Follow-Up of Left-Ventricular Assist Device Patients With Telemonitoring: A National Retrospective Multicentric Study...

Left-ventricular assist devices (LVADs) are a major therapeutic option in advanced heart failure (adHF), improving survival rates and quality of life (QoL). Complications, however, can alter their prognosis. Specialized telemonitoring could facilitate LVAD follow-ups and improve outcomes. This study aimed to evaluate the usefulness of telemonitoring for LVAD patients.

Patients, followed up with a web application (SateliaLVAD), were included in a national retrospective study at nine tertiary hospitals in France. Characteristics and detected hospitalization risk alerts data were collected. The risk of hospitalization was categorized based on a clinical algorithm (green: no risk, orange: heightened risk, and red: emergent contact with patient and possible hospitalization).

In total, 161 patients were included (male: 82.0%, mean age: 62.2 years). Indications for LVAD were mainly ischemic cardiomyopathy (82.0%) and bridge to transplant (50.3%). The mean follow-up duration lasted 19.9 [1-45] months with 76 (47.2%) patients continuing telemonitoring. Compliance was high (79.0%). The main reason for cessation was death (30.6%). Total hospitalization risk alerts detected by telemonitoring were: orange alerts (n = 8265, 72.3%) and red alerts (n = 1613, 14.1%) with 48.5% of cases resolved (orange: 50.8% vs. red: 54.8%). The most frequent type of resolved alert was for a measured risk of cardiac decompensation (orange: 2227 vs. red: 382).

To our knowledge, this is the first extensive study to describe the follow-up of LVAD patients by a dedicated telemonitoring application. Telemonitoring as a specific follow-up tool may be feasible for this subpopulation. Future randomized studies on specific prospective evaluations such as survival and QoL are needed.