Comparison of partners-heart failure algorithm vs care alert in remote heart failure management

Table 1 Study population

Clinical characteristics of the study population
Age (yr)	70.3 ± 8.3
Male (%)	78.3
EF (%)	27.5 ± 6.5
Etiology post-ischemic DC (%)	63.2
Idiopathic DC (%)	33.7
Valvular DC (%)	2
Congenital DC (%)	1.1
NYHA II (%)	17.3
III (%)	78.6
IV (%)	4.1
Optimized pharmacological treatment (%)	63.21
Prevention: Primary (%)	73.7
Secondary (%)	18.3
SVT (%)	3.7
Syncope (%)	3.2
Cardiac arrest (%)	5.1
AF permanent (%)	16.3
Persistent (%)	7.4
Paroxysmal (%)	4.1
Devices: Consulta™ CRT-D	37.4
Concerto™ II CRT-D (%)	26.3
Viva XT™ CRT-D (%)	22.1
Protecta XT™ CRT-D (%)	14.2

¹The low percentage of optimized pharmacological treatment is related to reduce aldosterone antagonists administration in patients affected by chronic kidney disease. EF: Ejection fraction; DC: Dilated cardiomyopathy; NYHA: New York Heart Association; SVT: Sustained ventricular tachycardia; AF: Atrial fibrillation; CRT-D: Cardiac resynchronization therapy-defibrillator.

Table 2 Pharmacological treatment modifications following positive or negative partners-heart failure transmissions and care alert

Active clinical actions	Partners-HF +	Care alert +
Pharmacological treatment modification during telephonic contact
Diuretic dosage increase	120	25
BB dosage increase	57	22
AAD administration	2	2
ACE-I and ARA dosage increase	4	0
OAC administration	5	5
Clinical examination and pharmacological treatment modification
Diuretic dosage increase	9	4
BB dosage increase	8	3
AAD administration	1	1
ACE-I and ARA dosage increase	1	1
Anti-platelet administration	0	0

+: Positive; BB: Beta-blockers; AAD: Anti-arrhythmic drugs; ACE-I: Angiotensin-converting-enzyme inhibitors; ARA: Angiotensin II-receptor antagonists; OAC: Oral anti-coagulant; HF: Heart failure.

Table 3 Diagnostic accuracy of partners-heart failure and care alert in determining active clinical actions

	Active clinical actions (2-3)	Non-active/no clinical actions (0-1)	Total transmissions
Positive partners-HF transmissions	193	35	228
Negative partners-HF transmissions	6	431	437
Positive care alert transmissions	22	30	52
Negative care alert transmissions	177	436	613
Overall transmissions followed by an action	199	466	665
Appendix partners-HF algorithm
Parameters	Criterion
Fluid index	≥ 60 d
AT/AF duration	≥ 6 h and not persistent AT/AF
VR during AT/AF	AT/AF ≥ 24 h and VR ≥ 90 bpm
Patient activity	< 1 h over 1 wk
NHR	≥ 85 bpm for 7 consecutive days
HRV	< 60 ms for 7 consecutive days
%CRT pacing	< 90% for 5 of 7 d
Shock (s)	≥ 1 shock

AT: Atrial tachycardia; AF: Atrial fibrillation; VR: Ventricular rate; NHR: Night heart rate; HRV: Heart rate variability; CRT: Cardiac resynchronization therapy; HF: Heart failure.