Journal of Cardiac Failure
Volume 15, Issue 6 , Pages 475-481 , August 2009

Changes in Intrathoracic Impedance are Associated With Subsequent Risk of Hospitalizations for Acute Decompensated Heart Failure: Clinical Utility of Implanted Device Monitoring Without a Patient Alert

  • Roy S. Small, MD

      Affiliations

    • Lancaster Heart and Stroke Foundation, Lancaster, Pennsylvania
    • Corresponding Author InformationReprint requests: Roy Small MD, The Heart Group, 217 Harrisburg Ave, Lancaster, PA 17603. Tel: (717) 397-5484; Fax: (717) 509 3882.
    • ,
  • William Wickemeyer, MD

      Affiliations

    • Iowa Heart Center, Des Moines, Iowa
    • ,
  • Robin Germany, MD

      Affiliations

    • University of Oklahoma, Oklahoma City, Oklahoma
    • ,
  • Bobbi Hoppe, MD

      Affiliations

    • North Memorial Hospital, Robbinsdale, Minnesota
    • ,
  • John Andrulli, DO

      Affiliations

    • Cooper Heart Institute, Camden, New Jersey
    • ,
  • Peter A. Brady, MD

      Affiliations

    • The Mayo Clinic, Rochester, Minnesota
    • ,
  • Melody Labeau

      Affiliations

    • Medtronic, Inc., Minneapolis, Minnesota
    • ,
  • Jodi Koehler, MS

      Affiliations

    • Medtronic, Inc., Minneapolis, Minnesota
    • ,
  • Shantanu Sarkar, PhD

      Affiliations

    • Medtronic, Inc., Minneapolis, Minnesota
    • ,
  • Douglas A. Hettrick, PhD

      Affiliations

    • Medtronic, Inc., Minneapolis, Minnesota
    • ,
  • W.H. Wilson Tang, MD

      Affiliations

    • The Cleveland Clinic, Cleveland, Ohio

Received 29 October 2008 ,Revised 30 December 2008 ,Accepted 27 January 2009.

References 

  1. Aghababian RV. Acutely decompensated heart failure: opportunities to improve care and outcomes in the emergency department. Rev Cardiovasc Med. 2002;3:S3–S9
  2. Jong P, Vowinckel E, Liu PP, Gong Y, Tu JV. Prognosis and determinants of survival in patients newly hospitalized for heart failure: a population-based study. Arch Intern Med. 2002;162:1689–1694
  3. Cowie MR, Fox KF, Wood DA, Metcalfe C, Thompson SG, Coats AJ, et al. Hospitalization of patients with heart failure: a population-based study. Eur Heart J. 2002;23:877–885
  4. Mahdyoon H, Klein R, Eyler W, Lakier JB, Chakko SC, Gheorghiade M. Radiographic pulmonary congestion in end-stage congestive heart failure. Am J Cardiol. 1989;63:625–627
  5. Stevenson LW, Perloff JK. The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA. 1989;261:884–888
  6. Dokainish H, Zoghbi WA, Lakkis NM, Al-Bakshy F, Dhir M, Quinones MA, et al. Optimal noninvasive assessment of left ventricular filling pressures: a comparison of tissue Doppler echocardiography and B-type natriuretic peptide in patients with pulmonary artery catheters. Circulation. 2004;109:2432–2439
  7. Adamson PB, Magalski A, Braunschweig F, Bohm M, Reynolds D, Steinhaus D, et al. Ongoing right ventricular hemodynamics in heart failure: clinical value of measurements derived from an implantable monitoring system. J Am Coll Cardiol. 2003;41:565–571
  8. Yu CM, Wang L, Chau E, Chan RH, Kong S, Tang M, et al. Intrathoracic impedance monitoring in patients with heart failure: correlation with fluid status and feasibility of early warning preceding hospitalization. Circulation. 2005;112:841–848
  9. Vollmann D, Nägele H, Schauerte P, Wiegand U, Butter C, Zanotto G, et al. European InSync Sentry Observational Study Investigators. Clinical utility of intrathoracic impedance monitoring to alert patients with an implanted device of deteriorating chronic heart failure. Eur Heart J. 2007;28:1835–1840
  10. Adamson PB, Smith AL, Abraham WT, Kleckner KJ, Stadler RW, Shih A, et al. Continuous autonomic assessment in patients with symptomatic heart failure: prognostic value of heart rate variability measured by an implanted cardiac resynchronization device. Circulation. 2004;110:2389–2394
  11. Maines M, Catanzariti D, Cemin C, Vaccarini C, Vergara G. Usefulness of intrathoracic fluids accumulation monitoring with an implantable biventricular defibrillator in reducing hospitalizations in patients with heart failure: a case-control study. J Interv Card Electrophysiol. 2007;19:201–207
  12. Ponikowski P, Anker SD, Chua TP, Szelemej R, Piepoli M, Adamopoulos S, et al. Depressed heart rate variability as an independent predictor of death in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1997;79:1645–1650
  13. Ypenburg C, Bax JJ, van der Wall EE, Schalij MJ, van Erven L. Intrathoracic impedance monitoring to predict decompensated heart failure. Am J Cardiol. 2007;99:554–557

 All decisions regarding this manuscript were made by a guest editor. Funded by Medtronic, Inc, Minneapolis, MN.

 Dr. Small has received speaking fees and research support from Medtronic, Inc. Dr. Germany is a consultant and has received research grants from Medtronic, Inc. Ms. Koehler and Ms. Labeau are full time employees of Medtronic, Inc. Drs. Hettrick and Sarkar are full time employees of Medtronic, Inc.

PII: S1071-9164(09)00034-7

doi: 10.1016/j.cardfail.2009.01.012

Journal of Cardiac Failure
Volume 15, Issue 6 , Pages 475-481 , August 2009

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