Key result
HF alert remote monitoring with early intervention yields a ~4% 30-day heart failure hospitalization rate.
Why the study?
Remote monitoring algorithms can identify heart failure patients at high risk of 30-day decompensation and prompt earlier therapeutic interventions, possibly impacting outcomes. This study examined the relationship between therapeutic interventions triggered by high-risk alerts and hospitalization outcomes in patients with cardiac electronic implantable devices.
Does remote monitoring using heart failure algorithms coupled with early therapeutic intervention reduce 30-day hospitalizations in patients with heart failure and cardiac electronic implantable devices?
Observational (n=49)
No
Does remote monitoring using heart failure algorithms coupled with early therapeutic intervention reduce 30-day hospitalizations in patients with heart failure and cardiac electronic implantable devices?
Remote monitoring using multiparameter heart failure algorithms coupled with targeted early interventions (primarily diuretic titration) was associated with a very low 30-day hospitalization rate (3.6%) following high-risk alerts.
Low 30-day HF hospitalization after high-risk alerts supports targeted interventions in device patients; leaves open efficacy versus usual care.
Background Remote monitoring (RM) has emerged as a critical tool in managing heart failure (HF) patients (P). HF algorithms can identify P with high risk of 30-day decompensation by combining parameters such as thoracic impedance, arrhythmia burden, percentage of right ventricular pacing, night ventricular rate, or patient activity levels. A multidisciplinary approach in RM leads to earlier therapeutic interventions, possibly impacting patient outcomes. We analyzed data from patients with HF and cardiac electronic implantable devices, under RM, focusing on high-risk alerts and examining the relationship between therapeutic interventions and hospitalization outcomes. Methods The sample included 49 P (69.4% male, median age 76 years), with various HF etiologies. A single-center retrospective analysis of high-risk alerts using two different algorithms (Triage HF, Medtronic®; and HeartLogic, Boston Scientific®) was conducted. We sought to study 30-day hospitalizations in P with high-risk alerts and their correlation with therapeutic interventions using chi-square tests. Results There were 55 high-risk alerts from January 2024 to November 2025. Of these high-risk alerts, 72.7% were related to increased thoracic impedance, 56.4% to low patient activity, and 52.7% to increased night ventricular rates. Therapeutic interventions occurred in 56.4% of these cases, while 43.6% were maintained under regular surveillance. Of all interventions, 71% were based on increasing diuretics. In two years, there were only 2 hospitalizations in 30 day follow-up of the alerts, suggesting that most interventions were successful and the surveillance strategy was well identified and applied. Conclusion RM provides valuable insights into HF decompensation risk, with congestion and low activity being predominant triggers for high-risk alerts. From a total of 55 high-risk alerts only 3.6% required hospitalization. This suggests the important role of an RM programme in HF P in lowering hospitalizations.
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Marques et al. (2026) conducted an observational in Heart failure (n=49). Remote monitoring-guided therapeutic intervention (e.g., increasing diuretics) vs. Regular surveillance was evaluated on 30-day hospitalization following a high-risk alert. Remote monitoring with early intervention (56.4% of alerts) or surveillance resulted in a 3.6% (2/55 alerts) 30-day heart failure hospitalization rate.
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