Personalized Intervention Strategy Based on a Risk Score Generated From Subcutaneous Insertable Cardiac Monitor: Results From Phase 1 of ALLEVIATE‐HF Article Swipe
Rami Kahwash
,
Michael R. Zile
,
Prasad Chalasani
,
Barry Bertolet
,
Laura M. Gravelin
,
Muhammad Shahzeb Khan
,
Jennifer Wehking
,
Brian Van Dorn
,
Shantanu Sarkar
,
Verla Laager
,
Bart Gerritse
,
Aimee Laechelt
,
Javed Butler
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1161/jaha.124.035501
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1161/jaha.124.035501
Background Diagnostic variables from insertable cardiac monitors may be useful in identifying patients at increased risk of heart failure (HF) events. High‐risk alerts must be coupled with interventions to improve outcomes. We aim to assess the safety of a predefined protocolized intervention pathway activated by insertable cardiac monitor high‐risk alerts. Methods and Results ALLEVIATE‐HF (Algorithm Using LINQ Sensors for Evaluation and Treatment of Heart Failure) Phase 1 was a randomized interventional study enrolling patients with New York Heart Association class II/III and a recent HF event. A HF risk score based on insertable cardiac monitor diagnostics, including impedance, respiration rate, atrial fibrillation burden, heart rate during atrial fibrillation, heart rate variability, and activity duration, was calculated. A protocolized intervention pathway was activated when high‐risk scores were detected that involved physician‐prescribed nurse‐implemented uptitration of diuretic for 4 days, unless safety rule‐out conditions were met. Interventions could be repeated if high‐risk scores persisted and did not require worsening symptoms. In total, 59 patients were randomized (mean age 68.2±11.8 years; 59.3% male); 67.8% with ejection fraction ≥50%. The mean follow‐up was 11.8±8.1 months. Overall, 146 high‐risk scores were recorded in 33 patients and 118 interventions occurred in 75 (51.4%) high‐risk alerts that did not meet safety rule‐out criteria. There were no serious adverse events and 13 adverse events related to interventions. In patients with symptoms at intervention initiation, symptoms resolved in 37 interventions (80%) and worsened in 8 (17%). In asymptomatic patients, symptoms developed in 3 interventions (7%). Conclusions A personalized medication intervention based on insertable cardiac monitor risk score can be safely instituted in patients with HF, irrespective of symptoms. Registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT04452149.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1161/jaha.124.035501
- OA Status
- gold
- Cited By
- 6
- References
- 29
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4403337636
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4403337636Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1161/jaha.124.035501Digital Object Identifier
- Title
-
Personalized Intervention Strategy Based on a Risk Score Generated From Subcutaneous Insertable Cardiac Monitor: Results From Phase 1 of ALLEVIATE‐HFWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-10-11Full publication date if available
- Authors
-
Rami Kahwash, Michael R. Zile, Prasad Chalasani, Barry Bertolet, Laura M. Gravelin, Muhammad Shahzeb Khan, Jennifer Wehking, Brian Van Dorn, Shantanu Sarkar, Verla Laager, Bart Gerritse, Aimee Laechelt, Javed ButlerList of authors in order
- Landing page
-
https://doi.org/10.1161/jaha.124.035501Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1161/jaha.124.035501Direct OA link when available
- Concepts
-
Medicine, Atrial fibrillation, Heart failure, Psychological intervention, Ejection fraction, Adverse effect, Internal medicine, Randomized controlled trial, Cardiology, Emergency medicine, Intensive care medicine, PsychiatryTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
6Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 4, 2024: 2Per-year citation counts (last 5 years)
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29Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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