Author + information
- Christophe Smeetsa,b,
- Frederik Verbruggea,b,
- Julie Vrankena,b,
- Jo Van der Auweraa,b,
- Wilfried Mullensa,b,
- Matthias Duponta,b,
- Lars Grietena,b,
- Hélène De Cannièrea,b,
- Dorien Lanssensa,b,
- Thijs Vandenberka,b,
- Valerie Stormsa,b,
- Inge Thijsa,b and
- Pieter Vandervoorta,b
Background: The use of implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices is expanding in heart failure (HF). Most of the current devices are provided with remote monitoring functions, including bioimpedance. The question remains whether bioimpedance has a positive impact on clinical outcome.
Methods: Consecutive ICD and CRT patients (n=282) participating in protocol-driven remote follow-up inside a single tertiary care center (Ziekenhuis Oost-Limburg, Genk, Belgium) were followed prospectively. Bioimpedance alerts were analyzed with subsequently triggered interventions.
Results: In 154/282 patients (55%), the ICD or CRT device was equipped with a remote bioimpedance algorithm. During 34±12 months of follow-up, 2,096 remote monitoring alerts were received (2.6 per patient-year of follow-up). Since 591 (28%) of all alerts were bioimpedance alerts, patients with versus without an ICD or CRT including a bioimpedance algorithm had significantly more alerts (3.4 versus 1.8 alerts per patient-year of follow-up, p<0.001). In 18% of unique bioimpedance alerts, an intervention was triggered, which comprised sending the patient to the outpatient cardiology clinic (4%), general practitioner (5%), or changes in medical therapy by telephonic instruction (9%). No significant differences were observed concerning the number of elective follow-up visits in the outpatient HF clinic, nor for the number of hospital admissions with a primary diagnosis of HF or mean length of hospital stay between both groups.
Conclusions: Bioimpedance alerts constituted a substantial amount of incoming alerts when turned on during remote follow-up and triggered an intervention in only one out of five cases. The observation that patients with an ICD or CRT with bioimpedance algorithms turned on had significantly more remote monitoring alerts without improved clinical outcome, suggests that one might consider to turn them off and focus on other alarms in case of time restraints.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Heart Failure Gadgets Galore
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1199-256
- 2017 American College of Cardiology Foundation