Affiliation:
1. Cardiology Department Unidade Local de Saúde Alto Ave Guimarães Portugal
2. School of Medicine University of Minho Braga Portugal
Abstract
AbstractBackgroundHeart failure (HF) patients are at constant risk of decompensation, and urgent hospital admissions can be life‐threatening events. Monitoring biological variables has been proved to be an important mechanism to anticipate decompensations. TriageHF is a validated diagnostic algorithm tool available on Medtronic® cardiac implantable electronic devices that combines physiological data to stratify a patient's risk of HF hospitalization in the following 30 days in low, medium or high risk. We aimed to evaluate the utility of TriageHF algorithm to predict the occurrence of acute clinical decompensation events (ACDE), including HF and non‐HF cardiovascular events, within a 30‐day period in a population of HF patients with reduced ejection fraction.MethodsWe reviewed the transmissions received by the Medtronic® Carelink™ Network between August 2022 and July 2023. The heart failure risk status (HFRS) and the device parameters contributing to that risk, from the previous 30 days, were collected, along with the occurrence of ACDEs within 30 days.ResultsWe retrospectively assessed 207 transmissions from the 64 patients included in the study. Among the 93 medium HFRS transmissions, 16 (17.2%) resulted in ACDEs. For the 21 high HFRS transmissions, 10 (47.6%) resulted in ACDEs. Considering the ACDEs, 60.7% were preceded by an alarm‐initiated transmission. Except for heart rate variability, each diagnostic parameter demonstrated effectiveness in stratifying risk for ACDEs. Optivol® and the Combined Heart Rhythm showed independent association with ACDEs (p < .001). Patients with medium and high HFRS were, respectively, 8.6 and 29.1 times more likely to experience an ACDE in the next 30 days than low risk patients. A medium‐high HFRS conferred a sensitivity of 92.9% and a NPV of 97.8% for an ACDE.ConclusionTriageHF is a useful method for predicting ACDEs and has the potential to trigger medical actions to prevent hospitalizations.