Prospective evaluation of the multisensor HeartLogic algorithm for heart failure monitoring

Abstract

Background The HeartLogic algorithm measures data from multiple implantable cardioverter‐defibrillator‐based sensors and combines them into a single index. The associated alert has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation. Hypothesis We describe a multicenter experience of remote HF management by means of HeartLogic and appraise the value of an alert‐based follow‐up strategy. Methods The alert was activated in 104 patients. All patients were followed up according to a standardized protocol that included remote data reviews and patient phone contacts every month and at the time of alerts. In‐office examinations were performed every 6 months or when deemed necessary. Results During a median follow‐up of 13 (10–16) months, the overall number of HF hospitalizations was 16 (rate 0.15 hospitalizations/patient‐year) and 100 alerts were reported in 53 patients. Sixty alerts were judged clinically meaningful, and were associated with multiple HF‐related conditions. In 48 of the 60 alerts, the clinician was not previously aware of the condition. Of these 48 alerts, 43 triggered clinical actions. The rate of alerts judged nonclinically meaningful was 0.37/patient‐year, and the rate of hospitalizations not associated with an alert was 0.05/patient‐year. Centers performed remote follow‐up assessments of 1113 scheduled monthly transmissions (10.3/patient‐year) and 100 alerts (0.93/patient‐year). Monthly remote data review allowed to detect 11 (1%) HF events requiring clinical actions (vs 43% actionable alerts, P < .001). Conclusions HeartLogic allowed relevant HF‐related clinical conditions to be identified remotely and enabled effective clinical actions to be taken; the rates of unexplained alerts and undetected HF events were low. An alert‐based management strategy seemed more efficient than a scheduled monthly remote follow‐up scheme.

Use of a novel implantable cardioverter‐defibrillator multisensor algorithm for heart failure monitoring in a COVID‐19 patient: A case report

“…This seems to suggest that in this case, the clinical event had a cardiac origin. As previously described, 12,13 the HeartLogic alert diagnosed an impending HF event before signs or symptoms occurred, it early detected discontinuation of the HF therapy and allowed to reestablish it promptly.…”

Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

“…As known, RM can be used with the purpose of remote device check or for monitoring patients' status (heart rhythm, fluid overload, right ventricular pressure, oximetry, etc. ), thus with a shift from strictly device-centred follow-up to perspectives centred on the patient (and patient-device interactions) [23][24][25][26][27][28]. The organization of disease management of heart failure, though RM in patients with implanted devices is complex, requires an interplay between the competence on devices and heart failure management and, therefore, should be object of promotion for the post-COVID-19 recovery phase.…”

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

“…The results of two large prospective multicentre registries were published in 2020 [ 39 , 40 ]. Calò and colleagues aimed to evaluate the correlation between the S1 and S3 as measured by the CIED and echocardiographic indexes of systolic and diastolic left ventricular function [ 39 ].…”

“…In the second recently published prospective multicentre registry, Santini and colleagues reported 100 HeartLogic TM alerts in 53 of the 104 patients (0.93 alerts per patient year) [ 40 ]. Sixty of these alerts (60%) were classified as clinically meaningful as they were associated with heart-failure-related events or resulted in active clinical actions (e.g., ambulant medication adjustments).…”