In:
European Journal of Heart Failure, Wiley, Vol. 16, No. 4 ( 2014-04), p. 419-425
Abstract:
We hypothesized that diagnostic data in implantable devices evaluated on the day of discharge from a heart failure hospitalization ( HFH ) can identify patients at risk for HF readmission ( HFR ) within 30 days. Methods and results In this retrospective analysis of four studies enrolling patients with CRT devices, we identified patients with a HFH , device data on the day of discharge, and 30‐day post‐discharge clinical follow‐up. Four diagnostic criteria were evaluated on the discharge day: (i) intrathoracic impedance 〉 8 Ω below reference impedance; (ii) AF burden 〉 6 h; (iii) CRT pacing 〈 90%; and (iv) night heart rate 〉 80 b.p.m. Patients were considered to have higher risk for HFR if ≥2 criteria were met, average risk if 1 criterion was met, and lower risk if no criteria were met. A Cox proportional hazards model was used to compare the groups. The data cohort consisted of a total of 265 HFHs in 175 patients, of which 36 (14%) were followed by HFR . On the discharge day, ≥2 criteria were met in 43 (16% of 265 HFHs ), only 1 criterion was met in 92 (35%), and none of the four criteria were met in 130 HFHs (49%); HFR rates were 28, 16, and 7%, respectively. HFH with ≥2 criteria met was five times more likely to have HFR compared with HFH with no criteria met (adjusted hazard ratio 5.0; 95% confidence interval 1.9–13.5, P = 0.001). Conclusion Device‐derived diagnostic criteria evaluated on the day of discharge identified patients at significantly higher risk of HFR .
Type of Medium:
Online Resource
ISSN:
1388-9842
,
1879-0844
DOI:
10.1002/ejhf.2014.16.issue-4
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
1500332-2
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