Usefulness of intrathoracic fluids accumulation monitoring with an implantable biventricular defibrillator in reducing hospitalizations in patients with heart failure: a case-control study

J Interv Card Electrophysiol. 2007 Sep;19(3):201-7. doi: 10.1007/s10840-007-9155-4. Epub 2007 Sep 6.

Abstract

Background: The reduction of hospitalizations in patients with heart failure (HF) may have clinical and economical implications.

Materials and methods: In a case-control study, we compared the number of hospital admissions for congestive HF during the same follow-up period in two homogeneous groups of patients, each consisting of 27 consecutive patients treated with biventricular pacing and back-up defibrillator (B-ICD) in our institution. The first group was implanted with an InSync Sentry, (Medtronic Inc, Minneapolis, MN, US), a B-ICD device with the OptiVol feature for monitoring intrathoracic fluid accumulation and equipped with an active acoustic alarm (Group 1); the second group was implanted with an InSync III Marquis (Medtronic), a B-ICD device with similar features except for the absence of the OptiVol (Group 2). Follow-up visits were performed at 3 month interval or in case of acoustic alarm.

Results: The patient clinical characteristics of the two groups were similar. In Group 1, with 359 +/- 98 days follow-up, 12 of the 27 patients, experienced 18 OptiVol alarms with only one hospital admission for congestive HF occurring in a patient who ignored the acoustic alarm for 13 days. In Group 2, eight HF hospitalizations occurred in seven patients (p < 0.05).

Conclusions: The OptiVol feature is a useful tool for the clinical management of HF patients as it can result in early treatment during the pre-clinic stage of HF decompensation and in a significant reduction of hospital admissions for congestive HF.

MeSH terms

  • Acoustics
  • Aged
  • Cardiac Pacing, Artificial*
  • Case-Control Studies
  • Cohort Studies
  • Death, Sudden, Cardiac / prevention & control
  • Defibrillators, Implantable*
  • Equipment Design
  • Female
  • Heart Failure / pathology*
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Time Factors