Can an Implantable Device Give Early Warning of Congestive Heart Failure?

An audible alert to patients when intrathoracic impedance crossed a defined threshold not only failed to improve outcomes, it increased the rate of HF hospitalization.

Identifying patients with heart failure (HF) who are at risk for decompensation and subsequent hospitalization or death remains an important clinical challenge. Results of recent telemonitoring trials have — to the surprise of many — been unimpressive (JW Cardiol Nov 16 2010).

Implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices often include a feature that measures intrathoracic impedance, potentially providing an early warning system for decompensation by detecting pulmonary fluid retention. In the manufacturer-sponsored, randomized, controlled DOT-HF trial, investigators tested intrathoracic impedance monitoring in 335 patients with systolic HF (mean age, 64; 86% men) enrolled 6 months after i…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)