Abstract 13787: Use of a Novel Cardiac Implantable Electronic Device Digital Care Pathway (TriageHF-Plus) is Associated With a Reduction in All-Cause Unplanned Hospitalizations

Abstract

Introduction: Heart failure hospitalization (HFH) is common, but it is also potentially preventable. The TriageHF risk score is an implantable cardiac device feature that uses data from up to 9 physiological parameters to classify patients as low, medium, or high risk of HFH in the next 30-days. Aim: To evaluate a remote management heart failure (HF) care pathway (“TriageHF-Plus”) that combines the TriageHF risk score with a structured telephone-based remote clinical patient assessment, by comparing rates of non-elective hospitalizations experienced by patients receiving TriageHF-Plus in a real-world clinical setting to those observed in patients receiving Standard of Care (SoC). Methods: Between Sept 2019 - Sept 2020, 415 patients with TriageHF compatible ICD or CRT devices were prospectively recruited from 3 UK hospitals. Once enrolled, all high risk TriageHF episodes were managed via the TriageHF-Plus pathway; these patients received a structured telephone assessment to assess for both HF and non-HF-related acute issues. Rates of non-elective hospitalizations observed following enrollment in the TriageHF-Plus cohort were compared with those observed in an unselected control cohort of HF patients with CIEDs receiving SoC (n=435) between Jan 2017 - Dec 2018. Results: Patient demographics and hospitalization data are presented in the Table. Nearly all patients in the TriageHF-Plus cohort had HF (91.9%) and the majority (77.8%) had a CRT device. In TriageHF-Plus, there were 135 unplanned all-cause hospitalizations, compared with 358 in SoC; and rates per patient year for all-cause (0.41 vs 0.57, p=0.001), cardiovascular (0.14 vs 0.29, p=0.037) and heart failure (0.02 vs 0.07, p=0.003) hospitalizations were all significantly lower in the TriageHF-Plus cohort. Conclusions: In a population of predominantly HF patients with CIEDs, the TriageHF-Plus pathway reduced rates of unplanned hospitalizations compared with SoC, with the greatest reduction observed in HFH.