Heart failure & cardiomyopathies
Performance of a multi-sensor implantable defibrillator algorithm for heart failure monitoring in the presence of atrial fibrillation
Authors' conclusion
Patients received more alerts during periods of AF. The ability of the algorithm to identify increased risk of HF events was confirmed during AF, despite a lower IN/OUT-of-alert incidence rate ratio in comparison with non-AF periods and non-AF patients.
Study context
- Population
- ICD patients with HeartLogic heart failure (HF) monitoring activated, 26 centres
- Participants
- 568 patients · 26 centres
- Exposure
- HeartLogic performance during atrial high-rate episode (AHRE) burden ≥20 h/day (atrial fibrillation (AF)) vs <1 h/day periods, and vs matched non-AHRE patients
- AHREn = 53
- Matched non-AHREn = 106reference
Methodological detailsmulticentre, propensity-score matched (2:1)
- Multicentre
- Propensity-score matched (2:1)
Main finding
As reported in the abstract
Alert rate and IN/OUT-of-alert HF hospitalization rates
AHRE
- Alert rate, AHRE burden <1 h/day
- 1.2 (95% CI: 1.0-1.5)/patient-year
- Alert rate, AHRE burden ≥20 h/day
- 2.0 (95% CI: 1.5-2.6)/patient-year
- HF hospitalization rate, IN-alert
- 0.34 (95% CI: 0.15-0.69)/patient-year
- HF hospitalization rate, OUT-of-alert
- 0.06 (95% CI: 0.02-0.14)/patient-year
Matched non-AHRE
- HF hospitalization rate, IN-alert
- 0.29 (95% CI: 0.12-0.60)/patient-year
- HF hospitalization rate, OUT-of-alert
- 0.04 (95% CI: 0.02-0.08)/patient-year
Alert rate, AHRE burden <1 h/day
AHRE1.2 (95% CI: 1.0-1.5)/patient-year
Matched non-AHRENot reported in the abstract
Alert rate, AHRE burden ≥20 h/day
AHRE2.0 (95% CI: 1.5-2.6)/patient-year
Matched non-AHRENot reported in the abstract
HF hospitalization rate, IN-alert
AHRE0.34 (95% CI: 0.15-0.69)/patient-year
Matched non-AHRE0.29 (95% CI: 0.12-0.60)/patient-year
HF hospitalization rate, OUT-of-alert
AHRE0.06 (95% CI: 0.02-0.14)/patient-year
Matched non-AHRE0.04 (95% CI: 0.02-0.08)/patient-year
IN-alert vs OUT-of-alertIncidence rate ratio (95% CI)
AHRE group, AHRE burden <1 h/day
8.59(1.67–55.31)
AHRE group, AHRE burden ≥20 h/day
2.70(1.01–28.33)
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Performance of a multi-sensor implantable defibrillator algorithm for heart failure monitoring in the presence of atrial fibrillation. Europace. Published 1 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it