Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
Cardiovascular Research Centre Aalst,OLV Clinic, Department of Cardiology, Aalst, Belgium.
J Card Fail. 2023 Nov;29(11):1522-1530. doi: 10.1016/j.cardfail.2023.04.012. Epub 2023 May 21.
The implantable cardiac defibrillator-based HeartLogic algorithm aims to detect impending fluid retention in patients with heart failure (HF). Studies show that HeartLogic is safe to integrate into clinical practice. The current study investigates whether HeartLogic provides clinical benefit on top of standard care and device telemonitoring in patients with HF.
A multicenter, retrospective, propensity-matched cohort analysis was performed in patients with HF and implantable cardiac defibrillators, and it compared HeartLogic to conventional telemonitoring. The primary endpoint was the number of worsening HF events. Hospitalizations and ambulatory visits due to HF were also evaluated.
Propensity score matching yielded 127 pairs (median age 68 years, 80% male). Worsening HF events occurred more frequently in the control group (2; IQR 0-4) compared to the HeartLogic group (1; IQR 0-3; P = 0.004). The number of HF hospitalization days was higher in controls than in the HeartLogic group (8; IQR 5-12 vs 5; IQR 2-7; P = 0.023), and ambulatory visits for diuretic escalation were more frequent in the control group than in the HeartLogic group (2; IQR 0-3 vs 1; IQR 0-2; P = 0.0001).
Integrating the HeartLogic algorithm in a well-equipped HF care path on top of standard care is associated with fewer worsening HF events and shorter duration of fluid retention-related hospitalizations.
植入式心脏除颤器的 HeartLogic 算法旨在检测心力衰竭(HF)患者即将发生的体液潴留。研究表明,HeartLogic 安全地整合到临床实践中。本研究旨在探讨 HeartLogic 在 HF 患者的标准治疗和设备远程监测的基础上是否提供临床获益。
对植入式心脏除颤器的 HF 患者进行了一项多中心、回顾性、倾向评分匹配的队列分析,并将 HeartLogic 与传统远程监测进行了比较。主要终点是恶化 HF 事件的数量。还评估了因 HF 住院和门诊就诊的情况。
倾向评分匹配产生了 127 对(中位数年龄 68 岁,80%为男性)。与 HeartLogic 组(1;IQR 0-3)相比,对照组(2;IQR 0-4)恶化 HF 事件发生更频繁(P=0.004)。对照组的 HF 住院天数高于 HeartLogic 组(8;IQR 5-12 与 5;IQR 2-7;P=0.023),对照组利尿剂升级的门诊就诊次数也多于 HeartLogic 组(2;IQR 0-3 与 1;IQR 0-2;P=0.0001)。
在标准治疗的基础上,将 HeartLogic 算法整合到配备完善的 HF 护理路径中,与恶化 HF 事件的减少和与液体潴留相关的住院时间缩短相关。