Heart failure & cardiomyopathies

Artificial Intelligence–Enabled Detection and Management of Physiological Instability in Heart Failure: Results of the Randomized LINK-HF2 Trial

JACC Heart FailPublished prospective, randomized, open-label, blinded-endpoint study

Primary result · HF rehospitalization (main exploratory clinical endpoint)Result — go to the resultHazard ratio 0.90 95% CI 0.43–1.84

Authors' conclusion

AI-enabled continuous physiological monitoring was feasible and reduced AI-detected physiological instability. Although this feasibility study did not demonstrate a reduction in exploratory clinical events, these findings highlight that accurate physiological risk detection alone may be insufficient to modify clinical risk without mechanistically aligned and trusted therapeutic responses. (Detection of Physiological Anomaly Using Artificial Intelligence and Prevention of Heart Failure Hospitalization [LINK-HF2]; NCT04502563).

Study context

Population
Adults hospitalized for acute heart failure (HF), enrolled at discharge
Participants
171 analyzed participants
Comparison
Artificial intelligence (AI)-guided monitoring with clinician notification vs standard care
  • interventionn = 80
  • controln = 91reference
Methodological details5 Veterans Affairs medical centers, feasibility study
  • 5 Veterans Affairs medical centers
  • Feasibility study

Primary result

As reported in the abstract

HF rehospitalization (main exploratory clinical endpoint) · over the follow-up period

Hazard ratio

0.90

95% CI 0.43–1.84

P = 0.76

Events by treatment group

Intervention vs control
HR 0.90 (95% CI 0.43–1.84); P = 0.76

Further findings

OutcomeHR (95% CI)P value
Composite of all-cause unplanned rehospitalizations, emergency department visits, and all-cause mortality (secondary exploratory) · did not differ between groups1.03 (0.63–1.70)P = 0.89
AI-detected physiological instability · lower rate with intervention0.76 (0.60–0.97)P = 0.025

Monitoring adherence

Median monitoring adherence (% of follow-up days)
72.4%

Clinician response time to communicated notifications

Median time to response
1 day (range: 1-5 days)

Acceptability and barriers (qualitative analysis)

High patient acceptance and clinician engagement
Workflow integration and response uncertainty identified as the primary barriers to implementation

Original publication

Artificial Intelligence–Enabled Detection and Management of Physiological Instability in Heart Failure: Results of the Randomized LINK-HF2 Trial. JACC Heart Fail. Published 9 October 2026. doi:10.1016/j.jchf.2026.103422

Summarised from the published abstract; every number is checked against it

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