Remote heart failure management using the HeartLogic algorithm. RE-HEART registry

Bagudá, Javier de Juan; Gómez, J.J. Gávira; Iglesias, Marta Pachón; León, Rocío Cózar; Pérez, Vanessa Escolar; Fernández, Óscar González; Gandara, N Rivas; Artaza, Josebe Goirigolzarri; Molina, Beatriz Díaz; Gallego, Alfonso Macías; Mateo, Virgilio Martínez; Martı́nez, Juan Gabriel; Negrín, Natalia Marrero; Salinas, Gonzalo Luis Alonso; Torres, Luis G.; Jiménez, Juan F. Delgado; Sánchez-Aguilera, P.; Infante, Ernesto Díaz; Torres, M F Arcocha; Conde, Laura; Fernández, Ana Belén Méndez; Castellano, Nicasio Pérez; Lopez, J. M.; Delgado, Inês; Fernández-Anguita, Manuel; Ruiz, P. Ramos; Moreno, Olga Medina; Pereda, David Cordero; Rus, Carlos de Diego; Arribas, Fernando; Bolao, Ignacio García; Salguero‐Bodes, Rafael

doi:10.1016/j.rec.2021.09.015

Cited by 7 publications

(15 citation statements)

References 17 publications

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“…In previous works, the ability of HeartLogic to detect actionable HF events has been demonstrated, facilitating effective remote management [ 25 , 26 , 27 , 28 , 29 ]. In the context of the COVID-19 pandemic, the multisensor diagnostic platform was used effectively to facilitate the remote assessment of patient conditions.…”

Section: Discussionmentioning

confidence: 99%

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Ziacchi

Calò

D’Onofrio

et al. 2022

Biology

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Aims: The utilization of remote monitoring platforms was recommended amidst the COVID-19 pandemic. The HeartLogic index combines multiple implantable cardioverter defibrillator (ICD) sensors and has proved to be a predictor of impending heart failure (HF) decompensation. We examined how multiple ICD sensors behave in the periods of anticipated restrictions pertaining to physical activity. Methods: The HeartLogic feature was active in 349 ICD and cardiac resynchronization therapy ICD patients at 20 Italian centers. The period from 1 January to 19 July 2020, was divided into three phases: pre-lockdown (weeks 1–11), lockdown (weeks 12–20), post-lockdown (weeks 21–29). Results: Immediately after the implementation of stay-at-home orders (week 12), we observed a significant drop in median activity level whereas there was no difference in the other contributing parameters. The median composite HeartLogic index increased at the end of the Lockdown. The weekly rate of alerts was significantly higher during the lockdown (1.56 alerts/week/100 pts, 95%CI: 1.15–2.06; IRR = 1.71, p = 0.014) and post-lockdown (1.37 alerts/week/100 pts, 95%CI: 0.99–1.84; IRR = 1.50, p = 0.072) than that reported in pre-lockdown (0.91 alerts/week/100 pts, 95%CI: 0.64–1.27). However, the median duration of alert state and the maximum index value did not change among phases, as well as the proportion of alerts followed by clinical actions at the centers and the proportion of alerts fully managed remotely. Conclusions: During the lockdown, the system detected a significant drop in the median activity level and generated a higher rate of alerts suggestive of worsening of the HF status.

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Section: Discussionmentioning

confidence: 99%

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Ziacchi

Calò

D’Onofrio

et al. 2022

Biology

View full text Add to dashboard Cite

show abstract

“…It is also of note that the reported rate of unexplained alerts was low (0.39 alerts per patient-year) and that in more than 80% of cases alerts could be resolved by telephone. 34 However, these promising results have not yet been validated in a randomised study. MANAGE-HF (NCT03237858), currently in the inclusion phase, is the first randomised clinical trial designed to assess the impact of HeartLogic on hospitalisation and mortality in symptomatic (NYHA functional class II-III) HF patients with either a previous decompensation or elevated natriuretic peptides.…”

Section: Evidencementioning

confidence: 98%

“…21,22 We have recently published an ambispective study with the first data from the RE-HEART registry, which included 288 patients from 15 centres across Spain. 34 In that study, the HeartLogic algorithm was shown to predict a HF decompensation or clinically relevant event in more than half of the alerts, on average 20 days in advance. Sensitivity and negative predictive value were close to 100%, with a specificity of over 90%.…”

Section: Evidencementioning

confidence: 99%

“…Sensitivity and negative predictive value were close to 100%, with a specificity of over 90%. 34 The HeartLogic was demonstrated to be useful in identifying events and individualising patient follow-up, knowing that decompensation outside the alert state is unlikely. It is also of note that the reported rate of unexplained alerts was low (0.39 alerts per patient-year) and that in more than 80% of cases alerts could be resolved by telephone.…”

Section: Evidencementioning

confidence: 99%

“…Figure 4 shows the follow-up protocol based on monitoring with the HeartLogic algorithm in the centres included in the Spanish RE-HEART registry. 34 When the HeartLogic index enters the alert state, it does so early enough to that the precipitating factors of an HF admission can be addressed. Through telematic or face-to-face contact three possible scenarios are defined:…”

Section: Application Of Heartlogic In Daily Clinical Practicementioning

confidence: 99%

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Clinical Utility of HeartLogic, a Multiparametric Telemonitoring System, in Heart Failure

et al. 2022

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Telemonitoring through multiple variables measured on cardiac devices has the potential to improve the follow-up of patients with heart failure. The HeartLogic algorithm (Boston Scientific), implemented in some implantable cardiac defibrillators and cardiac resynchronisation therapy, allows monitoring of the nocturnal heart rate, respiratory movements, thoracic impedance, physical activity and the intensity of heart tones, with the aim of predicting major clinical events. Although HeartLogic has demonstrated high sensitivity for the detection of heart failure decompensations, its effects on hospitalisation and mortality in randomised clinical trials has not yet been corroborated. This review details how the HeartLogic algorithm works, compiles available evidence from clinical studies, and discusses its application in daily clinical practice.

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Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities

et al. 2023

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AimsThe HeartLogic algorithm combines multiple implantable defibrillator (ICD) sensor data and has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation in cardiac resynchronization therapy (CRT-D) patients. We evaluated the performance of this algorithm in non-CRT ICD patients and in the presence of co-morbidities. Methods and resultsThe HeartLogic feature was activated in 568 ICD patients (410 with CRT-D) from 26 centres. The median follow-up was 26 months [25th-75th percentile: 16-37]. During follow-up, 97 hospitalizations were reported (53 cardiovascular) and 55 patients died. We recorded 1200 HeartLogic alerts in 370 patients. Overall, the time IN the alert state was 13% of the total observation period. The rate of cardiovascular hospitalizations or death was 0.48/patient-year (95% CI: 0.37-0.60) with the HeartLogic IN the alert state and 0.04/patient-year (95%

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Remote heart failure management using the HeartLogic algorithm. RE-HEART registry

Cited by 7 publications

References 17 publications

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Implantable Cardioverter Defibrillator Multisensor Monitoring during Home Confinement Caused by the COVID-19 Pandemic

Clinical Utility of HeartLogic, a Multiparametric Telemonitoring System, in Heart Failure

Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities

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