Abstract 6902: Heart Failure Measurements Using Heartlogic Directly Correlates with Increased Burden of Atrial Fibrillation

Abstract

Introduction: Atrial Fibrillation (AF) is a risk factor for death in patients with heart failure (HF). Device sensor measurements from ICDs/CRT-Ds can provide detailed data on the impact of AF on HF. HeartLogic index, HF sensor monitoring can detect worsening HF with high sensitivity. Hypothesis: We hypothesize HeartLogic sensors would be able to detect worsening HF with increased AF burden. Methods: AF burden was measured as time greater than atrial tachyarrhythmia rate of 170 bpm. Each patient day was grouped into 7 groups based on daily AF burden: No AF/normal sinus rhythm (NSR), >0min, >6min, >1hr, >5.5hr, >12hr, and 24hr. Total 15,533 US patients from ALTITUDE database with HeartLogic devices and a minimum of 365 days of data were analyzed, 754 patients with all 7 levels of AF burden were included. For each group, mean daily heart sounds (S3, S1), respiratory rate (RR), rapid shallow breathing index (RSBI), thoracic impedance (TI), daily and night heart rate (HR, NHR), patient time active, HeartLogic index, and the percent of in-alert days were evaluated. Sensors were compared during each AF burden and during NSR using paired T-test. Results: AF burden groups above 6min were associated to significant worsening in S1, RR, RSBI, NHR, HR and HeartLogic index (figure). Significant reduction in patient activity occurred above 5.5hr of AF burden. In-alert days (%) increased significantly during AF burden above 6min compared with NSR. Conclusions: This data suggests potential use of HeartLogic sensors to identify patients whose HF status is most impacted by development of AF and those who may benefit most from rhythm control. Additional studies using sensor based AF management may improve clinical outcomes.