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De Juan Bagudá J, Caravaca-Pérez P, Arribas Ynsaurriaga F, Delgado Jiménez JF. Circadian pattern of heart rate in patients with heart failure. Response. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:507. [PMID: 38492799 DOI: 10.1016/j.rec.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 03/18/2024]
Affiliation(s)
- Javier De Juan Bagudá
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Facultad de Medicina, Salud y Deporte, Universidad Europea de Madrid, Madrid, Spain.
| | | | - Fernando Arribas Ynsaurriaga
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan F Delgado Jiménez
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Garcia R, Gras D, Mansourati J, Defaye P, Bisson A, Boveda S, Gandjbakhch E, Gras M, Gueffet JP, Himbert C, Jacon P, Khattar P, Lequeux B, Li A, Mansourati V, Minois D, Marijon E, Pierre B, Probst V, Degand B. Pre-emptive treatment of heart failure exacerbations in patients managed with the HeartLogic™ algorithm. ESC Heart Fail 2024; 11:1228-1235. [PMID: 38234123 DOI: 10.1002/ehf2.14624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/21/2023] [Accepted: 11/20/2023] [Indexed: 01/19/2024] Open
Abstract
AIMS Heart failure (HF) is a chronic disease affecting 64 million people worldwide and places a severe burden on society because of its mortality, numerous re-hospitalizations and associated costs. HeartLogic™ is an algorithm programmed into implanted devices incorporating several biometric parameters which aims to predict HF episodes. It provides an index which can be monitored remotely, allowing pre-emptive treatment of congestion to prevent acute decompensation. We aim to assess the impact and security of pre-emptive HF management, guided by the HeartLogic™ index. METHODS AND RESULTS The HeartLogic™ France Cohort Study is an investigator-initiated, prospective, multi-centre, non-randomized study. Three hundred ten patients with a history of HF (left ventricular ejection fraction ≤40%; or at least one episode of clinical HF with elevated NT-proBNP ≥450 ng/L) and implanted with a cardioverter defibrillator enabling HeartLogic™ index calculation will be included across 10 French centres. The HeartLogic™ index will be monitored remotely for 12 months and in the event of a HeartLogic™ index ≥16, the local investigator will contact the patient for assessment and adjust HF treatment as necessary. The primary endpoint is unscheduled hospitalization for HF. Secondary endpoints are all-cause mortality, cardiovascular death, HF-related death, unscheduled hospitalizations for ventricular or atrial arrhythmia and HeartLogic™ index evolution over time. Blood samples will be collected for biobanking, and quality of life will be assessed. Finally, the safety of a HeartLogic™-triggered strategy for initiating or increasing diuretic therapy will be assessed. A blind and independent committee will adjudicate the events. CONCLUSIONS The HeartLogic™ France Cohort Study will provide robust real-world data in a cohort of HF patients managed with the HeartLogic™ algorithm allowing pre-emptive treatment of heart failure exacerbations.
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Affiliation(s)
- Rodrigue Garcia
- Department of Cardiology, University Hospital of Poitiers, Poitiers, France
- Centre d'investigation clinique 1402, University Hospital of Poitiers, Poitiers, France
| | - Daniel Gras
- Department of Cardiology, Hôpital privé du Confluent, Nantes, France
| | | | - Pascal Defaye
- Department of Cardiology, University Hospital Grenoble Alpes, Grenoble, France
| | - Arnaud Bisson
- Department of Cardiology, University Hospital of Tours, Chambray-lès-Tours, France
- Department of Cardiology, University Hospital of Orléans, Orléans, France
| | - Serge Boveda
- Department of Cardiology, Clinique Pasteur, Toulouse, France
- Universiteit Ziekenhuis, Vrije Universiteit Brussel (VUB), Jette, Belgium
| | | | - Matthieu Gras
- Department of Cardiology, University Hospital of Poitiers, Poitiers, France
| | | | - Caroline Himbert
- Department of Cardiology, Hôpital la Pitié Salpétrière, Paris, France
| | - Peggy Jacon
- Department of Cardiology, University Hospital Grenoble Alpes, Grenoble, France
| | - Pierre Khattar
- Department of Cardiology, Hospital of Lorient, Lorient, France
| | - Benoit Lequeux
- Department of Cardiology, University Hospital of Poitiers, Poitiers, France
| | - Anthony Li
- Department of Cardiology, St. George's University of London, Cranmer Terrace, London, UK
| | | | - Damien Minois
- Department of Cardiology, University Hospital of Nantes, Nantes Cedex 1, France
| | - Eloi Marijon
- Department of Cardiology, Hôpital Européen Georges Pomipdou, Paris, France
- Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | - Bertrand Pierre
- Department of Cardiology, University Hospital of Tours, Chambray-lès-Tours, France
| | - Vincent Probst
- Department of Cardiology, University Hospital of Nantes, Nantes Cedex 1, France
| | - Bruno Degand
- Department of Cardiology, University Hospital of Poitiers, Poitiers, France
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Lenormand T, Bodin A, Fauchier L. The Role of the Wearable Defibrillator in Heart Failure. Curr Heart Fail Rep 2024; 21:33-42. [PMID: 38236485 DOI: 10.1007/s11897-023-00641-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE OF REVIEW Wearable cardioverter defibrillators (WCDs) have been developed as a temporary measure for protecting patients at risk for sudden cardiac death that do not meet the indication for implantable cardioverter defibrillator (ICD), most notably in the early stages of heart failure with reduced ejection fraction before reassessment of their left ventricular ejection fraction. In this review, we report available evidence in the literature and guidelines regarding WCD use in order to try to define the role WCDs may have in heart failure. RECENT FINDINGS In the last decade, most observational studies found WCDs to be both safe and effective in terminating ventricular arrhythmias in various indications, mostly centered around heart failure with reduced ejection fraction. The only available randomized controlled trial using WCD did not however show a benefit on patients' survival. Hence, recent guidelines only recommended its use in limited indications. Recent data also suggest a possible interest of WCD in monitoring patients, a finding that may prove useful in the context of new-onset heart failure. Data regarding WCD benefit is scarce, and definitive conclusions on its utility are hard to draw. In the context of heart failure, and particularly new-onset heart failure, WCD might find a role in a global comprehensive management of the disease, both acting as an educational tool, a monitoring tool, and, most importantly, a safe and effective tool in preventing sudden cardiac death. The low level of evidence however invites caution, and the decision of prescribing a WCD needs to be individualized and thoroughly discussed with the patient whose compliance is key with this device.
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Affiliation(s)
- Thibault Lenormand
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Faculté de Médecine, Université François Rabelais, Tours, France
| | - Alexandre Bodin
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Faculté de Médecine, Université François Rabelais, Tours, France
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Faculté de Médecine, Université François Rabelais, Tours, France.
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Tfelt-Hansen J, Garcia R, Albert C, Merino J, Krahn A, Marijon E, Basso C, Wilde AAM, Haugaa KH. Risk stratification of sudden cardiac death: a review. Europace 2023; 25:euad203. [PMID: 37622576 PMCID: PMC10450787 DOI: 10.1093/europace/euad203] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 08/26/2023] Open
Abstract
Sudden cardiac death (SCD) is responsible for several millions of deaths every year and remains a major health problem. To reduce this burden, diagnosing and identification of high-risk individuals and disease-specific risk stratification are essential. Treatment strategies include treatment of the underlying disease with lifestyle advice and drugs and decisions to implant a primary prevention implantable cardioverter-defibrillator (ICD) and perform ablation of the ventricles and novel treatment modalities such as left cardiac sympathetic denervation in rare specific primary electric diseases such as long QT syndrome and catecholaminergic polymorphic ventricular tachycardia. This review summarizes the current knowledge on SCD risk according to underlying heart disease and discusses the future of SCD prevention.
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Affiliation(s)
- Jacob Tfelt-Hansen
- Cardiology Department, Copenhagen University Hospital-Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark
- Section of Forensic Genetics, Department of Forensic Medicine, Copenhagen University, Frederik V’s Vej 11, Copenhagen 2100, Denmark
| | - Rodrigue Garcia
- Cardiology Department, University Hospital of Poitiers, 2 rue de la Milétrie, Poitiers 86000, France
- Centre d'Investigation Clinique 1402, University Hospital of Poitiers, 2 rue de la Milétrie, Poitiers 86000, France
| | - Christine Albert
- Cardiology Department, Smidt Heart Institute, Cedars-Sinai Hospital, Los Angeles, CA, USA
| | - Jose Merino
- Department of Cardiology, La Paz University Hospital, IdiPaz, P. Castellana, 261, Madrid 28046, Spain
- Department of Cardiology, Viamed Santa Elena University Hospital, C/La Granja, 8, Madrid 28003, Spain
| | - Andrew Krahn
- Centre for Cardiovascular Innovation, Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eloi Marijon
- Cardiology Department, European Georges Pompidou Hospital, Paris, France
| | - Cristina Basso
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, Padova 35121, Italy
| | - Arthur A M Wilde
- Department of Cardiology, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Cardiology, Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Kristina Hermann Haugaa
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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