Reduction in Heart Failure Hospitalizations Through Real-World HeartLogicTM Alert Response　― A Multicenter Study in Japan ―

Background: Heart failure (HF) is a progressive disease characterized by an increasing incidence of hospitalization over time. HeartLogic TM (HL) is a multiparametric remote monitoring system designed to detect early signs of HF decompensation. Using a multicenter database, this real-world study evaluated whether responses to HL alerts could reduce HF-related hospitalization. Methods and Results: We retrospectively analyzed 246 patients implanted with an HL-enabled implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator across 8 Japanese centers. Patients were categorized as alert-responsive (AR; n=167) or non-responsive (NR; n=79). Alert responses included multidisciplinary review and telephone triage to determine the need for clinical visits. HF hospitalization rates during the alert-off (before activation) and the alert-on (after alert activation) periods were compared. During the alert-off period, 50 hospitalizations occurred over 648 person-years (77.1 per 1,000 person-years); during the alert-on, 91 hospitalizations occurred over 498 person-years (182.6 per 1,000 person-years). From the alert-off to the alert-on period, HF hospitalization increased 3.24-fold (95% confidence interval [CI] 1.63–6.41) in the NR group, but only 1.28-fold (95% CI 0.81–2.03) in the AR group. The relative increase in HF hospitalization was significantly attenuated in the AR group (adjusted relative ratio 0.40; 95% CI 0.18–0.89; P=0.025). Conclusions: Although HF-related hospitalizations progressively increase as the disease advances, real-world alert responses may reduce hospitalizations and healthcare costs in clinical practice.