Usefulness of intrathoracic fluids accumulation monitoring with an implantable biventricular defibrillator in reducing hospitalizations in patients with heart failure: a case-control study.
BACKGROUND
The reduction of hospitalizations in patients with heart failure (HF) may have clinical and economical implications.


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.
Maines
Massimiliano
M
Division of Cardiology, Santa Maria del Carmine Hospital, Corso Verona, 4, 38068, Rovereto (TN), Italy. mainesdrmax@hotmail.com
Catanzariti
Domenico
D
Cemin
Claudio
C
Vaccarini
Chiara
C
Vergara
Giuseppe
G
D000162:Acoustics; D000368:Aged; D002304:Cardiac Pacing, Artificial; D016022:Case-Control Studies; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D004867:Equipment Design; D005260:Female; D006333:Heart Failure / Q000473:pathology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors