scholarly journals Predicting heart failure decompensation using cardiac implantable electronic devices: a review of practices and challenges

2015 ◽  
Vol 18 (8) ◽  
pp. 977-986 ◽  
Author(s):  
Nathaniel M. Hawkins ◽  
Sean A. Virani ◽  
Matthew Sperrin ◽  
Iain E. Buchan ◽  
John J.V. McMurray ◽  
...  
Keyword(s):  
Heart Failure ◽  
Electronic Devices ◽  
Cardiac Implantable Electronic Devices ◽  
Heart Failure Decompensation

scholarly journals Protecting the most vulnerable during COVID-19 and beyond: a case report on the remote management of heart failure patients with cardiac implantable electronic devices

2020 ◽  
Vol 4 (FI1) ◽  
pp. 1-6
Author(s):  
Fozia Zahir Ahmed ◽  
Carol Crosbie ◽  
Matthew Kahn ◽  
Manish Motwani
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Electronic Devices ◽  
Management Strategies ◽  
Phone Call ◽  
Cardiac Resynchronization ◽  
Physiological Data ◽  
Related Data ◽  
Cardiac Implantable Electronic Devices ◽  
Increased Risk

Abstract Background Heart failure (HF) patients with cardiac implantable electronic devices (CIEDs) represent an important cohort. They are at increased risk of hospitalization and mortality. We outline how remote-only management strategies, which leverage transmitted health-related data, can be used to optimize care for HF patients with a CIED during the COVID-19 pandemic. Case summary An 82-year-old man with HF, stable on medical therapy, underwent cardiac resynchronization therapy implantation in 2016. Modern CIEDs facilitate remote monitoring by providing real-time physiological data (thoracic impedance, heart rate and rhythm, etc.). The ‘Triage Heart Failure Risk Score’ (Triage-HFRS), available on Medtronic CIEDs, integrates several monitored physiological parameters into a risk prediction model classifying patients as low, medium, or high risk of HF events within 30 days. In November 2019, the patient was enrolled in an innovative clinical pathway (Triage-HF Plus) whereby any ‘high’ Triage-HF risk status transmission prompts a phone call-based virtual consultation. A high-risk alert was received via remote transmission on 11 March, triggering a phone call assessment. Upon reporting increasing breathlessness, diuretics were initiated. The prescription was remotely issued and delivered to the patient’s home. This approach circumvented the need for all face-to-face reviews, delivering care in an entirely remote manner. Discussion The challenges posed by COVID-19 have prompted us to think differently about how we deliver care for patients, both now and following the pandemic. Contemporary CIEDs facilitate the ability to remotely monitor HF patients by providing rich physiological data that can help identify individuals at elevated risk of decompensation using automated device-generated alerts.

scholarly journals Cardiac implantable electronic devices: a marker for poor outcome in patients with COVID-19 infection

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
B Wizman ◽  
M Haim ◽  
N Yasoor ◽  
I Peles ◽  
V Novack ◽  
...  
Keyword(s):  
Heart Failure ◽  
Medical Center ◽  
Electronic Devices ◽  
Univariate Analysis ◽  
Control Group ◽  
Age And Gender ◽  
Poor Outcome ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Devices ◽  
And Gender

Abstract Background A high percentage of SARS-CoV-2 patients suffer from comorbidities and there is increasing evidence that previous cardiac disease contributes to poor outcome in these patients (1,2). There is a paucity of information regarding the implications of the disease in patients with cardiac implantable electronic devices (CIEDs). Due to the increasing use of CIEDs in the management of arrhythmias and heart failure, determining the association between CIEDs and the severity of this disease is essential. Aim To obtain an adequate understanding regarding the association between cardiac devices and severity of COVID-19 infection in order to achieve optimum management of these patients. Methods All clinical and demographic parameters were collected retrospectively from a cohort of patients who underwent implantation of CIED in our Medical Center, Israel. We included 42 patients who tested positive for SARS-CoV-2, between January and December of 2020. Propensity score matching based on age and gender and adjusted Kaplan Meier curve of mortality were performed in order to evaluate the clinical outcome of patients with CIEDs and SARS- CoV-2 infection in comparison to the control group. Results The mean age of patients was 72.9 years, compose of 50% male and 50% female in both groups. In the group of patients with CIEDs, 11 (26.1%) patients had implantable defibrillator, and 31 (73.8%) had pacemaker. Univariate analysis revealed that patients with CIEDs suffered more from heart failure, coronary artery disease and atrial fibrillation, as well as hypertension, diabetes, and chronic kidney disease. Four patients (9.5%) with cardiac devices were hospitalized in the ICU due to critical illness, as compared to 1 (0.6%) patient in the control group (p=0.005). Moreover, 10 patients in the cardiac devices group (23.8%) died of SARS-CoV-2 infection, versus 25 (14.9%) in the control group. Conclusions CIEDs are a marker of poor outcome in patients with SARS-CoV-2 infection. Patients with CIEDs suffer from increased comorbidities in comparison with age and gender matched population and therefore should be managed with the utmost caution. FUNDunding Acknowledgement Type of funding sources: None. KM curve of all-cause mortality

scholarly journals Home Management of Heart Failure and Arrhythmias in Patients with Cardiac Devices during Pandemic

2021 ◽  
Vol 10 (8) ◽  
pp. 1618
Author(s):  
Andrea Matteucci ◽  
Michela Bonanni ◽  
Marco Centioni ◽  
Federico Zanin ◽  
Francesco Geuna ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ventricular Tachycardia ◽  
Hospital Admissions ◽  
Electronic Devices ◽  
Home Monitoring ◽  
Home Management ◽  
Cardiac Implantable Electronic Devices ◽  
Cardiac Devices ◽  
The Impact

Background: The in-hospital management of patients with cardiac implantable electronic devices (CIEDs) changed early in the COVID-19 pandemic. Routine in-hospital controls of CIEDs were converted into remote home monitoring (HM). The aim of our study was to investigate the impact of the lockdown period on CIEDs patients and its influence on in-hospital admissions through the analysis of HM data. Methods: We analysed data recorded from 312 patients with HM during the national quarantine related to COVID-19 and then compared data from the same period of 2019. Results: We observed a reduction in the number of HM events in 2020 when compared to 2019. Non-sustained ventricular tachycardia episodes decreased (18.3% vs. 9.9% p = 0.002) as well as atrial fibrillation episodes (29.2% vs. 22.4% p = 0.019). In contrast, heart failure (HF) alarm activation was lower in 2019 than in 2020 (17% vs. 25.3% p = 0.012). Hospital admissions for critical events recorded with CIEDs dropped in 2020, including those for HF. Conclusions: HM, combined with telemedicine use, has ensured the surveillance of CIED patients. In 2020, arrhythmic events and hospital admissions decreased significantly compared to 2019. Moreover, in 2020, patients with HF arrived in hospital in a worse clinical condition compared to previous months.

Cryoballoon ablation of atrial fibrillation in patients with advanced systolic heart failure and cardiac implantable electronic devices

2018 ◽  
pp. 1081-1088 ◽  
Author(s):  
Patrycja Pruszkowska ◽  
Radosław Lenarczyk ◽  
Jakub Gumprecht ◽  
Ewa Jedrzejczyk-Patej ◽  
Michał Mazurek ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Electronic Devices ◽  
Systolic Heart Failure ◽  
Cryoballoon Ablation ◽  
Cardiac Implantable Electronic Devices

scholarly journals Early Detection of Fluid Retention in Patients with Advanced Heart Failure: A Review of a Novel Multisensory Algorithm, HeartLogicTM

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1361
Author(s):  
Michelle Feijen ◽  
Anastasia D. Egorova ◽  
Saskia L. M. A. Beeres ◽  
Roderick W. Treskes
Keyword(s):  
Heart Failure ◽  
Early Detection ◽  
Electronic Devices ◽  
Advanced Heart Failure ◽  
Fluid Retention ◽  
Future Developments ◽  
Cardiac Implantable Electronic Devices ◽  
Significant Burden ◽  
Index Value

Heart failure (HF) hospitalisations due to decompensation are associated with shorter life expectancy and lower quality of life. These hospitalisations pose a significant burden on the patients, doctors and healthcare resources. Early detection of an upcoming episode of decompensation may facilitate timely optimisation of the ambulatory medical treatment and thereby prevent heart-failure-related hospitalisations. The HeartLogicTM algorithm combines data from five sensors of cardiac implantable electronic devices into a cumulative index value. It has been developed for early detection of fluid retention in heart failure patients. This review aims to provide an overview of the current literature and experience with the HeartLogicTM algorithm, illustrate how the index can be implemented in daily clinical practice and discuss ongoing studies and potential future developments of interest.

scholarly journals Last before-death transmission in patients with heart failure and implantable cardioverter-defibrillator followed by remote monitoring - insights from the COMMIT-HF registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
M Dyrbus ◽  
M Tajstra ◽  
L Pyka ◽  
A Kurek ◽  
M Gasior
Keyword(s):  
Heart Failure ◽  
Remote Monitoring ◽  
Hospital Admissions ◽  
Biventricular Pacing ◽  
Electronic Devices ◽  
Funding Sources ◽  
Cardiac Implantable Electronic Devices ◽  
Patients With Heart Failure ◽  
Median Period ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background  Remote monitoring (RM) of cardiac implantable electronic devices (CIED) in patients with heart failure allows to regularly analyze the devices" and patients" conditions.  Purpose  The purpose of this study was evaluation of the ultimate transmissions sent before death in patients monitored remotely.  Methods  The last transmissions delivered by the devices in patients enrolled into COMMIT-HF Registry (NCT02536443) who died when monitored remotely have been retrospectively analysed. The characteristics and contents of the transmissions and clinical reactions undertaken have been obtained from the RM systems of four major RM providers.  Results  Of 1,306 patients with CIEDs who were enrolled at the RM programme in our centre, 267 died and their last transmission occurred less than 90 days before death, of which 133 (49.8%) were scheduled and 134 (50.2%) alert-triggered. The median period between transmission and death was 31 days for scheduled and 8 days for alert-triggered transmissions. The most frequent alert-triggered transmissions were atrial fibrillation/flutter (35.8%) and ventricular tachyarrhythmias (24.6%). A clinical reaction has been undertaken after 9.8% of planned and 67.1% of alert-triggered transmissions and consisted mainly of telephone consultations and referrals for hospital admissions.  Conclusions  This is the first analysis of the ultimate transmissions delivered by CIEDs before death. In approximately 50% of patients, the last transmission has been alert-triggered. Hence, an appropriate organization of the RM facility, which should immediately analyse and react to the transmission, seems mandatory to obtain clinical benefit in patients with HF and RM. Causes of alerts and clinical reactionsCause of alertAll alert-triggered transmissions (N = 134)AF/AFL episode, n (%)48 (35.8%)Ventricular tachycardia, n (%)18 (13.4%)Ventricular fibrillation, n (%)15 (11.2%)Biventricular pacing percentage reduction, n (%)15 (11.2%)Others38 (28.3%)Congestion monitor indications, n (%)14 (10.4%)Clinical reactionPlanned transmission (N = 133)Alert-triggered transmission (N = 134)Telephone consultation10 (7.5%)58 (43.2%)Referral to the GP or outpatient specialist clinic visit2 (1.5%)12 (8.9%)Referral for hospital admission1 (0.7%)18 (13.4%)Pharmacotherapy modificationN/A2 (1.5%)Abstract Figure.

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