Early Detection of Fluid Retention in Patients with Advanced Heart Failure: A Review of a Novel Multisensory Algorithm, HeartLogicTM

Feijen, M; Egorova, Anastasia D.; Beeres, Saskia L.M.A.; Treskes, Roderick W

doi:10.3390/s21041361

Cited by 11 publications

(6 citation statements)

References 45 publications

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“…Previously, CIED-based single sensor impedance measurements were not robust enough to detect impending fluid retention (17)(18)(19). Overcoming many of the drawbacks of its predecessors, the HeartLogic TM algorithm combines five pathophysiological CIED-based sensors: the first and the third heart sounds (S1 and S3, respectively) and the ratio of S3/S1, respiration rate, intrathoracic impedance, night heart rate and physical activity to detect impending fluid retention (8,9). A study from Calò et al confirmed that CIED measured heart sounds can accurately detect systolic and diastolic left ventricular functional impairment (20) et al demonstrated that all individual sensor values of the HeartLogic TM algorithm deviated significantly prior to an event of decompensated heart failure (13).…”

Section: Discussionmentioning

confidence: 99%

“…However, CIEDs also allow for continuous monitoring of a range of physiological parameters through various sensors. The recently developed CIED based algorithm HeartLogic TM (Boston Scientific St. Paul, United States) uses five sensors to detect impending fluid retention (8,9). These five sensors assess the first and the third heart sounds (S1 and S3, respectively) and the S3/S1ratio, respiration rate, intrathoracic impedance, night heart rate and physical activity (9).…”

Section: Introductionmentioning

confidence: 99%

“…The recently developed CIED based algorithm HeartLogic TM (Boston Scientific St. Paul, United States) uses five sensors to detect impending fluid retention (8,9). These five sensors assess the first and the third heart sounds (S1 and S3, respectively) and the S3/S1ratio, respiration rate, intrathoracic impedance, night heart rate and physical activity (9). All parameters are collected automatically and computed into the HeartLogic TM index.…”

Section: Introductionmentioning

confidence: 99%

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Performance of a HeartLogicTM Based Care Path in the Management of a Real-World Chronic Heart Failure Population

Feijen

Egorova

Treskes

et al. 2022

Front. Cardiovasc. Med.

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AimEarly detection of impending fluid retention and timely adjustment of (medical) therapy can prevent heart failure related hospitalizations. The multisensory cardiac implantable electronic device (CIED) based algorithm HeartLogicTM aims to alert in case of impending fluid retention. The aim of the current analysis is to evaluate the performance of the HeartLogicTM guided heart failure care path in a real-world heart failure population and to investigate whether the height of the index and the duration of the alert state are indicative of the degree of fluid retention.MethodsConsecutive adult heart failure patients with a CIED and an activated HeartLogicTM algorithm were eligible for inclusion. Patients were followed up according to the hospital's heart failure care path. The device technician reviewed alerts for a technical CIED checkup. Afterwards, the heart failure nurse contacted the patient to identify impending fluid retention. An alert was either true positive or false positive. Without an alert a patient was true negative or false negative.ResultsAmong 107 patients, [82 male, 70 (IQR 60–77) years, left ventricular ejection fraction 37 ± 11%] 130 HeartLogicTM alerts were available for analysis. Median follow up was 14 months [IQR 8–23]. The sensitivity to detect impending fluid retention was 79%, the specificity 88%. The positive predictive was value 71% and the negative predictive value 91%. The unexplained alert rate was 0.23 alerts/patient year and the false negative rate 0.17 alerts/patient year. True positive alerts [42 days (IQR 28–63)] lasted longer than false positive alerts [28 days (IQR 21–44)], p = 0.02. The maximal HeartLogicTM index was higher in true positive alerts [26 (IQR 21–34)] compared to false positive alerts [19 (IQR 17–24)], p < 0.01. Patients with higher HeartLogicTM indexes required more intense treatment (index height in outpatient setting 25 [IQR 20–32], day clinic treatment 28 [IQR 24–36] and hospitalized patients 45 [IQR 35–58], respectively), p < 0.01.ConclusionThe CIED-based HeartLogicTM algorithm facilitates early detection of impending fluid retention and thereby enables clinical action to prevent this at early stage. The current analysis illustrates that higher and persistent alerts are indicative for true positive alerts and higher index values are indicative for more severe fluid retention.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Performance of a HeartLogicTM Based Care Path in the Management of a Real-World Chronic Heart Failure Population

Feijen

Egorova

Treskes

et al. 2022

Front. Cardiovasc. Med.

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“…Remote monitoring allows early recognition of technical issues (such as lead failure, battery depletion, programming issues including insufficient margins for sensing or capture) as well as early detection of arrhythmias [ 26 , 27 ]. Furthermore, several CIED types may provide comprehensive information on worsening heart failure and thereby conceptually prevent heart failure hospitalisations [ 28 , 29 ]. The current results support the previously described effectiveness of remote monitoring in lowering hospitalisation and mortality rates [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

No substantial excess all-cause mortality among cardiac implantable electronic device patients during the first COVID‑19 lockdown in the Leiden area

et al. 2022

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In the Netherlands, the coronavirus disease 2019 (COVID‑19) pandemic has resulted in excess mortality nationwide. Chronic heart disease patients are at risk for a complicated COVID‑19 course. The current study investigates all-cause mortality among cardiac implantable electronic device (CIED) patients during the first peak of the pandemic and compares the data to the statistics for the corresponding period in the two previous years. Data of adult CIED patients undergoing follow-up at the Leiden University Medical Centre were analysed. All-cause mortality between 1 March and 31 May 2020 was evaluated and compared to the data for the same period in 2019 and 2018. At the beginning of the first peak of the pandemic, 3,171 CIED patients (median age 70 years; 68% male; 41% ischaemic aetiology) were alive. Baseline characteristics of the 2019 (n = 3,216) and 2018 (n = 3,169) cohorts were comparable. All-cause mortality during the peak of the pandemic was 1.4% compared to 1.6% and 1.4% in the same period in 2019 and 2018, respectively (p = 0.84). During the first peak of the COVID‑19 pandemic, there was no substantial excess mortality among CIED patients in the Leiden area, despite the fact that this is group at high risk for a complicated course of a COVID‑19 infection. Strict adherence to the preventive measures may have prevented substantial excess mortality in these vulnerable patients.

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“…11 Some of the most prominent and promising devices include CardioMEMS Heart Failure System, HeartPOD (Abbott), HeartLogic (Boston Scientific), V-LAP (Vectorious Medical Technologies), Medtronic OptiVol Fluid Status Monitoring and CareLink Network (OptiLink Heart Failure), and Chronicle IHM (Medtronic). [14][15][16][17][18][19][20] However, many of these TM technologies are invasive and require patient adherence, typically for the transfer of patientinitiated sensor data to an internet-connected device. 17 Previous studies have reported high adherence rates, but it should be noted that these studies typically exclude patients who are non-adherent with TM or disinclined to participate due to onerous trial protocols.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Home Monitoring of Patients With Heart Failure: Primary Care Experience With an Autonomous Foot-Measuring Device

Murugappan,

Raut

2023

Home Health Care Management & Practice

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In recent years, telemonitoring solutions have gained prominence for monitoring patients at home. However, patient and clinician enthusiasm, as well as adherence rates, have been inconsistent. This article presents a primary care evaluation of an autonomous foot-measuring home device, designed to monitor physiological changes in medium to high-risk chronic heart failure patients at risk of decompensation. The Heartfelt device garnered positive reception among the 13 participating patients. Remarkably, in 77% of cases (10 patients), the device captured and transmitted patient data on more than half of the days each month, while only 8% (one patient) managed to provide equivalent daily measurements using weighing scales. These results indicate that the Heartfelt device holds promise as an effective telemonitoring solution for patients who face adherence challenges with traditional telemonitoring systems, and self-management checks more generally. By adopting this technology, healthcare providers may be better equipped to proactively manage chronic heart failure patients and improve overall patient outcomes.

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Early Detection of Fluid Retention in Patients with Advanced Heart Failure: A Review of a Novel Multisensory Algorithm, HeartLogicTM

Cited by 11 publications

References 45 publications

Performance of a HeartLogicTM Based Care Path in the Management of a Real-World Chronic Heart Failure Population

Performance of a HeartLogicTM Based Care Path in the Management of a Real-World Chronic Heart Failure Population

No substantial excess all-cause mortality among cardiac implantable electronic device patients during the first COVID‑19 lockdown in the Leiden area

Enhancing Home Monitoring of Patients With Heart Failure: Primary Care Experience With an Autonomous Foot-Measuring Device

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