Heart failure & cardiomyopathies
Performance of a Multisensor Implantable Defibrillator Algorithm for Heart Failure Monitoring Related to Co-Morbidities
Main finding · CV hospitalizations or deathResult — go to the resultIncidence rate ratio 13.35 95% CI 8.83–20.51Authors' conclusion
The burden of HeartLogic alerts was similar between CRT-D and ICD patients, while patients with AF and CKD seemed more exposed to alerts. Nonetheless, the ability of the HeartLogic algorithm to identify periods of significantly increased risk of clinical events was confirmed, regardless of the type of device and the presence of AF or CKD.
Study context
- Population
- ICD patients (CRT-D and non-CRT ICD) with HeartLogic multisensor heart failure (HF) algorithm activated, 26 centres410 with CRT-D
- Participants
- 568 patients
- Exposure
- HeartLogic IN alert state vs OUT of alert state
- Outcome
- CV hospitalizations or death
- Follow-up
- Median 26 months
Methodological detailsmulticentre, 97 hospitalizations (53 CV), 55 deaths during follow-up, 1200 HeartLogic alerts in 370 patients
- Multicentre
- 97 hospitalizations (53 CV), 55 deaths during follow-up
- 1200 HeartLogic alerts in 370 patients
Main finding
As reported in the abstract
Incidence rate ratio
13.35
95% CI 8.83–20.51
P < 0.001
By group
- Time IN alert state, % of total observation period
- 13%
Observational data: associations, not effects.
Further findings
Predictors of HeartLogic alerts
| HR (95% CI) | P value | ||
|---|---|---|---|
| AF on implantationIndependent predictor | 1.62 (1.27–2.07) | P < 0.001 | |
| CKDIndependent predictor | 1.53 (1.21–1.93) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Predictors of HeartLogic alertsCRT-Dvs ICDNot associated | 1.03 (0.82–1.30) | P = 0.775 | |
| 0.512Hazard ratio (log scale) |
Occurrence of alerts and CV hospitalization or death (multivariate)
| HR (95% CI) | P value | ||
|---|---|---|---|
| AlertsAfter multivariate correction | 1.92 (1.05–3.51) | P = 0.036 | |
| 0.20.5125Hazard ratio (log scale) |
Clinical events IN vs OUT of alert state, by CRT-D/ICD, atrial fibrillation (AF)/non-AF, chronic kidney disease (CKD)/non-CKD (subgroups)
- IRR range across all subgroups
- 9.72 to 14.54 (all P < 0.001)
Original publication
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