Triage-HF Validation in Heart Failure Clinical Practice: Importance of Episode Duration.

The prevention of heart failure (HF) exacerbation is crucial for patient prognosis, and preventive treatment for potential symptoms and warning signs is essential in this context. The TriageHF © algorithm has been retrospectively validated and has demonstrated good correlation with HF episodes. This study analyzes the effectiveness of the TriageHF © algorithm in routine clinical practice, emphasizing the role of episode duration in its predictive capacity. From October 2017 to October 2020, all patients who received a Medtronic Amplia DR implant were prospectively selected for analysis. To evaluate the algorithm's diagnostic capacity, it was compared with the clinical diagnosis of HF episodes during follow-up. The sustained moderate-risk (more than 7 days) and high-risk alerts both showed high positive predictive values (11.25% and 27.27%, respectively), along with an increase in the relative risk of HF, particularly in high-risk alerts (hazard ratio is 46.21 times higher than for sustained moderate-risk alerts). Furthermore, there was higher event-free survival in real low-risk alerts than in both sustained medium-risk and high-risk alerts ( < 0.01). TriageHF © can predict the worsening of patients with ICD CRT. Medium-risk alerts lasting less than 7 days do not pose a greater risk of HF episodes, while high-risk alerts, regardless of their duration, are highly correlated with HF episodes.