Implantable CRT device diagnostics identify patients with increased risk for heart failure hospitalization.
J Interv Card Electrophysiol
; 23(3): 235-42, 2008 Dec.
Article
in En
| MEDLINE
| ID: mdl-18810621
ABSTRACT
PURPOSE:
To determine the association between device-determined diagnostic indices, including intrathoracic impedance, and heart failure (HF) hospitalization.METHODS:
Clinical and device diagnostic data of 558 HF patients indicated for CRT-D therapy (In Sync Sentry, Medtronic Inc.) were prospectively collected from 34 centers. Device-recorded intrathoracic impedance fluid index threshold crossing event (TCE), mean activity counts, tachyarrhythmia events, night heart rate (NHR) and heart rate variability (HRV) were compared within patients with vs. without documented HF hospitalization.RESULTS:
Mean follow-up was 326 +/- 216 days. Patients hospitalized for HF had significantly higher rates of TCE, a higher percentage of days with the thoracic impedance fluid index above the programmed threshold, a higher percentage of days with low activity, with low HRV or with high NHR. Multivariate analysis showed that TCE resulted in a 36% increased probability of HF hospitalization. Both TCE duration and patient activity were also significantly associated with hospitalization. Kaplan Meier analysis indicated that patients with more TCE events were significantly more likely to be hospitalized (log rank test, p = 0.005).CONCLUSIONS:
Decreased intrathoracic impedance, low patient activity and low HRV were all independently associated with increased risk for HF hospitalization in HF patients treated with resynchronization therapy. Device-derived diagnostic data may provide valuable and reliable indices for the prognostic stratification of HF patients.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiac Pacing, Artificial
/
Heart Failure
/
Hospitalization
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
J Interv Card Electrophysiol
Journal subject:
CARDIOLOGIA
Year:
2008
Document type:
Article
Affiliation country:
Italy