PRecision Event Monitoring for PatienTs with Heart Failure using HeartLogic (PREEMPT-HF) study design and enrolment
John Boehmer1, Andrew J Sauer2, Roy Gardner3
1Penn State Hershey Medical Center, Hershey, PA, USA.
Insights
The PREEMPT-HF study explored the HeartLogic multisensor index and its sensors for predicting heart failure (HF) readmissions. This research aims to improve HF management by analyzing sensor data trends.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- The HeartLogic multisensor index is a known sensitive predictor of worsening heart failure (HF).
- Limited data exists on the association between the HeartLogic index, its constituent sensors, and HF readmissions.
- Understanding these associations is crucial for refining HF management strategies.
Purpose of the Study:
- To explore the association between the HeartLogic multisensor index and its sensors with heart failure readmissions.
- To characterize sensor changes in relation to HF readmission, tachyarrhythmias, and other event subgroups.
- To provide clinical data that may refine the use of HeartLogic for improved patient outcomes.
Main Methods:
- The PREEMPT-HF study was a global, prospective, observational, post-market study involving 2183 HF patients with specific implantable devices.
- HeartLogic sensor data and alerts were blinded to clinicians.
- Data on all-cause hospitalizations and HF outpatient visits were collected over 12 months.
Main Results:
- 2183 patients were enrolled across 103 sites between June 2018 and June 2020.
- The patient cohort included a significant proportion with cardiac resynchronization therapy with defibrillator (61%), over 65 years old (61%), and with NYHA class II or III HF (53% and 33%).
- Key patient characteristics included ejection fraction <25% (21%), ischemic heart disease (50%), and history of renal dysfunction (23%).
Conclusions:
- The PREEMPT study will yield clinical data and blinded sensor trends.
- These data will aid in characterizing sensor changes associated with HF readmission and other events.
- The findings are expected to refine the clinical application of HeartLogic and enhance patient outcomes.
Aims:
The HeartLogic multisensor index has been found to be a sensitive predictor of worsening heart failure (HF). However, there is limited data on this index's association and its constituent sensors with HF readmissions.
Methods And Results:
The PREEMPT-HF study is a global, multicentre, prospective, observational, single-arm, post-market study. HF patients with an implantable defibrillator device or cardiac resynchronization therapy with defibrillator with HeartLogic capabilities were eligible if sensor data collection was turned on and the HeartLogic feature was not enabled. Thus, the HeartLogic Index/alert and heart sounds sensor trends were unavailable via the LATITUDE remote monitoring system to clinicians (blinded). Evaluation of subject medical records at 6 months and a final in-clinic visit at 12 months was required for collection of all-cause hospitalizations and HF outpatient visits. The purpose of this study is exploratory, no formal hypothesis tests are planned, and no adjustment for multiple testing will be performed. A total of 2183 patients were enrolled at 103 sites between June 2018 and June 2020. A significant proportion of the patients were implanted with implantable defibrillator devices (39%) versus cardiac resynchronization therapy with defibrillator (61%); were female (27%); over 65 (61%); New York Heart Association class I (13%), II (53%), and III (33%); ejection fraction < 25% (21%); ischaemic (50%); and with a history of renal dysfunction (23%).
Conclusions:
The PREEMPT study will provide clinical data and blinded sensor trends for the characterization of sensor changes with HF readmission, tachyarrhythmias, and event subgroups. These data may help to refine the clinical use of HeartLogic and to improve patient outcomes.
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