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Updated: Jun 27, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Clinical impact of remote heart failure management using the multiparameter ICD HeartLogic alert
Javier de Juan Bagudá1, Rocío Cózar León2, Juan J Gavira Gómez3
1Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Medicina, Salud y Deporte, Universidad Europea de Madrid, Madrid, Spain.
Insights
A new protocol using HeartLogic alerts significantly reduced heart failure (HF) hospitalizations and outpatient visits. This remote management strategy by nursing staff proved effective in managing HF decompensation.
Area of Science:
- Cardiology
- Digital Health
- Nursing Science
Background:
- Heart failure (HF) decompensation poses a significant clinical challenge.
- The HeartLogic index, a multiparametric implantable cardioverter-defibrillator algorithm, is a sensitive predictor of impending HF decompensation.
- Standardized follow-up protocols are crucial for effective HF management.
Purpose of the Study:
- To evaluate the impact of a standardized nursing-led follow-up protocol utilizing remote management of HeartLogic alerts.
- To assess the effectiveness of this protocol in reducing heart failure hospitalizations and outpatient visits.
Main Methods:
- A prospective study involving 392 HF patients across 19 Spanish centers.
- Activation of the HeartLogic algorithm with remote data analysis and telephone-based patient contact for alerts.
- Clinical actions were managed remotely or via outpatient visits.
- Comparison of 12-month periods before and after protocol adoption.
Main Results:
- A significant reduction in the primary endpoint (HF hospitalizations or death) was observed post-protocol adoption (11% vs. 22%, P<.001).
- The mean number of HF hospitalizations per patient decreased significantly (0.18 vs. 0.39, P<.001).
- HF outpatient visits also showed a significant reduction (12% vs. 24%, P<.001), with a decrease in mean visits per patient (0.16 vs. 0.47, P<.001).
Conclusions:
- A standardized follow-up protocol based on remote management of HeartLogic alerts is effective for managing HF patients.
- This approach led to a significant decrease in heart failure hospitalizations and outpatient visits.
- Nursing staff can effectively implement remote management strategies for HF patients using alert-based protocols.
Introduction And Objectives:
The multiparametric implantable cardioverter-defibrillator HeartLogic index has proven to be a sensitive and timely predictor of impending heart failure (HF) decompensation. We evaluated the impact of a standardized follow-up protocol implemented by nursing staff and based on remote management of alerts.
Methods:
The algorithm was activated in HF patients at 19 Spanish centers. Transmitted data were analyzed remotely, and patients were contacted by telephone if alerts were issued. Clinical actions were implemented remotely or through outpatient visits. The primary endpoint consisted of HF hospitalizations or death. Secondary endpoints were HF outpatient visits. We compared the 12-month periods before and after the adoption of the protocol.
Results:
We analyzed 392 patients (aged 69±10 years, 76% male, 50% ischemic cardiomyopathy) with implantable cardioverter-defibrillators (20%) or cardiac resynchronization therapy defibrillators (80%). The primary endpoint occurred 151 times in 86 (22%) patients during the 12 months before the adoption of the protocol, and 69 times in 45 (11%) patients (P<.001) during the 12 months after its adoption. The mean number of hospitalizations per patient was 0.39±0.89 pre- and 0.18±0.57 postadoption (P<.001). There were 185 outpatient visits for HF in 96 (24%) patients before adoption and 64 in 48 (12%) patients after adoption (P<.001). The mean number of visits per patient was 0.47±1.11 pre- and 0.16±0.51 postadoption (P<.001).
Conclusions:
A standardized follow-up protocol based on remote management of HeartLogic alerts enabled effective remote management of HF patients. After its adoption, we observed a significant reduction in HF hospitalizations and outpatient visits.
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