Evaluation of remote dielectric sensing (ReDS) technology-guided therapy for decreasing heart failure re-hospitalizations.
OBJECTIVE
We tested whether remote dielectric sensing (ReDS)-directed fluid management reduces readmissions in patients recently hospitalized for heart failure (HF).


BACKGROUND
Pulmonary congestion is the most common cause of worsening HF leading to hospitalization. Accurate remote monitoring of lung fluid volume may guide optimal treatment and prevent re-hospitalization. ReDS technology is a quantitative non-invasive method for measuring absolute lung fluid volume.


METHODS
Patients hospitalized for acute decompensated HF were enrolled during their index admission and followed at home for 90days post-discharge. Daily ReDS readings were obtained using a wearable vest, and were used as a guide to optimizing HF therapy, with a goal of maintaining normal lung fluid content. Comparisons of the number of HF hospitalizations during ReDS-guided HF therapy were made, both to the 90days prior to enrollment and to the 90days following discontinuation of ReDS monitoring.


RESULTS
Fifty patients were enrolled, discharged, and followed at home for 76.9±26.2days. Patients were 73.8±10.3years old, 40% had LVEF above 40%, and 38% were women. Compared to the pre- and post-ReDS periods, there were 87% and 79% reductions in the rate of HF hospitalizations, respectively, during ReDS-guided HF therapy. The hazard ratio between the ReDS and the pre-ReDS period was 0.07 (95% CI [0.01-0.54] p=0.01), and between the ReDS and the post-ReDS period was 0.11 (95% CI [0.014-0.88] p=0.037).


CONCLUSIONS
These findings suggest that ReDS-guided management has the potential to reduce HF readmissions in acute decompensated HF patients recently discharged from the hospital.
Cardio-Vascular Institute, Baruch Padeh Medical Center, Poriya, Israel; Faculty of Medicine in the Galilee, Bar Ilan University, Tiberias, Israel.
Offer
O
Amir
Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.
Tuvia
T
Ben-Gal
Cardiology Department, Soroka Medical Center, Beer-Sheva, Israel.
Jean Marc
JM
Weinstein
Lady Davis Carmel Medical Center, Haifa, Israel.
Jorge
J
Schliamser
Columbia University, New York, NY, United States.
Daniel
D
Burkhoff
Sensible Medical Innovations Ltd., Netanya, Israel.
Aharon
A
Abbo
Division of Cardiovascular Medicine, The Ohio State University, OH, USA. Electronic address: William.Abraham@osumc.edu.
William T
WT
Abraham
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010359:Patient Readmission / Q000639:trends; D011446:Prospective Studies; D058998:Remote Sensing Technology / Q000592:standards* / Q000639:trends
D020097:Natriuretic Peptide, Brain
B-type natriuretic peptide; Diuretics; Heart failure; Hospitalizations