Evidence map›Paper›PMID 38291778›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024

Predicting worsening heart failure hospitalizations in patients with implantable cardioverter defibrillators: is it all about alerts? A pooled analysis of nine trials.

Giovanni Luca Botto, Gianfranco Sinagra, Alan Bulava, Alessio Gargaro, Tobias Timmel, Daniele Giacopelli, Antonio D'Onofrio, Laurence Guédon-Moreau

Abstract read
In one paragraph

Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Comprehensive vs. standard remote monitoring of cardiac resynchronization devices in heart failure patients: results of the ECOST-CRT study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Trial
  3. Article
  4. Review
  5. Review
  6. EHRA perspective on the digital data revolution in arrhythmia management: insights from the association's annual summit.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Review
  7. Remote monitoring and heart failure.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Giovanni Luca BottoU.O. Electrophysiology, ASST Rhodense, 95 Viale Carlo Forlanini, 20024 Garbagnate Milanese (MI), Italy.ORCID 0000-0002-8049-7517
Gianfranco SinagraCardiothoracovascular Department, Cattinara Hospital, ASUGI and University of Trieste, Trieste, Italy.ORCID 0000-0003-2700-8478
Alan BulavaFaculty of Health and Social Sciences, Ceske Budejovice Hospital, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic.ORCID 0000-0002-1742-207X
Alessio GargaroClinical Unit, Biotronik Italia S.P.A., Cologno Monzese (MI), Italy.ORCID 0000-0002-7327-303X
Tobias TimmelCenter for Clinical Research, Biotronik SE & Co. KG, Berlin, Germany.ORCID 0000-0002-2074-466X
Daniele GiacopelliClinical Unit, Biotronik Italia S.P.A., Cologno Monzese (MI), Italy.ORCID 0000-0003-1584-7944
Antonio D'OnofrioUnità Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie, Monaldi Hospital, Naples, Italy.ORCID 0000-0002-8739-5572
Laurence Guédon-MoreauCHU Lille, University of Lille, Lille University Hospital Center, Lille, Hauts-de-France, France.

Funding

Biotronik
6 · The paper itself

Abstract

aimsTo predict worsening heart failure hospitalizations (WHFHs) in patients with implantable defibrillators and remote monitoring, the HeartInsight algorithm (Biotronik, Berlin, Germany) calculates a heart failure (HF) score combining seven physiologic parameters: 24 h heart rate (HR), nocturnal HR, HR variability, atrial tachyarrhythmia, ventricular extrasystoles, patient activity, and thoracic impedance. We compared temporal trends of the HF score and its components 12 weeks before a WHFH with 12-week trends in patients without WHFH, to assess whether trends indicate deteriorating HF regardless of alert status. METHODS AND

resultsData from nine clinical trials were pooled, including 2050 patients with a defibrillator capable of atrial sensing, ejection fraction ≤ 35%, NYHA class II/III, no long-standing atrial fibrillation, and 369 WHFH from 259 patients. The mean HF score was higher in the WHFH group than in the no WHFH group (42.3 ± 26.1 vs. 30.7 ± 20.6, P < 0.001) already at the beginning of 12 weeks. The mean HF score further increased to 51.6 ± 26.8 until WHFH (+22% vs. no WHFH group, P = 0.003). As compared to the no WHFH group, the algorithm components either were already higher 12 weeks before WHFH (24 h HR, HR variability, thoracic impedance) or significantly increased until WHFH (nocturnal HR, atrial tachyarrhythmia, ventricular extrasystoles, patient activity).

conclusionThe HF score was significantly higher at, and further increased during 12 weeks before WHFH, as compared to the no WHFH group, with seven components showing different behaviour and contribution. Temporal trends of HF score may serve as a quantitative estimate of HF condition and evolution prior to WHFH.

Indexed as

Defibrillators, ImplantableHeart FailureTachycardia, VentricularCardiac Complexes, PrematureHospitalizationHumansHeart failure scoreHeart rateImplantable defibrillatorsPredictive algorithmRemote monitoringWorsening heart failure hospitalization

Identifiers

PMID38291778
PMCPMC10858640

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.