Heart failure & cardiomyopathies
Differentiating sensor changes in a composite heart failure implantable cardioverter-defibrillator (ICD) monitoring index: clinical correlates and implications
Authors' conclusion
HeartLogic alerts are mostly triggered by changes in heart sounds, but clinical events are more linked to respiration rate, RSBI, and night heart rate. Recurrent alerts often involve different sensors, indicating diverse mechanisms of HF progression.
Study context
- Population
- Patients with heart failure (HF) carrying ICDs with the HeartLogic algorithm, 26 centresCRT-D, n = 410
- Participants
- 568 patients
- Outcome
- Relative changes in ICD sensors at onset of HeartLogic alerts, their association with patient characteristics, and outcomes
Methodological detailsmulticentre, HeartLogic alerts triggered patient contact and potential treatment
- Multicentre
- HeartLogic alerts triggered patient contact and potential treatment
Main finding
As reported in the abstract
HeartLogic alerts recorded
1200
Patients with alerts
370
S3 highest-change sensor (% of alerts)
27%
S3/S1 highest-change sensor (% of alerts)
25%
Observational data: associations, not effects.
Further findings
Alert prevalence and rate by atrial fibrillation (AF) and chronic kidney disease (CKD) at implantation
- Alert prevalence, AF vs no AF
- 84% vs 58%
- Alert prevalence, CKD vs no CKD
- 72% vs 59%
- Alert rate, AF vs no AF
- 1.51 vs 0.88 per patient-year
- Alert rate, CKD vs no CKD
- 1.30 vs 0.89 per patient-year
- P < .05
Recurrent alerts
- Patients with >1 alert
- 247
- Highest-change sensor varied between successive alerts
- 85%
Alerts associated with HF hospitalization or death
- Alerts associated with HF hospitalization or death
- 88 (7%)
- Respiration rate or RSBI as highest-change sensor
- 11%, P = .007 vs S3/S1
- Night heart rate as highest-change sensor
- 11%, P = .031 vs S3/S1
- Clinical events, first alert vs subsequent alerts
- 12.6% vs 5.2%, P < .001
Original publication
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