OptiVol for Volume Assessment in Patients With Continuous Flow Left Ventricular Assist Device.
Journal
ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
pubmed:
30
1
2021
medline:
27
4
2021
entrez:
29
1
2021
Statut:
ppublish
Résumé
OptiVol (Medtronic PLC, Minneapolis, MN) is a diagnostic feature of some cardiac implantable electronic devices (CIEDs) based on changes in thoracic impedance (TI) over time. Changes in TI can predict heart failure (HF) hospitalizations and mortality in HF populations. However, the utility of this feature is unknown in patients with a left ventricular assist device (LVAD). To determine if OptiVol and TI correlate with clinical HF events in a population of LVAD patients, hospitalization outcomes were collected retrospectively from the electronic health records at a single academic medical center in 80 LVAD patients with an OptiVol-capable CIED. Demographics, medical history, and available clinical data were reviewed and reported. The primary outcomes of interest were TI and OptiVol trends before and after hospitalization, and association of trends before and after these events was evaluated. Most patients had a HeartMate II LVAD and most CIEDs were defibrillators, and 23 (29%) had at least one HF hospitalization during the study period. HF hospitalizations were preceded by signs of volume overload in Optivol (60%) and TI (78%) with recovery of these measures post hospitalization in 33% and 25% of patients, respectively. Monitoring of TI and OptiVol may be one effective component of HF management in LVAD patients as part of a comprehensive program.
Identifiants
pubmed: 33512914
doi: 10.1097/MAT.0000000000001244
pii: 00002480-202102000-00013
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
192-195Informations de copyright
Copyright © ASAIO 2020.
Déclaration de conflit d'intérêts
Disclosure: The authors have no conflicts of interest to report.
Références
Yu CM, Bleeker GB, Fung JW, et al. Left ventricular reverse remodeling but not clinical improvement predicts long-term survival after cardiac resynchronization therapy. Circulation. 2005; 112:1580–1586
Abraham WT, Compton S, Haas G, et al.; FAST Study Investigators. Intrathoracic impedance vs daily weight monitoring for predicting worsening heart failure events: Results of the Fluid Accumulation Status Trial (FAST). Congest Heart Fail. 2011; 17:51–55
Small RS, Wickemeyer W, Germany R, et al. Changes in intrathoracic impedance are associated with subsequent risk of hospitalizations for acute decompensated heart failure: Clinical utility of implanted device monitoring without a patient alert. J Card Fail. 2009; 15:475–481
Whellan DJ, Ousdigian KT, Al-Khatib SM, et al.; PARTNERS Study Investigators. Combined heart failure device diagnostics identify patients at higher risk of subsequent heart failure hospitalizations: Results from PARTNERS HF (Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients With Heart Failure) study. J Am Coll Cardiol. 2010; 55:1803–1810
Small RS, Whellan DJ, Boyle A, et al. Implantable device diagnostics on day of discharge identify heart failure patients at increased risk for early readmission for heart failure. Eur J Heart Fail. 2014; 16:419–425
Whellan DJ, Sarkar S, Koehler J, et al. Development of a method to risk stratify patients with heart failure for 30-day readmission using implantable device diagnostics. Am J Cardiol. 2013; 111:79–84
Tang WH, Warman EN, Johnson JW, Small RS, Heywood JT. Threshold crossing of device-based intrathoracic impedance trends identifies relatively increased mortality risk. Eur Heart J. 2012; 33:2189–2196
Bartoli CR, Demarest CT, Khalpey Z, Takayama H, Naka Y. Current management of left ventricular assist device erosion. J Card Surg. 2013; 28:776–782
Drakos SG, Wever-Pinzon O, Selzman CH, et al. Magnitude and time course of changes induced by continuous-flow left ventricular assist device unloading in chronic heart failure: Insights into cardiac recovery. J Am Coll Cardiol. 2013; 61:1985–1994
Slotwiner D, Varma N, Akar JG, et al. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm. 2015; 12:e69–100