Early relevant alerts from remote monitoring in heart failure patients with a cardiac implanted electronic device: what implications for long term outcome?

• DOI: 10.1093/europace/euae102.498
• Publication Date: 2024-05-24T12:28:40Z
• Authors: D A Mei; J F Imberti; F Sbarra; K Serafini; M Mantovani; G Leo; B Cherubini; L Gerra; M Vitolo; N Bonini; E Mauro; V Turco; E Casali; G Boriani
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Arrhythmias and device therapy

Abstract Background Alarms generated by remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) have been associated with worse clinical outcomes in patients heart failure (HF). However, whether the timing RM alerts impact on trajectories HF is still debated. Purpose To examine occurring first 180 days after CIED implant outcomes, as well potential predictors. Methods we retrospectively enrolled all a history implanted CRT-D or an ICD at our tertiary. We collected data regarding ATP, shock and score above threshold (defined multiparametric scores provided validated manufacturers). defined early relevant (Early-RA) alarms received during implant. The primary outcome study was composite death hospitalization. Logistic Cox regression analyses were used to determine associations. occurrence early-RA time dependent covariate. Results A total 272 included analysis (median age 67.4 years, IQR 58.6-74.6, 19.9% female). Twenty had (7.3% overall population) found be older, more severely symptomatic for HF, higher prevalence atrial fibrillation (AF) chronic kidney disease (CKD) (all p values<0.05). On other hand, etiology did not differ between two groups. At univariate logistic analysis, following factors significantly early-RA: (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.00-1.10), NYHA class (OR 2.44, CI 1.01-5.82) CKD 3.41, 1.21-8.98), but these results confirmed multivariable regression. After median follow-up 959 (IQR 432-1484), reporting events (45.0% vs 12.3% p<0.001). time-dependent adjusted age, sex, left ventricular ejection fraction type CIED, that independently risk (hazard [HR] 3.61, 95%CI 1.42-9.18) (Figure). Early-RA also (HR 5.58, 1.68-18.50) while no significant association hospitalization 2.46, 0.80-7.57, p=0.116). Conclusions detected CIEDs relatively phase (within from implant), patients.Study Outcome according Early RATime