TY - JOUR
T1 - Device monitoring of heart failure in cardiac resynchronization therapy device recipients
T2 - A single-center experience with a novel multivector impedance monitoring system
AU - Forleo, Giovanni B.
AU - Panattoni, Germana
AU - Schirripa, Valentina
AU - Papavasileiou, Lida P.
AU - Della Rocca, Domenico G.
AU - Politano, Alessandro
AU - Ticconi, Fabio
AU - Biscione, Carmine
AU - Sergi, Domenico
AU - Di Molfetta, Arianna
AU - Santini, Luca
AU - Capria, Ambrogio
AU - Romeo, Francesco
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
KW - Cardiac resynchronization therapy
KW - CorVue
KW - Heart failure
KW - Hospitalization
KW - Impedance monitoring
KW - Intrathoracic impedance
KW - Multivector impedance
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U2 - 10.2459/JCM.0b013e3283650587
DO - 10.2459/JCM.0b013e3283650587
M3 - Article
C2 - 23996011
AN - SCOPUS:84885434375
VL - 14
SP - 726
EP - 732
JO - Journal of Cardiovascular Medicine
JF - Journal of Cardiovascular Medicine
SN - 1558-2027
IS - 10
ER -