BACKGROUND: Implantable cardiac sensors have shown promise in reducing rehospitalization for heart failure (HF), but the efficacy of noninvasive approaches has not been determined. The objective of this study was to determine the accuracy of noninvasive remote monitoring in predicting HF rehospitalization. METHODS: The LINK-HF study (Multisensor Non-invasive Remote Monitoring for Prediction of Heart Failure Exacerbation) examined the performance of a personalized analytical platform using continuous data streams to predict rehospitalization after HF admission. Study subjects were monitored for up to 3 months using a disposable multisensor patch placed on the chest that recorded physiological data. Data were uploaded continuously via smartphone to a cloud analytics platform. Machine learning was used to design a prognostic algorithm to detect HF exacerbation. Clinical events were formally adjudicated. RESULTS: One hundred subjects aged 68.4±10.2 years (98% male) were enrolled. After discharge, the analytical platform derived a personalized baseline model of expected physiological values. Differences between baseline model estimated vital signs and actual monitored values were used to trigger a clinical alert. There were 35 unplanned nontrauma hospitalization events, including 24 worsening HF events. The platform was able to detect precursors of hospitalization for HF exacerbation with 76% to 88% sensitivity and 85% specificity. Median time between initial alert and readmission was 6.5 (4.2-13.7) days. CONCLUSIONS: Multivariate physiological telemetry from a wearable sensor can provide accurate early detection of impending rehospitalization with a predictive accuracy comparable to implanted devices. The clinical efficacy and generalizability of this low-cost noninvasive approach to rehospitalization mitigation should be further tested. Registration: URL: https://www.clinicaltrials.gov. Unique Identifier: NCT03037710.
BACKGROUND: Implantable cardiac sensors have shown promise in reducing rehospitalization for heart failure (HF), but the efficacy of noninvasive approaches has not been determined. The objective of this study was to determine the accuracy of noninvasive remote monitoring in predicting HF rehospitalization. METHODS: The LINK-HF study (Multisensor Non-invasive Remote Monitoring for Prediction of Heart Failure Exacerbation) examined the performance of a personalized analytical platform using continuous data streams to predict rehospitalization after HF admission. Study subjects were monitored for up to 3 months using a disposable multisensor patch placed on the chest that recorded physiological data. Data were uploaded continuously via smartphone to a cloud analytics platform. Machine learning was used to design a prognostic algorithm to detect HF exacerbation. Clinical events were formally adjudicated. RESULTS: One hundred subjects aged 68.4±10.2 years (98% male) were enrolled. After discharge, the analytical platform derived a personalized baseline model of expected physiological values. Differences between baseline model estimated vital signs and actual monitored values were used to trigger a clinical alert. There were 35 unplanned nontrauma hospitalization events, including 24 worsening HF events. The platform was able to detect precursors of hospitalization for HF exacerbation with 76% to 88% sensitivity and 85% specificity. Median time between initial alert and readmission was 6.5 (4.2-13.7) days. CONCLUSIONS: Multivariate physiological telemetry from a wearable sensor can provide accurate early detection of impending rehospitalization with a predictive accuracy comparable to implanted devices. The clinical efficacy and generalizability of this low-cost noninvasive approach to rehospitalization mitigation should be further tested. Registration: URL: https://www.clinicaltrials.gov. Unique Identifier: NCT03037710.
Authors: Niraj Varma; Iwona Cygankiewicz; Mintu P Turakhia; Hein Heidbuchel; Yu-Feng Hu; Lin Yee Chen; Jean-Philippe Couderc; Edmond M Cronin; Jerry D Estep; Lars Grieten; Deirdre A Lane; Reena Mehra; Alex Page; Rod Passman; Jonathan P Piccini; Ewa Piotrowicz; Ryszard Piotrowicz; Pyotr G Platonov; Antonio Luiz Ribeiro; Robert E Rich; Andrea M Russo; David Slotwiner; Jonathan S Steinberg; Emma Svennberg Journal: Circ Arrhythm Electrophysiol Date: 2021-02-12
Authors: Niraj Varma; Iwona Cygankiewicz; Mintu P Turakhia; Hein Heidbuchel; Yufeng Hu; Lin Yee Chen; Jean-Philippe Couderc; Edmond M Cronin; Jerry D Estep; Lars Grieten; Deirdre A Lane; Reena Mehra; Alex Page; Rod Passman; Jonathan P Piccini; Ewa Piotrowicz; Ryszard Piotrowicz; Pyotr G Platonov; Antonio Luiz Ribeiro; Robert E Rich; Andrea M Russo; David Slotwiner; Jonathan S Steinberg; Emma Svennberg Journal: Cardiovasc Digit Health J Date: 2021-01-29
Authors: Wei Ning Chi; Courtney Reamer; Robert Gordon; Nitasha Sarswat; Charu Gupta; Emily White VanGompel; Julie Dayiantis; Melissa Morton-Jost; Urmila Ravichandran; Karen Larimer; David Victorson; John Erwin; Lakshmi Halasyamani; Anthony Solomonides; Rema Padman; Nirav S Shah Journal: Appl Clin Inform Date: 2021-12-29 Impact factor: 2.342
Authors: Craig J Goergen; MacKenzie J Tweardy; Steven R Steinhubl; Stephan W Wegerich; Karnika Singh; Rebecca J Mieloszyk; Jessilyn Dunn Journal: Annu Rev Biomed Eng Date: 2021-12-21 Impact factor: 11.324