Assessment of heart failure parameters by telemonitoring patients with an implantable cardioverter defibrillator

Abstract

Abstract Introduction Different heart failure (HF) parameters have been evaluated in patients with an implantable cardioverter defibrillator (ICD). Recently, a multi-parameters HF index available in some ICDs has been proposed for patients monitoring in order to prevent hospitalizations for HF. We sought to analyze this index in our patients, based on the occurrence of hospitalizations for HF and/or all-cause mortality. As a second endpoint, the level of NT-pro-BNP, the treatment of HF and the Minnesota score (quality of life) were as well evaluated. Method This was on an open, single-center, case-control study. Inclusions started on March 2017 to end up in November 2020 with the main criteria of HF with left ventricular ejection fraction (LVEF) <35%, DDD or CRT-D implanted in primary prevention. A control group was composed of patients receiving telemonitoring and a control group composed of patients receiving standard monitoring. A 1/1 pairing was carried out, based on 3 criteria: age, sex and the date of ICD implantation. Data collection was carried out in August 2021. Results 74 patients were included in the study; none was lost to follow-up. The occurrence of hospitalization for HF and/or death from any cause was found at the end of the study in 7 of 37 patients in the remote monitoring group versus 22 events of 37 in patients receiving standard monitoring (p=0.011). The number of deaths from any cause was 4 in the study group vs 8 in the control group (NS, p=0.21). The average length of hospital stay is 6.27 days (± 23.6) for patients receiving remote monitoring compared to 9.14 days (± 22.1) p=0.64. NT-pro-BNP was found with a median level of 553 pg/mL [146; 1541] in the remotely monitored group against 498 pg/mL [211; 1400] in controls (p=0.77). The assessment of quality of life by the Minnesota score shows a similar result (p=0.7). Analysis of the treatment of HF shows a significantly (p<0.01) greater presence of anti-aldosterone in patients receiving remote monitoring. Conclusion Our study demonstrates the benefit of the telemonitoring protocol on the occurrence of hospitalizations for heart failure and/or all-cause mortality in heart failure patients with an ICD. We observe a significantly higher percentage of anti-aldosterone treatment in monitored patients, suggesting a more optimized medical treatment. Funding Acknowledgement Type of funding sources: None.