Development and validation of an integrated diagnostic algorithm derived from parameters monitored in implantable devices for identifying patients at risk for heart failure hospitalization in an ambulatory setting

European Heart Journal

Volumn 34, Issue 31, 2013, Pages 2472-2480

  Cowie, Martin R ^a,b   Sarkar, Shantanu ^c   Koehler, Jodi ^c   Whellan, David J ^d   Crossley, George H ^e   Tang, Wai Hong Wilson ^f   Abraham, William T ^g   Sharma, Vinod ^c   Santini, Massimo ^h  

^a NATIONAL HEART AND LUNG INSTITUTE   (United Kingdom)

^b ROYAL BROMPTON HOSPITAL   (United Kingdom)

^c MEDTRONIC INC   (United States)

^d THOMAS JEFFERSON UNIVERSITY   (United States)

^e UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE   (United States)

^f LERNER RESEARCH INSTITUTE   (United States)

^g OHIO STATE UNIVERSITY   (United States)

^h SAN FILIPPO NERI HOSPITAL   (Italy)

Author keywords

Ambulatory monitoring; Heart failure; Hospitalization; Implantable device diagnostics; Risk

Indexed keywords

ALDOSTERONE ANTAGONIST; ANGIOTENSIN RECEPTOR ANTAGONIST; ANTICOAGULANT AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; DIGOXIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; THROMBOCYTE ANTIBODY; WARFARIN;

ARTICLE; FEMALE; FOLLOW UP; HEART ATRIUM FIBRILLATION; HEART FAILURE; HEART RATE; HEART RATE VARIABILITY; HEART VENTRICLE TACHYCARDIA; HIGH RISK POPULATION; HOSPITALIZATION; HUMAN; IMPLANTABLE CARDIOVERTER DEFIBRILLATOR; LOW RISK POPULATION; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; SURVIVAL;

AMBULATORY MONITORING; HEART FAILURE; HOSPITALIZATION; IMPLANTABLE DEVICE DIAGNOSTICS; RISK;

AGED; ALGORITHMS; DEFIBRILLATORS, IMPLANTABLE; FEMALE; HEART FAILURE; HOSPITALIZATION; HUMANS; KAPLAN-MEIER ESTIMATE; MALE; MONITORING, AMBULATORY; RISK ASSESSMENT; ROC CURVE; TIME FACTORS;

EID: 84881479500     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/eht083     Document Type: Article

References (26)

1. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Kber L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rnnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J 2012;33:1787-1847.
2. Yu CM, Wang L, Chau E, Chan RH, Kong SL, Tang MO, Christensen J, Stadler RW, Lau CP. Intrathoracic impedance monitoring in patients with heart failure: correlation with fluid status and feasibility of early warning preceding hospitalization. Circulation 2005;112:841-848.
3. Sarkar S, Koehler J, Crossley GH, Tang WHW, Abraham WT, Whellan DJ. Burden of atrial fibrillation and poor rate control detected by continuous monitoring via implanted devices identifies when a patient is at risk for heart failure hospitalization. Am Heart J 2012;164:616-624.
4. Adamson PB, Smith AL, Abraham WT, Kleckner KJ, Stadler RW, Shih A, Rhodes MM. InSync III Model 8042 and Attain OTW Lead Model 4193 Clinical Trial Investigators. Continuous autonomic assessment in patients with symptomatic heart failure: prognostic value of heart rate variability measured by an implanted cardiac resynchronization device. Circulation 2004;110:2389-2394.
5. Whellan DJ, Ousdigian KT, Al-Khatib SM, Pu W, Sarkar S, Porter CB, Pavri BB, O'Connor CM. Combined heart failure device diagnostics identify patients at higher risk of subsequent heart failure hospitalizations: results from PARTNERS HF (Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients With Heart Failure) study. J Am Coll Cardiol 2010;55:1803-1810.
6. Page E, Cazeau S, Ritter P, Galley D, Casset C. Physiological approach to monitor patients in congestive heart failure: application of a new implantable device-based system to monitor daily life activity and ventilation. Europace 2007;9:687-693.
7. Singh JP, Rosenthal LS, Hranitzky PM, Berg KC, Mullin CM, Thackeray L, Kaplan A. Device diagnostics and long-term clinical outcome in patients receiving cardiac resynchronization therapy. Europace 2009;11:1647-1653.
8. Pearl J. Probabilistic Reasoning in Intelligent Systems. San Mateo, CA: Morgan Kaufman, 1988.
9. Jensen FV, Nielsen TD. Bayesian Networks and Decision Graphs. 2nd ed, New York: Springer, 2007.
10. Lucas PJ, van der Gaag LC, Abu-Hanna A. Bayesian Networks in biomedicine and health-care. Artif Intell Med 2004;30:201-214.
11. Small RS, Wickemeyer W, Germany R, Hoppe B, Andrulli J, Brady PA, Labeau M, Koehler J, Sarkar S, Hettrick DA, Tang WH. Changes in intrathoracic impedance are associated with subsequent risk of hospitalizations for acute decompensated heart failure: clinical utility of implanted device monitoring without a patient alert. J Card Fail 2009;15:475-481.
12. Perego GB, Landolina M, Vergara G, Lunati M, Zanotto G, Pappone A, Lonardi G, Speca G, Iacopino S, Varbaro A, Sarkar S, Hettrick DA, Denaro A. Implantable CRT device diagnostics identify patients with increased risk for heart failure hospitalization. J Interv Card Electrophysiol 2008;23:235-242.
13. Crossley GH, Boyle A, Vitense H, Chang Y, Mead RH. The CONNECT (Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision) trial the value of wireless remote monitoring with automatic clinician alerts. J Am Coll Cardiol 2011;57:1181-1189.
14. Abraham WT, Compton S, Haas G, Foreman B, Canby RC, Fishel R, McRae S, Toledo GB, Sarkar S, Hettrick DA. Superior performance of intrathoracic impedance-derived fluid index versus daily weight monitoring in heart failure patients: results of the Fluid Accumulation Status Trial (FAST) congest. Heart Fail 2011;17:51-55.
15. Conraads VM, Tavazzi L, Santini M, Oliva F, Gerritse B, Yu CM, Cowie MR. Sensitivity and positive predictive value of implantable intrathoracic impedance monitoring as a predictor of heart failure hospitalizations: the SENSE-HF trial. Eur Heart J 2011;32:2266-2273.
16. Kannel WB, D'Agostino RB, Silbershatz H, Belanger AJ, Wilson PW, Levy D. Profile for estimating risk of heart failure. Arch Intern Med 1999;159:1197-1204.
17. Lee DS, Austin PC, Rouleau JL, Liu PP, Naimark D, Tu JV. Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model. JAMA 2003;290:2581-2587.
18. Levy WC, Mozaffarian D, Linker DT, Sutradhar SC, Anker SD, Cropp AB, Anand I, Maggioni A, Burton P, Sullivan MD, Pitt B, Poole-Wilson PA, Mann DL, Packer M. The seattle heart failure model: prediction of survival in heart failure. Circulation 2006;113:1424-1433.
19. Peterson PN, Rumsfeld JS, Liang L, Albert NM, Hernandez AF, Peterson ED, Fonarow GC, Masoudi FA. A validated risk score for in-hospital mortality in patients with heart failure from the American Heart Association get with the guidelines program. Circ Cardiovasc Qual Outcomes 2010;3:25-32.
20. Bourge RC, Abraham WT, Adamson PB, Aaron MF, Aranda JM Jr, Magalski A, Zile MR, Smith AL, Smart FW, O'Shaughnessy MA, Jessup ML, Sparks B, Naftel DL, Stevenson LW. Randomized controlled trial of an implantable continuous hemodynamic monitor in patients with advanced heart failure: the COMPASS-HF study. J Am Coll Cardiol 2008;51:1073-1079.
21. Abraham WT, Adamson PB, Bourge RC, Aaron MF, Costanzo MR, Stevenson LW, Strickland W, Neelagaru S, Raval N, Krueger S, Weiner S, Shavelle D, Jeffries B, Yadav JS. Wireless pulmonary artery haemodynamic monitoring in chronic heart failure: a randomised controlled trial. Lancet 2011;377: 658-666.
22. Kimmelstiel C, Levine D, Perry K, Patel AR, Sadaniantz A, Gorham N, Cunnie M, Duggan L, Cotter L, Shea-Albright P, Poppas A, LaBresh K, Forman D, Brill D, Rand W, Gregory D, Udelson JE, Lorell B, Konstam V, Furlong K, Konstam MA. Randomized, controlled evaluation of short- and long-term benefits of heart failure disease management within a diverse provider network: the SPAN-CHF trial. Circulation 2004;110:1450-1455.
23. Cleland JG, Louis AA, Rigby AS, Janssens U, Balk AH. Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study. J Am Coll Cardiol 2005;45:1654-1664.
24. Jaarsma T, van der Wal MH, Lesman-Leegte I, Luttik ML, Hogenhuis J, Veeger NJ, Sanderman R, Hoes AW, van Gilst WH, Lok DJ, Dunselman PH, Tijssen JG, Hillege HL, van Veldhuisen DJ. Effect of moderate or intensive disease management program on outcome in patients with heart failure: Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH). Arch Intern Med 2008;168:316-324.
25. van Veldhuisen DJ, Braunschweig F, Conraads V, Ford I, Cowie MR, Jondeau G, Kautzner J, Aguilera RM, Lunati M, Yu CM, Gerritse B, Borggrefe M. Intrathoracic impedance monitoring, audible patient alerts, and outcome in patients with heart failure. Circulation 2011;124:1719-1726.
26. Whellan DJ, Sarkar S, Koehler J, Small RS, Boyle A, Warman EN, Abraham WT. Development of a method to risk stratify patients with heart failure for 30-day readmission using implantable device diagnostics. Am J Cardiol 2013;111:79-84.