Key result
Greater daily variability in the HeartInsight score was associated with a higher tendency toward heart failure hospitalization, though it did not reach statistical significance after adjustment for CKD and LVEF (OR 1.03, p=0.287).
Why the study?
This study investigated whether elevations above, and daily fluctuations in, the HeartInsight score threshold aid prediction of hospitalization for HF.
Does HeartInsight score variability predict hospitalization for heart failure in patients with cardiovascular implantable electronic devices?
Cohort (n=61)
No
Does HeartInsight score variability predict hospitalization for heart failure in patients with cardiovascular implantable electronic devices?
Monitoring daily fluctuations and standard deviation of the HeartInsight score may help predict heart failure hospitalization better than relying solely on absolute threshold elevations.
Greater HeartInsight variability was not independently linked to HF hospitalization; hypothesis-generating for remote monitoring utility in CIED patients.
Background Patients with heart failure (HF) can be monitored remotely using cardiovascular implantable electronic devices (CIEDs). In Japan, the HeartInsight algorithm has been implemented in selected implantable cardioverter defibrillators and cardiac resynchronization therapy devices. This retrospective study investigated whether elevations above, and daily fluctuations in, the HeartInsight score threshold aid prediction of hospitalization for HF. Methods This study included 61 patients. Data were extracted from the BIOTRONIK Home Monitoring system; the number of days of HeartInsight score calculation, coefficient of variation, standard deviation, maximum value during the observation period, and mean values were analyzed. The primary endpoint was the first hospitalization for HF after CIED implantation. Patients were divided into two groups (HF hospitalization and non‐HF hospitalization), and each parameter was compared between the groups. Results The first hospitalization for HF after CIED implantation occurred in 10 of 61 patients (16%). Although the HF hospitalization group was younger than the non‐HF hospitalization group, the two groups exhibited no differences in coronary risk factors, pharmacological therapies, or threshold elevation in HeartInsight scores. However, the HF hospitalization group demonstrated a tendency toward higher values, with significant differences observed in the maximum value and the difference between the maximum and mean values. Although few patients exhibited threshold elevation, greater daily variability was associated with a higher tendency toward HF hospitalization. Conclusions Although predicting HF hospitalization based solely on threshold elevation is challenging, monitoring daily fluctuations may aid prediction. Evaluating score variability is important, even among patients without threshold elevation.
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Sekido et al. (2026) conducted a cohort in Heart failure with cardiovascular implantable electronic devices (n=61). HeartInsight score variability (standard deviation) vs. Low HeartInsight score variability was evaluated on First hospitalization for heart failure after CIED implantation (OR 1.03, 95% CI 0.98-1.09, p=0.287). Greater daily variability in the HeartInsight score was associated with a higher tendency toward heart failure hospitalization, though it did not reach statistical significance after adjustment for CKD and LVEF (OR 1.03, p=0.287).
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