A retrospective evaluation of the use of congestion alert monitoring alongside device diagnostics in predicting heart failure decompensation

Using existing implantable cardiac devices, it may be possible to mitigate the risk of unplanned hospitalisation for heart failure (HF) by detecting changes to diagnostic parameters. Devices have the capability to continuously monitor trends in diagnostics such as intrathoracic impedance (ITI), patient activity, percentage of pacing, atrial fibrillation (AF) burden, ventricular rate during AF, ventricular arrhythmias and therapy delivered from the device; changes to these are thought to precede worsening HF. Clinics can be alerted to changes via remote monitoring (RM) platforms, providing an opportunity for treatment. Recent studies have shown using a multi-parameter approach to assess a patient’s risk of HF decompensation may be more effective than congestion alert monitoring using ITI alone.