HeartLogic algorithm for heart failure monitoring in the era of CoViD-19 pandemic and remote monitoring/telemedicine

Abstract

Abstract Background Due to the current CoViD-19 pandemic, the number of outpatient hospital visits has significantly decreased, creating a fundamental need for telemedicine. Remote monitoring of implantable cardiac devices has emerged as a powerful and well-validated tool to follow patients with heart failure (HF) and cardiac resynchronization therapy (CRTs) devices. Purpose The aim of our study was to evaluate the CRT HeartLogic algorithm performance in the detection of HF episodes in a real-life population followed with remote monitoring. Methods Fifty-four patient (mean age 73±7 years, 72% males) with HF and reduced left ventricular ejection fraction were implanted with a HeartLogic-enabled CRT device and were enrolled in the Boston Scientific Latitude remote monitoring platform. Remote data were reviewed every month and at the time of an alert. The HeartLogic nominal value of 16 was used to trigger an alert episode. Patients were then contacted by phone and actions were taken to manage the potential HF condition detected by the alert. Results During a median follow-up of 12 (6–18) months, the HeartLogic alert was triggered in 9 patients (9/54, 17%). The median time between threshold crossing and a HF clinical event was 11 (2–19) days. The maximum HeartLogic index value was 43 (mean 29±8). Three events occurred after inappropriate discontinuation of HF therapy. All the events required clinical action. Four out of 9 patients required diuretic dosage increase, 1/9 electrical cardioversion for new onset atrial fibrillation, 3/9 hospitalization for i.v. therapy. One patient showed only mild HF symptoms but was found to have concomitant CoViD-19 infection. Conclusion The HeartLogic algorithm is useful to detect HF worsening and undertake appropriate clinical actions. Telemedicine and device remote monitoring are very helpful tools allowing early detection of HF-related clinical conditions. This is of utmost importance in the era of CoViD-19 pandemic, when scheduled access to the hospital for routine follow-up appointments might be limited. Funding Acknowledgement Type of funding sources: None.