Non-invasive Thoracic Impedance Changes in COVID-19 Pulmonary Infection

Novel findings of respiratory rate increases using the multisensor HeartLogic heart failure monitoring algorithm in COVID-19-positive patients: a case series

Background

With the ongoing coronavirus disease 2019 (COVID-19) epidemic, remote monitoring of patients with implanted cardiac devices has become more important than ever, as physical distancing measures have placed limits on in-clinic device monitoring. Remote monitoring alerts, particularly those associated with heart failure trends, have proved useful in guiding care in regard to monitoring fluid status and adjusting heart failure medications.

Case summary

This report describes use of Boston Scientific’s HeartLogic algorithm, which is a multisensor device algorithm in implantable cardioverter-defibrillator devices that is proven to be an early predictor of heart failure decompensation by measuring several variables, including respiratory rate, nighttime heart rate, and heart sounds. We present three cases of patients who were actively surveilled by the various HeartLogic device algorithm sensors and were identified to have increasing respiratory rates high enough to trigger a HeartLogic alert prior to a positive COVID-19 diagnosis.

Discussion

We propose that the HeartLogic algorithm and its accompanying individual physiologic sensors demonstrate potential for use in identifying non-heart failure-related decompensation, such as COVID-19-positive diagnoses.