3 the patient's daily activities, 4 intrathoracic impedance for the detection of fluid accumulation, 5 the occurrence of arrhythmias, 6,7 and the integrity of the system 8 may provide early warning of changes in cardiac status or of safety issues and allow timely management. When these patients have clinical events such as ICD shocks or device audible alert notifications of possible critical situations, they often visit the emergency department or clinic for an unscheduled examination.…”

Section: Editorial See P 2965 Clinical Perspective On P 2992mentioning

confidence: 99%

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

et al. 2012

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Background-Heart failure patients with implantable cardioverter-defibrillators (ICDs) or an ICD for resynchronization therapy often visit the hospital for unscheduled examinations, placing a great burden on healthcare providers. We hypothesized that Internet-based remote interrogation systems could reduce emergency healthcare visits. Methods and Results-This multicenter randomized trial involving 200 patients compared remote monitoring with standard patient management consisting of scheduled visits and patient response to audible ICD alerts. The primary end point was the rate of emergency department or urgent in-office visits for heart failure, arrhythmias, or ICD-related events. Over 16 months, such visits were 35% less frequent in the remote arm (75 versus 117; incidence density, 0.59 versus 0.93 events per year; Pϭ0.005). A 21% difference was observed in the rates of total healthcare visits for heart failure, arrhythmias, or ICD-related events (4.40 versus 5.74 events per year; PϽ0.001). The time from an ICD alert condition to review of the data was reduced from 24.8 days in the standard arm to 1.4 days in the remote arm (PϽ0.001). The patients' clinical status, as measured by the Clinical Composite Score, was similar in the 2 groups, whereas a more favorable change in quality of life (Minnesota Living With Heart Failure Questionnaire) was observed from the baseline to the 16th month in the remote arm (Pϭ0.026). Conclusions-Remote monitoring reduces emergency department/urgent in-office visits and, in general, total healthcare use in patients with ICD or defibrillators for resynchronization therapy. Compared with standard follow-up through in-office visits and audible ICD alerts, remote monitoring results in increased efficiency for healthcare providers and improved quality of care for patients. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00873899.

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Section: Editorial See P 2965 Clinical Perspective On P 2992mentioning

confidence: 99%

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

et al. 2012

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“…11 The lack of strong associations between them in the present study is likely explained, in part, by the fact that they assess different aspects of functional status, reflecting different facets of health status, and perhaps the more indicative way of assessing a patient's true functional impairment is to measure activity during normal daily life, which formal laboratorybased exercise tests do not truly represent. As laboratorybased exercise testing is a somewhat 'unnatural' form of exercise that bears little relation to typical activity patterns, their usefulness as a true representation of patients' abilities is questionable.…”

Section: Issues Related To Ali Monitoringmentioning

confidence: 64%

“…11 Briefly, ALI was defined as the percentage of time during which the acceleration exceeded a pre-set fixed threshold at 50 mG (0.49 m/s 2 ); this threshold corresponded to a treadmill walk speed of approximately 3.2 km/h, equivalent to 2.8 METS. The CRT devices automatically and continuously recorded the ALI, providing a daily mean value for the past week and a weekly mean value for the previous period.…”

Section: Measurement Of Daily Physical Activitymentioning

confidence: 99%

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Activity Monitoring in Heart Failure Patients With Cardiac Resynchronization Therapy

Kawabata

Fantoni

Regoli³

et al. 2007

Circ J

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xercise intolerance is a hallmark of heart failure (HF) and is predictive of all-cause mortality and hospitalizations. 1,2 Discouraging a sedentary lifestyle and promoting physical activity have both been shown to improve functional capacity, quality of life, and clinical outcome. 3,4 Cardiac resynchronization therapy (CRT) restores the cardiac electro-mechanical synchrony, leading to improved pumping function in HF patients with ventricular conduction disturbances. Consequently, CRT is able to increase functional capacity, exercise tolerance, 5,6 and aerobic capacity, 7 to delay the onset of anaerobic metabolism, 5 and to decrease the sympathetic drive of the heart. 8 All these effects have been reported mainly in CRT patients with sinus rhythm (SR) within a few months after device implantation. 5,6 Long-term exercise data in HF patients treated with CRT are limited. Furthermore, etiology-, rhythm-, diabetes-, and age-related differences in the improvement in functionCirculation Journal Vol.71, December 2007 al capacity after CRT have not yet been fully evaluated.The 6-min walking test is frequently used to assess submaximal exercise capacity in HF patients treated with CRT. 5,9 However, the distance walked is influenced by several factors, including patient motivation, coaching, anatomical limitations, and physical training. Furthermore, in HF patients variability in the distance walked between 2 subsequent tests is frequently observed. 10 In contrast, symptom-limited exercise testing, eventually combined with an assessment of oxygen consumption, is influenced by familiarity with the test and may not reflect the patient's spontaneous daily physical activity, plus its routine determination is costly and time-consuming.Recent technological advances have made device-based monitoring of physical activity possible using data collected through the device's sensors. 11 Short-term, continuous, device-based monitoring of physical activity has proven to be feasible, although in a limited number of patients to date. 12 Because each device uses proprietary technology and analysis algorithms, the results obtained with 1 device may not be entirely applicable to other devices. Finally, whether this monitoring remains of value over the long term and in different subgroups of HF patients is unknown. It has been shown that the Activity Log Index (ALI), which quantifies body movement based on data derived from accelerometers built into the device, reliably tracks changes in the daily, spontaneous physical activity of patients with advanced HF. In addition, the ALI is well correlated with the distance walked within 6 min. 11 The aim of this study was to prospectively investigate the validity of long-term device-based monitoring of physical activity in advanced HF patients treated with CRT. Further- Activity Monitoring in Heart Failure Patients With Cardiac Resynchronization TherapyMihoko Kawabata, MD, PhD ‡, *; Cecilia Fantoni, MD* , **; Francois Regoli, MD*; Santi Raffa, MD*; Francesca Pastori, MD*; Simona Fratini, MD, Ph...

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“…This generates an enormous clinical workload which increases further when devices approach ERI, or in response to product advisories and recalls. The application of e-Health and Telemedicine for remote monitoring of patients with implanted devices may provide mechanism(s) for facilitating these tasks [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. Data are promising and it can be expected that remote monitoring systems will develop into dedicated monitoring and therapy platforms.…”

Section: Remote Monitoring Of Patients With Devicesmentioning

confidence: 99%

E-Health and Telemedicine: Current Situation and Future Challenges

Saner¹

2016

Kardiol. serdechno-sosud. khir.

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A novel method—the activity log index—for monitoring physical activity of patients with heart failure

Cited by 50 publications

References 4 publications

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

Activity Monitoring in Heart Failure Patients With Cardiac Resynchronization Therapy

E-Health and Telemedicine: Current Situation and Future Challenges

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