HeartLogic alerts preceded 81.9% of heart failure hospitalizations with scores rising significantly 45 days before admission, enabling potential early intervention.
Do HeartLogic scores and individual parameters significantly change in the lead-up to heart failure hospitalization in patients with HL-enabled implantable defibrillators?
HeartLogic scores and individual parameters like S3 show significant changes up to 45-60 days prior to heart failure hospitalization, offering a potential window for early intervention.
Absolute Event Rate: 0% vs 0%
Abstract Background Heart failure (HF) is a prevalent condition associated with costly hospitalizations and poor outcomes. The HeartLogic (HL) algorithm (Boston Scientific) predicts HF decompensation, but the evolution of HL and its contributing parameters before hospitalization remains unclear, limiting opportunities for early intervention and improvement of outcomes. Purpose This study aimed to evaluate trends in HL scores and individual contributing parameters (thoracic impedance, S3, and S1/S3 ratio) in the lead-up to HF hospitalization. Methods This retrospective study reviewed HF hospitalisations in patients with HL-enabled implantable defibrillators. Daily HL scores and parameter data were extracted at 90 (baseline), 60, 45, 30, 14, 7, and 0 days prior to heart failure hospitalisation and analysed for significance. Alert status was defined as HL ≥ 16. Results There were 116 HF admissions (median length of stay of 6 days (IQR: 3.00-11.00)) in 65 patients (75.4% male, mean age 70 ± 11 years). HL alerts preceded 95 (81.9%) admissions with a median lead time of 34 days (IQR: 11.50-61.50) and median alert duration of 99 days (IQR: 50.5-126.5). Compared to baseline, HL scores increased significantly as early as 45 days before hospitalization (+3.55, p = 0.047), with further increases at 30 days (p = 0.006) and highly significant increases at 14, 7, and 0 days (p 0.001). Thoracic impedance significantly decreased 14 days before hospitalization (p 0.001), while S3 increased significantly at 60 days (p = 0.01), and the S1/S3 ratio decreased significantly at 45 days (p = 0.004). Conclusion HL scores demonstrated early elevation, with significant changes observed as early as 45 days before hospitalisation, highlighting the opportunity for early intervention. Notably, S3 showed earlier trends than the composite HL score, suggesting their potential as earlier indicators of decompensation. Future prospective trials are needed to validate these findings and assess their impact on patient outcomes.HeartLogic Prior to Admission S1, S3, and S1/S3 Prior to Admission
Assad et al. (Sat,) reported a other. HeartLogic alerts preceded 81.9% of heart failure hospitalizations with scores rising significantly 45 days before admission, enabling potential early intervention.