Circulation journal : official journal of the Japanese Circulation Society · 2026
Reduction in Heart Failure Hospitalizations Through Real-World HeartLogicTM Alert Response - A Multicenter Study in Japan.
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Oka Takafumi, Takahara Mitsuyoshi, Kataoka Shohei, Nagashima Michio, Onuki Koumei, Yagishita Daigo, Ikeda Yoshifumi, Kanai Risa, Terazaki Yoshitaka, Yoshiga Yasuhiro, Fukuda Masakazu, Tsurugi Takuo, Fujiu Katsuhito, Hasumi Eriko, Nishii Nobuhiro, Iguchi Hiroki, Sakata Yasushi
Аннотация
BACKGROUND: Heart failure (HF) is a progressive disease characterized by an increasing incidence of hospitalization over time. HeartLogicTM(HL) is a multiparametric remote monitoring system designed to detect early signs of HF decompensation. Using a multicenter database, this real-world study evaluated whether responses to HL alerts could reduce HF-related hospitalization.
METHODS AND RESULTS: We retrospectively analyzed 246 patients implanted with an HL-enabled implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator across 8 Japanese centers. Patients were categorized as alert-responsive (AR; n=167) or non-responsive (NR; n=79). Alert responses included multidisciplinary review and telephone triage to determine the need for clinical visits. HF hospitalization rates during the alert-off (before activation) and the alert-on (after alert activation) periods were compared. During the alert-off period, 50 hospitalizations occurred over 648 person-years (77.1 per 1,000 person-years); during the alert-on, 91 hospitalizations occurred over 498 person-years (182.6 per 1,000 person-years). From the alert-off to the alert-on period, HF hospitalization increased 3.24-fold (95% confidence interval [CI] 1.63-6.41) in the NR group, but only 1.28-fold (95% CI 0.81-2.03) in the AR group. The relative increase in HF hospitalization was significantly attenuated in the AR group (adjusted relative ratio 0.40; 95% CI 0.18-0.89; P=0.025).
CONCLUSIONS: Although HF-related hospitalizations progressively increase as the disease advances, real-world alert responses may reduce hospitalizations and healthcare costs in clinical practice.
METHODS AND RESULTS: We retrospectively analyzed 246 patients implanted with an HL-enabled implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator across 8 Japanese centers. Patients were categorized as alert-responsive (AR; n=167) or non-responsive (NR; n=79). Alert responses included multidisciplinary review and telephone triage to determine the need for clinical visits. HF hospitalization rates during the alert-off (before activation) and the alert-on (after alert activation) periods were compared. During the alert-off period, 50 hospitalizations occurred over 648 person-years (77.1 per 1,000 person-years); during the alert-on, 91 hospitalizations occurred over 498 person-years (182.6 per 1,000 person-years). From the alert-off to the alert-on period, HF hospitalization increased 3.24-fold (95% confidence interval [CI] 1.63-6.41) in the NR group, but only 1.28-fold (95% CI 0.81-2.03) in the AR group. The relative increase in HF hospitalization was significantly attenuated in the AR group (adjusted relative ratio 0.40; 95% CI 0.18-0.89; P=0.025).
CONCLUSIONS: Although HF-related hospitalizations progressively increase as the disease advances, real-world alert responses may reduce hospitalizations and healthcare costs in clinical practice.