Impact and safety of remote monitoring of heart failure patients managed with the HeartLogic algorithm: the HeartLogic France Cohort Study

TL;DR

A study in France tested a remote monitoring system for heart failure patients, showing it can help prevent hospitalizations by alerting doctors early.

Contribution

This study demonstrates the real-world effectiveness and safety of using the HeartLogic algorithm for proactive heart failure management.

Findings

HeartLogic alerts led to treatment changes in 39.6% of cases.

66.7% of hospitalizations were preceded by a HeartLogic alert.

Only 6.1% of patients experienced unplanned hospitalizations.

Abstract

HeartLogic, an algorithm in implanted devices, predicts heart failure (HF) episodes via a remotely monitored index, aiding proactive congestion treatment to prevent acute decompensation. This study assessed the efficacy and safety of pre-emptive HF management using the HeartLogic index.

The HeartLogic France Cohort Study is a prospective multicentre investigation involving 310 HF patients with implanted cardioverter defibrillators enrolled from 10 French centres. The HeartLogic™ index was monitored for 12 months, and when the index reached ≥16, patients were contacted to adjust HF treatment. The primary endpoint was unscheduled hospitalization for HF. An independent blinded committee adjudicated the events. A total of 309 patients (65 ± 10 years old; 83.5% male, left ventricular ejection fraction 31 ± 9%) were included in the analysis. Ischemic cardiomyopathy was present in 61.2% (n = 189) of the patients, and 52.8% (n = 163) had a cardiac resynchronization therapy device. During follow-up, 406 alerts occurred in 158 patients (1.33 alerts/patient-year), resulting in treatment modification in 39.6% of alerts. A total of 24 unplanned HF hospitalizations occurred in 19 (6.1%) patients. Sixteen (66.7%) of those hospitalizations were preceded by a HeartLogic alert, of which 14 (87.5%) triggered a drug modification before hospitalization. Eighteen deaths (5.8%) occurred, including 10 due to cardiovascular causes. An increase in creatinine ≥30% and symptomatic hypotension were reported in two patients. Hyperkalemia and hyponatremia were not observed.

Pre-emptive HF management guided by the HeartLogic index was associated with low rates of unplanned hospitalizations and adverse events over a 12-month follow-up period.

ClinicalTrials.gov, ID: NCT04619888.

Graphical Abstract

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