Scientific publications
Clinical impact of remote heart failure management using the multiparameter ICD HeartLogic alert
Javier De Juan Bagudá 1 , Rocío Cózar León 2 , Juan J Gavira Gómez 3 , Marta Pachón 4 , Josebe Goirigolzarri Artaza 5 , Virgilio Martínez Mateo 6 , Vanessa Escolar Pérez 7 , Ángel Manuel Iniesta Manjavacas 8 , Nuria Rivas Gándara 9 , Jesús Álvarez-García 10 , Jesús Gabriel Sánchez Ramos 11 , Cristina Aguilera Agudo 12 , José Manuel Rubín López 13 , Alfonso Macías Gallego 14 , Silvia López Fernández 15 , Luis González Torres 16 , Juan Gabriel Martínez 17 , Natalia Marrero Negrín 18 , Javier Ramos Maqueda 19 , Mercedes Cabrera Ramos 19 , José María Medina Gil 18 , Carlos De Diego Rus 16 , Francisco José Bermúdez Jiménez 15 , Inés Madrazo 14 , Beatriz Díaz Molina 13 , Marta Cobo Marcos 20 , Ana Delia Ruiz Duthil 11 , David Cordero 21 , Ana Belén Méndez Fernández 9 , Laura Peña Conde 8 , María F Arcocha Torres 7 , Nicasio Pérez Castellano 22 , Miguel A Arias 4 , Ignacio García Bolao 3 , Ernesto Díaz Infante 2 , Monica Campari 23 , Fernando Arribas Ynsaurriaga 24 , Juan F Delgado Jiménez 24 , Sergio Valsecchi 23 , Rafael Salguero Bodes 24
Introduction and objectives: The multiparametric implantable cardioverter-defibrillator HeartLogic index has proven to be a sensitive and timely predictor of impending heart failure (HF) decompensation. We evaluated the impact of a standardized follow-up protocol implemented by nursing staff and based on remote management of alerts.
Methods: The algorithm was activated in HF patients at 19 Spanish centers. Transmitted data were analyzed remotely, and patients were contacted by telephone if alerts were issued. Clinical actions were implemented remotely or through outpatient visits. The primary endpoint consisted of HF hospitalizations or death. Secondary endpoints were HF outpatient visits. We compared the 12-month periods before and after the adoption of the protocol.
Results: We analyzed 392 patients (aged 69 ± 10 years, 76% male, 50% ischemic cardiomyopathy) with implantable cardioverter-defibrillators (20%) or cardiac resynchronization therapy defibrillators (80%). The primary endpoint occurred 151 times in 86 (22%) patients during the 12 months before the adoption of the protocol, and 69 times in 45 (11%) patients (P < .001) during the 12 months after its adoption. The mean number of hospitalizations per patient was 0.39 ± 0.89 pre- and 0.18 ± 0.57 postadoption (P < .001). There were 185 outpatient visits for HF in 96 (24%) patients before adoption and 64 in 48 (12%) patients after adoption (P < .001). The mean number of visits per patient was 0.47 ± 1.11 pre- and 0.16 ± 0.51 postadoption (P < .001).
Conclusions: A standardized follow-up protocol based on remote management of HeartLogic alerts enabled effective remote management of HF patients. After its adoption, we observed a significant reduction in HF hospitalizations and outpatient visits.
CITATION Rev Esp Cardiol (Engl Ed). 2024 Apr 30:S1885-5857(24)00148-8. doi: 10.1016/j.rec.2024.04.006
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