Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities
Abstract Aims The HeartLogic algorithm combines multiple implantable defibrillator (ICD) sensor data and has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation in cardiac resynchronization therapy (CRT‐D) patients. We evaluated the performance of this algori...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-08-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14416 |
| _version_ | 1797770717492674560 |
|---|---|
| author | Vincenzo Ezio Santobuono Stefano Favale Antonio D'Onofrio Michele Manzo Leonardo Calò Matteo Bertini Gianluca Savarese Luca Santini Antonio Dello Russo Carlo Lavalle Miguel Viscusi Claudia Amellone Raimondo Calvanese Giuseppe Arena Antonio Pangallo Antonio Rapacciuolo Daniele Porcelli Monica Campari Sergio Valsecchi Andrea Igoren Guaricci |
| author_facet | Vincenzo Ezio Santobuono Stefano Favale Antonio D'Onofrio Michele Manzo Leonardo Calò Matteo Bertini Gianluca Savarese Luca Santini Antonio Dello Russo Carlo Lavalle Miguel Viscusi Claudia Amellone Raimondo Calvanese Giuseppe Arena Antonio Pangallo Antonio Rapacciuolo Daniele Porcelli Monica Campari Sergio Valsecchi Andrea Igoren Guaricci |
| author_sort | Vincenzo Ezio Santobuono |
| collection | DOAJ |
| description | Abstract Aims The HeartLogic algorithm combines multiple implantable defibrillator (ICD) sensor data and has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation in cardiac resynchronization therapy (CRT‐D) patients. We evaluated the performance of this algorithm in non‐CRT ICD patients and in the presence of co‐morbidities. Methods and results The HeartLogic feature was activated in 568 ICD patients (410 with CRT‐D) from 26 centres. The median follow‐up was 26 months [25th–75th percentile: 16–37]. During follow‐up, 97 hospitalizations were reported (53 cardiovascular) and 55 patients died. We recorded 1200 HeartLogic alerts in 370 patients. Overall, the time IN the alert state was 13% of the total observation period. The rate of cardiovascular hospitalizations or death was 0.48/patient‐year (95% CI: 0.37–0.60) with the HeartLogic IN the alert state and 0.04/patient‐year (95% CI: 0.03–0.05) OUT of the alert state, with an incidence rate ratio of 13.35 (95% CI: 8.83–20.51, P < 0.001). Among patient characteristics, atrial fibrillation (AF) on implantation (HR: 1.62, 95% CI: 1.27–2.07, P < 0.001) and chronic kidney disease (CKD) (HR: 1.53, 95% CI: 1.21–1.93, P < 0.001) independently predicted alerts. HeartLogic alerts were not associated with CRT‐D versus ICD implantation (HR: 1.03, 95% CI: 0.82–1.30, P = 0.775). Comparisons of the clinical event rates in the IN alert state with those in the OUT of alert state yielded incidence rate ratios ranging from 9.72 to 14.54 (all P < 0.001) in all groups of patients stratified by: CRT‐D/ICD, AF/non‐AF, and CKD/non‐CKD. After multivariate correction, the occurrence of alerts was associated with cardiovascular hospitalization or death (HR: 1.92, 95% CI: 1.05–3.51, P = 0.036). Conclusions The burden of HeartLogic alerts was similar between CRT‐D and ICD patients, while patients with AF and CKD seemed more exposed to alerts. Nonetheless, the ability of the HeartLogic algorithm to identify periods of significantly increased risk of clinical events was confirmed, regardless of the type of device and the presence of AF or CKD. |
| first_indexed | 2024-03-12T21:27:14Z |
| format | Article |
| id | doaj.art-08a81fedfc7447ebbab738c5c09137d0 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-12T21:27:14Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-08a81fedfc7447ebbab738c5c09137d02023-07-28T06:30:48ZengWileyESC Heart Failure2055-58222023-08-011042469247810.1002/ehf2.14416Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbiditiesVincenzo Ezio Santobuono0Stefano Favale1Antonio D'Onofrio2Michele Manzo3Leonardo Calò4Matteo Bertini5Gianluca Savarese6Luca Santini7Antonio Dello Russo8Carlo Lavalle9Miguel Viscusi10Claudia Amellone11Raimondo Calvanese12Giuseppe Arena13Antonio Pangallo14Antonio Rapacciuolo15Daniele Porcelli16Monica Campari17Sergio Valsecchi18Andrea Igoren Guaricci19Interdisciplinary Department of Medicine, Cardiology Unit Polyclinic of Bari University of Bari ‘Aldo Moro’ Bari ItalyInterdisciplinary Department of Medicine, Cardiology Unit Polyclinic of Bari University of Bari ‘Aldo Moro’ Bari ItalyUnità Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie’ Monaldi Hospital Naples ItalyOO.RR. San Giovanni di Dio Ruggi d'Aragona Salerno ItalyPoliclinico Casilino Rome ItalyUniversity of Ferrara, S. Anna University Hospital Ferrara ItalyS. Giovanni Battista Hospital Foligno Italy‘Giovan Battista Grassi’ Hospital Rome ItalyUniversità Politecnica delle Marche, ‘Ospedali Riuniti’ Ancona ItalyPoliclinico Umberto I Rome ItalyS. Anna e S. Sebastiano Hospital Caserta Italy‘Maria Vittoria’ Hospital Turin ItalyOspedale del Mare, ASL NA1 Naples ItalyOspedale Civile Apuane Massa Italy‘Bianchi‐Melacrino‐Morelli’ Hospital Reggio Calabria ItalyPoliclinico Federico II Naples ItalyS. Pietro Fatebenefratelli Hospital Rome ItalyBoston Scientific Italia Milan ItalyBoston Scientific Italia Milan ItalyInterdisciplinary Department of Medicine, Cardiology Unit Polyclinic of Bari University of Bari ‘Aldo Moro’ Bari ItalyAbstract Aims The HeartLogic algorithm combines multiple implantable defibrillator (ICD) sensor data and has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation in cardiac resynchronization therapy (CRT‐D) patients. We evaluated the performance of this algorithm in non‐CRT ICD patients and in the presence of co‐morbidities. Methods and results The HeartLogic feature was activated in 568 ICD patients (410 with CRT‐D) from 26 centres. The median follow‐up was 26 months [25th–75th percentile: 16–37]. During follow‐up, 97 hospitalizations were reported (53 cardiovascular) and 55 patients died. We recorded 1200 HeartLogic alerts in 370 patients. Overall, the time IN the alert state was 13% of the total observation period. The rate of cardiovascular hospitalizations or death was 0.48/patient‐year (95% CI: 0.37–0.60) with the HeartLogic IN the alert state and 0.04/patient‐year (95% CI: 0.03–0.05) OUT of the alert state, with an incidence rate ratio of 13.35 (95% CI: 8.83–20.51, P < 0.001). Among patient characteristics, atrial fibrillation (AF) on implantation (HR: 1.62, 95% CI: 1.27–2.07, P < 0.001) and chronic kidney disease (CKD) (HR: 1.53, 95% CI: 1.21–1.93, P < 0.001) independently predicted alerts. HeartLogic alerts were not associated with CRT‐D versus ICD implantation (HR: 1.03, 95% CI: 0.82–1.30, P = 0.775). Comparisons of the clinical event rates in the IN alert state with those in the OUT of alert state yielded incidence rate ratios ranging from 9.72 to 14.54 (all P < 0.001) in all groups of patients stratified by: CRT‐D/ICD, AF/non‐AF, and CKD/non‐CKD. After multivariate correction, the occurrence of alerts was associated with cardiovascular hospitalization or death (HR: 1.92, 95% CI: 1.05–3.51, P = 0.036). Conclusions The burden of HeartLogic alerts was similar between CRT‐D and ICD patients, while patients with AF and CKD seemed more exposed to alerts. Nonetheless, the ability of the HeartLogic algorithm to identify periods of significantly increased risk of clinical events was confirmed, regardless of the type of device and the presence of AF or CKD.https://doi.org/10.1002/ehf2.14416Atrial fibrillationChronic kidney diseaseCRTHeart failureICDRisk stratification |
| spellingShingle | Vincenzo Ezio Santobuono Stefano Favale Antonio D'Onofrio Michele Manzo Leonardo Calò Matteo Bertini Gianluca Savarese Luca Santini Antonio Dello Russo Carlo Lavalle Miguel Viscusi Claudia Amellone Raimondo Calvanese Giuseppe Arena Antonio Pangallo Antonio Rapacciuolo Daniele Porcelli Monica Campari Sergio Valsecchi Andrea Igoren Guaricci Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities ESC Heart Failure Atrial fibrillation Chronic kidney disease CRT Heart failure ICD Risk stratification |
| title | Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities |
| title_full | Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities |
| title_fullStr | Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities |
| title_full_unstemmed | Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities |
| title_short | Performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co‐morbidities |
| title_sort | performance of a multisensor implantable defibrillator algorithm for heart failure monitoring related to co morbidities |
| topic | Atrial fibrillation Chronic kidney disease CRT Heart failure ICD Risk stratification |
| url | https://doi.org/10.1002/ehf2.14416 |
| work_keys_str_mv | AT vincenzoeziosantobuono performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT stefanofavale performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT antoniodonofrio performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT michelemanzo performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT leonardocalo performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT matteobertini performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT gianlucasavarese performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT lucasantini performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT antoniodellorusso performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT carlolavalle performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT miguelviscusi performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT claudiaamellone performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT raimondocalvanese performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT giuseppearena performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT antoniopangallo performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT antoniorapacciuolo performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT danieleporcelli performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT monicacampari performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT sergiovalsecchi performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities AT andreaigorenguaricci performanceofamultisensorimplantabledefibrillatoralgorithmforheartfailuremonitoringrelatedtocomorbidities |