Heart Failure -> Heart Failure Management: -> Monitoring D-PO05 - Poster Session V (ID 39) Poster

D-PO05-120 - Congestive Heart Failure Remote Monitoring: A 5 Year Experience (ID 1336)

Disclosure
 J.Z. Rosman: Nothing relevant to disclose.

Abstract

Background: 30 day CHF hospitalization rates after elevated OptiVol fluid index exceed 4%.
Objective: We aimed to assess long-term outcomes of a patient-centric educational approach to elevated OptiVol levels measured on remote ICD monitoring.
Methods: Patients with CHF and LVEF ≤40% with Medtronic ICDs were included for analysis. Remote monitoring was performed monthly between 1/2015 and 11/2019. An OptiVol fluid index ≥60Ω-days was considered an abnormal impedance measurement. Patients with elevated OptiVol fluid levels were contacted by a physician assistant for CHF screening. Patients without CHF were reassured and educated on diet, weight monitoring, signs and symptoms of CHF. Patients with CHF symptoms were referred to their cardiologist for further management . Cardiologists were instructed to treat patients based on clinical evaluation and not solely on impedance values (Image 1).
Results: 280 patients were included in analysis. Mean age was 78 years (+/- 9.1 years) and 221 patients (79%) were male. 205 (73%) patients had ischemic cardiomyopathy and the average LVEF was 25% (+/-6.5%). A total of 6,616 transmissions occurred over 5 years; of those, 575 (8.7%) were associated with elevated OptiVol fluid levels. Clinical follow up from the 575 transmissions was available in 449 (78%) cases. 30 day CHF hospitalization rates following an elevated OptiVol level was 2.2% (10/449).
Conclusion: Monthly remote monitoring of OptiVol fluid index measurements with a unique CHF screening and educational approach to elevated levels can significantly reduce CHF hospitalizations.
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