scholarly journals Use of a novel implantable cardioverter‐defibrillator multisensor algorithm for heart failure monitoring in a COVID‐19 patient: A case report

2021 ◽  
Author(s):  
Luca Bontempi ◽  
Manuel Cerini ◽  
Francesca Salghetti ◽  
Davide Fabbricatore ◽  
Clara Nozza ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Implantable Cardioverter Defibrillator ◽  
Cardioverter Defibrillator ◽  
Failure Monitoring ◽  
Heart Failure Monitoring

scholarly journals Inverse Relation between Condition of Heart Failure and Intrathoracic Impedance Measured by Implantable Cardioverter Defibrillator-A case report-

2005 ◽  
Vol 21 (5) ◽  
pp. 553-555
Author(s):  
Kohei Matsushita ◽  
Toshiyuki Ishikawa ◽  
Shinichi Sumita ◽  
Tsukasa Kobayashi ◽  
Hideyuki Ogawa ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Implantable Cardioverter Defibrillator ◽  
Inverse Relation ◽  
Cardioverter Defibrillator ◽  
Intrathoracic Impedance

scholarly journals Multiparameter Monitoring with a Wearable Cardioverter Defibrillator

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 22
Author(s):  
Ursula Rohrer ◽  
Martin Manninger ◽  
Andreas Zirlik ◽  
Daniel Scherr
Keyword(s):  
Heart Failure ◽  
Heart Failure Treatment ◽  
Cardioverter Defibrillator ◽  
Wearable Cardioverter Defibrillator ◽  
Monitoring Therapy ◽  
Temporary Treatment ◽  
Multiparameter Monitoring ◽  
Therapy Success ◽  
Failure Monitoring ◽  
Heart Failure Monitoring

A wearable cardioverter-defibrillator (WCD) is a temporary treatment option for patients at high risk for sudden cardiac death (SCD) and for patients who are temporarily not candidates for an implantable cardioverter defibrillator (ICD). In addition, the need for telemedical concepts in the detection and treatment of heart failure (HF) and its arrhythmias is growing. The WCD has evolved from a shock device detecting malignant ventricular arrhythmias (VA) and treating them with shocks to a heart-failure-monitoring device that captures physical activity and cardioacoustic biomarkers as surrogate parameters for HF to help the treating physician surveil and guide the HF therapy of each individual patient. In addition to its important role in preventing SCD, the WCD could become an important tool in heart failure treatment by helping prevent HF events by detecting imminent decompensation via remote monitoring and monitoring therapy success.

scholarly journals Heart failure monitoring using the wearable cardioverter defibrillator in patients with newly diagnosed heart failure

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
HAK Hillmann ◽  
J Eiringhaus ◽  
S Hohmann ◽  
JL Mueller-Leisse ◽  
C Zormpas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Step Count ◽  
Newly Diagnosed ◽  
Cardioverter Defibrillator ◽  
Wearable Cardioverter Defibrillator ◽  
Rate Step ◽  
Failure Monitoring ◽  
Heart Failure Monitoring

Abstract Funding Acknowledgements Type of funding sources: None. Background The wearable cardioverter-defibrillator (WCD) can be prescribed in patients with newly diagnosed heart failure. The WCD provides additional heart failure parameters, like heart rate, step count and body position, accessible via remote monitoring. The purpose of this study was to evaluate clinical relevance of additionally recorded data in patients using the WCD. Methods Patients with newly diagnosed heart failure and WCD, an average wear time with at least 20 hours per day and available heart failure parameters were included. The heart failure parameters were provided in 5-minute data intervals. An approximate for the heart rate variability was calculated via the standard deviation of the cycle length of the given heart rate per 5-minute data interval (HRV5). Results 276 patients (68% male) were included between 04/2013 and 12/2017. Mean age was 57.4 ± 15.3 years. 174 patients (63%) suffered from non-ischemic and 102 patients (37%) from ischemic cardiomyopathy. Mean NYHA functional class at prescription was 2.6 ± 0.8. Mean left ventricular ejection fraction (LVEF) was 25.3 ± 8.5%. Mean wear time of the WCD was 111.8 ± 74.5 days. Recorded median heart rate using the WCD was 70.8 (IQR 63.1 - 78.7) beats per minute on the first wear day and 64.5 (IQR 59.7 - 71.3) on the last wear day. Median step count amounted to 4294 (IQR 2283 - 7092) steps on the first wear day compared to 5688 (IQR 3153 - 8263) steps on the last wear day. Median HRV5 was 85.4 (IQR 60.1 - 109.8) ms on the first wear day and 110.4 (IQR 78.6 - 134.9) ms on the last wear day.  Between the first and last seven days of usage, median heart rate was significantly reduced (69.5 (IQR 62.0 - 76.8) to 65.9 (IQR 60.4 - 72.2) beats per minute; p < 0.001), while median step counts per day (4657 (IQR 2778 – 6918) to 5562 (IQR 3890 – 8446) steps; p < 0.001) and HRV5 (89.0 (IQR 64.8 - 110.7) to 111.0 (IQR 83.7 - 134.7) ms; p < 0.001) were significantly elevated. A higher delta of heart rate correlated with a higher delta of HRV5A (p < 0,001; rs = 0.488) between the first and last seven days of usage. A higher delta of step counts per day in the first and last seven days correlated with a higher HRV5 (p < 0.001; rs = 0.320). Patients with a higher delta of step count per day (p = 0,005; rs = 0,189) and patients with a higher delta of HRV5 (p = < 0.001; rs = 0.255) showed a higher delta of LVEF measured at prescription and three months follow-up. Conclusion The WCD provides heart failure monitoring using additional heart failure parameters. Patients with newly diagnosed heart failure show a significant difference in heart rate, step count per day and heart rate variability approximate between beginning and end of prescription time. Step count and heart rate variability correlate with LVEF reverse remodeling. Remote monitoring for parameters regarding heart failure might be helpful for close monitoring and further heart failure therapy optimization during WCD wearing.

scholarly journals MONITORIA: The start of a new era of ambulatory heart failure monitoring? Part I – Theoretical Rationale

2021 ◽  
Vol 40 (5) ◽  
pp. 329-337
Author(s):  
Carla Martins ◽  
José Machado da Silva ◽  
Diana Guimarães ◽  
Luís Martins ◽  
Manuel Vaz da Silva
Keyword(s):  
Heart Failure ◽  
Theoretical Rationale ◽  
New Era ◽  
Failure Monitoring ◽  
Heart Failure Monitoring

scholarly journals Quality and utility of [123I]I-metaiodobenzylguanidine cardiac SPECT imaging in nondiabetic postinfarction heart failure patients qualified for implantable cardioverter defibrillator

2021 ◽  
Author(s):  
Anna Teresińska ◽  
Olgierd Woźniak ◽  
Aleksander Maciąg ◽  
Jacek Wnuk ◽  
Jarosław Jezierski ◽  
...  
Keyword(s):  
Heart Failure ◽  
Implantable Cardioverter Defibrillator ◽  
Left Lung ◽  
Spect Imaging ◽  
Cardiac Innervation ◽  
Cardiac Spect ◽  
Cardioverter Defibrillator ◽  
Planar Images ◽  
Spect Images

Abstract Objective Impaired cardiac adrenergic activity has been demonstrated in heart failure (HF) and in diabetes mellitus (DM). [123I]I-metaiodobenzylguanidine (MIBG) enables assessment of the cardiac adrenergic nervous system. Tomographic imaging of the heart is expected to be superior to planar imaging. This study aimed to determine the quality and utility of MIBG SPECT in the assessment of cardiac innervation in postinfarction HF patients without DM, qualified for implantable cardioverter defibrillator (ICD) in primary prevention of sudden cardiac death. Methods Consecutive patients receiving an ICD on the basis of contemporary guidelines were prospectively included. Planar MIBG studies were followed by SPECT. The essential analysis was based on visual assessment of the quality of SPECT images (“high”, “low” or “unacceptable”). The variables used in the further analysis were late summed defect score for SPECT images and heart-to-mediastinum rate for planar images. MIBG images were assessed independently by two experienced readers. Results Fifty postinfarction nondiabetic HF subjects were enrolled. In 13 patients (26%), the assessment of SPECT studies was impossible. In addition, in 13 of 37 patients who underwent semiquantitative SPECT evaluation, the assessment was equivocal. Altogether, in 26/50 patients (52%, 95% confidence interval 38–65%), the quality of SPECT images was unacceptable or low and was limited by low MIBG cardiac uptake and by comparatively high, interfering MIBG uptake in the neighboring structures (primarily, in the lungs). Conclusions The utility of MIBG SPECT imaging, at least with conventional imaging protocols, in the qualification of postinfarction HF patients for ICD, is limited. In approximately half of the postinfarction HF patients, SPECT assessment of cardiac innervation can be impossible or equivocal, even without additional damage from diabetic cardiac neuropathy. The criteria predisposing the patient to good-quality MIBG SPECT are: high values of LVEF from the range characterizing the patients qualified to ICD (i.e., close to 35%) and left lung uptake intensity in planar images comparable to or lower than heart uptake.

scholarly journals Remote heart failure management using a multiparameter implantable cardioverter-defibrillator alert: the multicentric RE-HEART registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J De Juan Baguda ◽  
J.J Gavira Gomez ◽  
M Pachon Iglesias ◽  
L Pena Conde ◽  
J.M Rubin Lopez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Implantable Cardioverter Defibrillator ◽  
Median Duration ◽  
Office Visit ◽  
Active Phase ◽  
Cardiac Resynchronization ◽  
Office Visits ◽  
Icd Implantation ◽  
Cardioverter Defibrillator ◽  
Clinical Events

Abstract Background The HeartLogic algorithm combines multiple implantable cardioverter-defibrillator (ICD)-based sensors into an index for prediction of impending heart failure (HF) decompensation. In patients with ICD and cardiac resynchronization therapy ICD remotely monitored at 13 Spanish centers, we analyzed the association between clinical events and HeartLogic alerts and we described the use of the algorithm for the remote management of HF. Methods The association between clinical events and HeartLogic alerts was studied in the blinded phase (from ICD implantation to alert activation – no clinical actions taken in response to alerts) and in the following active phase (after alert activation – clinicians automatically notified in case of alert). Results We enrolled a total of 215 patients (67±13 years old, 77% male, 53% with ischemic cardiomyopathy) with ICD (19%) or CRT-D (81%). The median duration of the blinded phase was 8 [3–12] months. In this phase, the HeartLogic index crossed the threshold value (set by default to 16) 34 times in 20 patients. HeartLogic alerts were associated with 6 HF hospitalizations and 5 unplanned in-office visits for HF. Five additional HeartLogic threshold crossings were not associated with overt HF events, but occurred at the time of changes in drug therapy or of other clinical events. The rate of unexplained alerts was 0.25 alert-patient/year. The median time spent in alert was longer in the case of HF hospitalizations than of in-office visits (75 [min-max: 30–155] days versus 39 [min-max: 5–105] days). The maximum HeartLogic index value was 38±15 in the case of hospitalizations and 24±7 in that of minor HF events. The median duration of the following active phase was 5 [2–10] months. After HeartLogic activation, 40 alerts were reported in 26 patients. Twenty-seven (68%) alerts were associated with multiple HF- or non-HF related conditions or changes in prescribed HF therapy. Multiple actions were triggered by these alerts: HF hospitalization (4), unscheduled in-office visits (8), diuretics increase (8), change in other cardiovascular drugs (5), device reprogramming (2), atrial fibrillation ablation (1), patient education on therapy adherence (2). The rate of unexplained alerts not followed by any clinical action was 0.13 alert-patient/year. These alerts were managed remotely (device data review and phone contact), except for one alert that generated an unscheduled in-office visit. Conclusions HeartLogic index was frequently associated with HF-related clinical events. The activation of the associated alert allowed to remotely detect relevant clinical conditions and to implement clinical actions. The rate of unexplained alerts was low, and the work required in order to exclude any impending decompensation did not constitute a significant burden for the centers. Funding Acknowledgement Type of funding source: None

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