Device monitoring of heart failure in cardiac resynchronization therapy device recipients: A single-center experience with a novel multivector impedance monitoring system

Giovanni B. Forleo, Germana Panattoni, Valentina Schirripa, Lida P. Papavasileiou, Domenico G. Della Rocca, Alessandro Politano, Fabio Ticconi, Carmine Biscione, Domenico Sergi, Arianna Di Molfetta, Luca Santini, Ambrogio Capria, Francesco Romeo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives We investigated the performance of a new intrathoracic multivector impedance monitoring system for the prediction of heart failure events in consecutive device-implanted patients. Methods Eighty heart failure patients implanted with biventricular defibrillators with multivector impedance monitoring capability were prospectively enrolled. Clinical heart failure status and impedance data were assessed during follow-up and if patients presented with an alert or heart failure deterioration. Results During follow-up (8.0W4.4 months), 56 events of device alert for fluid index increase were identified in 29 patients, and a total of 39 heart failure events (defined by worsening of heart failure signs and symptoms) occurred in 23 patients. The sensitivity and positive predictive value (PPV) for heart failure deterioration was 61.5 and 42.9%, respectively. False-positive alerts occurred in 23 of 80 patients (28.8%), for an episode rate of 0.60 a year. Among all clinical heart failure events, decompensation caused hospitalization in 13 cases (33.3%), seven of them were preceded by an alert condition (53.8%) resulting in a sensitivity of 53.8% and a PPV of 17.9%. Conclusion The present study confirms the feasibility and clinical usefulness of this novel multivector impedance monitoring system. It would be worthwhile to perform larger studies to assess its actual clinical value in heart failure patients.

Original languageEnglish
Pages (from-to)726-732
Number of pages7
JournalJournal of Cardiovascular Medicine
Volume14
Issue number10
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Cardiac resynchronization therapy
  • CorVue
  • Heart failure
  • Hospitalization
  • Impedance monitoring
  • Intrathoracic impedance
  • Multivector impedance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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