Impact of Remote Monitoring on Hospitalizations for Heart Failure: A Five-year Single-center Experience.
Congestive heart failure
defibrillator
intrathoracic impedance
remote monitoring
Journal
The Journal of innovations in cardiac rhythm management
ISSN: 2156-3977
Titre abrégé: J Innov Card Rhythm Manag
Pays: United States
ID NLM: 101589872
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
24
01
2021
accepted:
04
03
2021
entrez:
3
9
2021
pubmed:
4
9
2021
medline:
4
9
2021
Statut:
epublish
Résumé
The impact of a provider-driven assessment and treatment algorithm based on remote OptiVol (Medtronic, Minneapolis, MN, USA) fluid index levels on hospitalizations for congestive heart failure (CHF) remains unknown. We implemented a physician-guided screening and educational strategy for elevated OptiVol fluid index levels measured on remote implantable cardioverter-defibrillator (ICD) monitoring and assessed clinical outcomes over a five-year period. Patients with CHF and a left ventricular ejection fraction (LVEF) of 40% or less with a previously implanted ICD underwent monthly remote monitoring from January 2015 to November 2019. An OptiVol fluid index of 60 Ω-days or more triggered a protocol-based CHF screening and therapy adjustment according to clinical presentation. Among 279 patients included in the study, 228 (81%) were male and 205 (73%) had ischemic cardiomyopathy. The average LVEF was 29% (± 7.3%). A total of 6,616 monthly transmissions were reviewed over five years; of those, 575 (8.7%) were associated with elevated OptiVol fluid index levels in 178 (64%) patients, and clinical follow-up data were available in 459 of 575 (80%) cases. Following abnormal OptiVol fluid levels on remote monitoring, CHF hospitalization occurred in 10 of 459 (2.2%) patient cases. In conclusion, monthly remote monitoring of OptiVol fluid index levels with a health care provider-guided CHF screening and an educational approach to abnormal OptiVol fluid index levels were associated with a low CHF hospitalization rate. This compared favorably to prior similar studies, and randomized controlled prospective studies evaluating similar algorithms are warranted.
Identifiants
pubmed: 34476114
doi: 10.19102/icrm.2021.120802
pii: icrm.2021.120802
pmc: PMC8384298
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4621-4624Informations de copyright
Copyright: © 2021 Innovations in Cardiac Rhythm Management.
Déclaration de conflit d'intérêts
Dr. Kloosterman serves on the Medtronic advisory committee. The other authors report no conflicts of interest for the published content.
Références
Circulation. 2005 Aug 9;112(6):841-8
pubmed: 16061743
Circ Heart Fail. 2012 Jan;5(1):63-71
pubmed: 22114101
Eur J Heart Fail. 2017 Mar;19(3):416-425
pubmed: 27568392
Circulation. 2012 Jun 19;125(24):2965-7
pubmed: 22626742
ESC Heart Fail. 2020 Feb;7(1):107-116
pubmed: 31794140
Eur J Heart Fail. 2016 Aug;18(8):977-86
pubmed: 26663507
Congest Heart Fail. 2011 Mar-Apr;17(2):51-5
pubmed: 21449992
Eur Heart J. 2017 Aug 7;38(30):2352-2360
pubmed: 28575235
Eur Heart J. 2016 Nov 01;37(41):3154-3163
pubmed: 26984864
Circulation. 2011 Oct 18;124(16):1719-26
pubmed: 21931078
J Am Coll Cardiol. 2013 Oct 15;62(16):e147-239
pubmed: 23747642
Europace. 2016 Mar;18(3):428-35
pubmed: 26683599
Eur J Heart Fail. 2010 Sep;12(9):1002-8
pubmed: 20615920
J Interv Card Electrophysiol. 2012 Nov;35(2):197-206
pubmed: 22688951
J Card Fail. 2009 Aug;15(6):475-81
pubmed: 19643357
J Am Coll Cardiol. 2010 Apr 27;55(17):1803-10
pubmed: 20413029
J Card Fail. 2011 Jul;17(7):569-76
pubmed: 21703529
Eur Heart J. 2013 Aug;34(31):2472-80
pubmed: 23513212
ESC Heart Fail. 2018 Oct;5(5):809-817
pubmed: 29934976
Circ Heart Fail. 2018 Dec;11(12):e004873
pubmed: 30562099
Am Heart J. 2010 Jul;160(1):42-8
pubmed: 20598971