Key result
The HeartInsight HF score was significantly higher 12 weeks prior to worsening heart failure hospitalization compared to patients without hospitalization (42.3 vs 30.7, P<0.001).
Why the study?
The study evaluated whether temporal trends of the HeartInsight heart failure score and its components indicate deteriorating heart failure regardless of alert status in patients with implantable defibrillators and remote monitoring.
Does the HeartInsight algorithm HF score predict worsening heart failure hospitalizations in patients with implantable defibrillators?
Observational (n=2,050)
Yes
Does the HeartInsight algorithm HF score predict worsening heart failure hospitalizations in patients with implantable defibrillators?
The HeartInsight algorithm HF score is significantly higher and increases during the 12 weeks prior to a worsening heart failure hospitalization, suggesting its utility as a quantitative estimate of HF evolution.
May support proactive HF monitoring in ICD patients; extends validation of HeartInsight for predicting decompensation.
AIMS: To predict worsening heart failure hospitalizations (WHFHs) in patients with implantable defibrillators and remote monitoring, the HeartInsight algorithm (Biotronik, Berlin, Germany) calculates a heart failure (HF) score combining seven physiologic parameters: 24 h heart rate (HR), nocturnal HR, HR variability, atrial tachyarrhythmia, ventricular extrasystoles, patient activity, and thoracic impedance. We compared temporal trends of the HF score and its components 12 weeks before a WHFH with 12-week trends in patients without WHFH, to assess whether trends indicate deteriorating HF regardless of alert status. METHODS AND RESULTS: Data from nine clinical trials were pooled, including 2050 patients with a defibrillator capable of atrial sensing, ejection fraction ≤ 35%, NYHA class II/III, no long-standing atrial fibrillation, and 369 WHFH from 259 patients. The mean HF score was higher in the WHFH group than in the no WHFH group (42.3 ± 26.1 vs. 30.7 ± 20.6, P < 0.001) already at the beginning of 12 weeks. The mean HF score further increased to 51.6 ± 26.8 until WHFH (+22% vs. no WHFH group, P = 0.003). As compared to the no WHFH group, the algorithm components either were already higher 12 weeks before WHFH (24 h HR, HR variability, thoracic impedance) or significantly increased until WHFH (nocturnal HR, atrial tachyarrhythmia, ventricular extrasystoles, patient activity). CONCLUSION: The HF score was significantly higher at, and further increased during 12 weeks before WHFH, as compared to the no WHFH group, with seven components showing different behaviour and contribution. Temporal trends of HF score may serve as a quantitative estimate of HF condition and evolution prior to WHFH.
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Botto et al. (2024) conducted an observational in Heart failure (n=2,050). HeartInsight algorithm HF score vs. Patients without worsening heart failure hospitalization was evaluated on Mean HF score 12 weeks before worsening heart failure hospitalization (p=<0.001). The HeartInsight HF score was significantly higher 12 weeks prior to worsening heart failure hospitalization compared to patients without hospitalization (42.3 vs 30.7, P<0.001).
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