RESULTS Device diagnostics showed strong correlation with established HF biomarkers and hemodynamic measures .
The findings from this review indicate that device diagnostic parameters predict impending HF much earlier than traditional methods of monitoring do .
Device diagnostics are also more accurate in the early prediction of HF when compared with noninvasive objective measures , particularly when multiple parameters are combined and monitored for trends .
Device diagnostics possess a distinct advantage over traditional methods of monitoring for HF because they allow clinicians to remotely monitor the status of their HF patients without relying on patient compliance for data entry and reporting .
Studies regarding the efficacy of device diagnostic parameters suggest that their integration into clinical practice will provide a more accurate and reliable mechanism for assisting clinicians in risk stratifying and predicting potential episodes of decompensated HF
BACKGROUND Traditional methods of heart failure ( HF ) management are based on reactive strategies to treat late indicators of decompensated HF .
Advances in monitoring methods have become available with the evolution of implantable cardioverter-defibrillators and cardiac-resynchronization therapy devices .
These devices provide new diagnostic data and remote monitoring capabilities that allow clinicians to proactively monitor patients for earlier signs of worsening HF .
The integration of data obtained from implantable cardioverter-defibrillator and cardiac-resynchronization therapy technology could improve outpatient HF care , potentially leading to decreased readmission rates and improved patient outcomes .
OBJECTIVE This review will synthesize the literature regarding the efficacy of device diagnostic data and the usability of the data in the clinical setting .
Implantable CRT device diagnostics identify patients with increased risk for heart failure hospitalization
Purpose To determine the association between device-determined diagnostic indices , including intrathoracic impedance , and heart failure ( HF ) hospitalization . Methods Clinical and device diagnostic data of 558 HF patients indicated for CRT-D therapy ( In Sync Sentry , Medtronic Inc. ) were prospect ively collected from 34 centers . Device-recorded intrathoracic impedance fluid index threshold crossing event ( TCE ) , mean activity counts , tachyarrhythmia events , night heart rate ( NHR ) and heart rate variability ( HRV ) were compared within patients with vs. without documented HF hospitalization . Results Mean follow-up was 326 ± 216 days . Patients hospitalized for HF had significantly higher rates of TCE , a higher percentage of days with the thoracic impedance fluid index above the programmed threshold , a higher percentage of days with low activity , with low HRV or with high NHR.Multivariate analysis showed that TCE result ed in a 36 % increased probability of HF hospitalization . Both TCE duration and patient activity were also significantly associated with hospitalization . Kaplan Meier analysis indicated that patients with more TCE events were significantly more likely to be hospitalized ( log rank test , p = 0.005 ) . Conclusions Decreased intrathoracic impedance , low patient activity and low HRV were all independently associated with increased risk for HF hospitalization in HF patients treated with resynchronization therapy . Device-derived diagnostic data may provide valuable and reliable indices for the prognostic stratification of HF patients
RESULTS Device diagnostics showed strong correlation with established HF biomarkers and hemodynamic measures .
The findings from this review indicate that device diagnostic parameters predict impending HF much earlier than traditional methods of monitoring do .
Device diagnostics are also more accurate in the early prediction of HF when compared with noninvasive objective measures , particularly when multiple parameters are combined and monitored for trends .
Device diagnostics possess a distinct advantage over traditional methods of monitoring for HF because they allow clinicians to remotely monitor the status of their HF patients without relying on patient compliance for data entry and reporting .
Studies regarding the efficacy of device diagnostic parameters suggest that their integration into clinical practice will provide a more accurate and reliable mechanism for assisting clinicians in risk stratifying and predicting potential episodes of decompensated HF
BACKGROUND Traditional methods of heart failure ( HF ) management are based on reactive strategies to treat late indicators of decompensated HF .
Advances in monitoring methods have become available with the evolution of implantable cardioverter-defibrillators and cardiac-resynchronization therapy devices .
These devices provide new diagnostic data and remote monitoring capabilities that allow clinicians to proactively monitor patients for earlier signs of worsening HF .
The integration of data obtained from implantable cardioverter-defibrillator and cardiac-resynchronization therapy technology could improve outpatient HF care , potentially leading to decreased readmission rates and improved patient outcomes .
OBJECTIVE This review will synthesize the literature regarding the efficacy of device diagnostic data and the usability of the data in the clinical setting .