ISSN: 1885-5857 Impact factor 2023 7.2
Vol. 77. Num. 12.
Pages 1008-1017 (December 2024)

Original article
Clinical impact of remote heart failure management using the multiparameter ICD HeartLogic alert

Impacto clínico del tratamiento a distancia de la insuficiencia cardiaca con la alerta multiparamétrica del DAI HeartLogic

Javier de Juan BagudáabcRocío Cózar LeóndJuan J. Gavira GómezeMarta PachónfJosebe Goirigolzarri ArtazagVirgilio Martínez MateohVanessa Escolar PéreziÁngel Manuel Iniesta ManjavacasjNuria Rivas GándarakJesús Álvarez-GarcíablJesús Gabriel Sánchez RamosmCristina Aguilera AgudonJosé Manuel Rubín LópezoAlfonso Macías GallegopSilvia López FernándezqLuis González TorresrJuan Gabriel MartínezsNatalia Marrero NegríntJavier Ramos MaquedauMercedes Cabrera RamosuJosé María Medina GiltCarlos De Diego RusrFrancisco José Bermúdez JiménezqInés MadrazopBeatriz Díaz MolinaoMarta Cobo MarcosbnAna Delia Ruiz DuthilmDavid CorderolAna Belén Méndez FernándezkLaura Peña CondejMaría F. Arcocha TorresiNicasio Pérez CastellanobgMiguel Á. AriasfIgnacio García BolaoeErnesto Díaz InfantedMonica CamparivFernando Arribas YnsaurriagaabwJuan F. Delgado JiménezabwSergio ValsecchivRafael Salguero Bodesabw
Imagen extra
Rev Esp Cardiol. 2024;77:1008-17
Abstract
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.

Keywords

Telemedicine
Implantable cardioverter-defibrillator
Cardiac resynchronization therapy
Heart failure
Risk stratification

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