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56 The Lung Impedance Monitoring in Treatment of Chronic Heart Failure: Results from the Limit-Chf Study
  1. Giulia Domenichini,
  2. Tsveta Rahneva,
  3. Ihab Diab,
  4. Onkar Dhillon,
  5. Victoria Baker,
  6. Ross Hunter,
  7. Mark Earley,
  8. Richard Schilling
  1. St. Bartholomew’s Hospital

Abstract

Introduction To assess the usefulness of intra-thoracic impedance monitoring (IIM) alerts in guiding medication therapy in chronic heart failure (CHF) patients (pts) to prevent hospitalisations/unplanned visits.

Methods CHF pts with OptiVol® or CorVue™ capable ICDs were randomised to either the active group (IIM alarm turned on and diuretic dose increased by 50% for one week) or the control group (IIM alarm turned off). The primary endpoint was the number of hospitalisations per pt at 1 year. The NYHA class, 6 min walk test (6MWT), BNP and Minnesota Living with HF (MLWHF) questionnaire score were collected at baseline and follow-up (f-up).

Results 80 pts were included and 71 reached 1 year f-up (7 pts died, 1 pt was lost at f-up and 1 pt was excluded from analysis since the congestion data were not collected by the device). The baseline characteristics and study outcomes are shown in the Table 1. After a median f-up of 13 months (IQR 12–14), there were 1.72 ± 1.45 alerts in the active group vs. 1.13 ± 1.0 in the control group, p = 0.07. In the active group 60.9% (42/69) of alerts led to increasing the diuretic dose. There was a total of 11 hospitalisations in the active group vs. 6 in the control group without significant differences in the number of episodes per pt (0.28 ± 0.85 vs. 0.15 ± 0.43, p = 0.95). There were no unplanned visits in the active group vs. 0.08 ± 0.27 per pt in the control group, p = 0.08. There was a moderate but significant reduction in HF related quality of life scores in the active group.

Conclusion In this study IIM did not reduce emergency treatment of HF however there was a positive impact on quality of life. This technology may have a useful role in managing HF pts with implantable devices.

Abstract 56 Table 1

  • Intra-thoracic impedance monitoring
  • Chronic heart failure
  • Implantable devices

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