Abstract 15659: Dynamic Device Derived Heart Failure Risk Score as a Predictor of Heart Failure Hospitalisation

Introduction: The number of people being admitted to hospital in England due to heart failure (HF) has risen by a third in the last five years. Implantable cardiac devices with integrated heart failure diagnostics are capable of combining daily measurements of multiple device-derived parameters and provide a heart failure risk score (HFRS) which might help predict HF worsening. Methods: Between 2015 and 2019 231 consecutive HF device patients were co-managed (CM) by specialist HF nurses in a tertiary centre. Follow-up was truncated at last device transmission in 2019. HF nurses’ interventions to alerts were recorded prospectively. HF-related hospitalisations were collected from hospital records. We analysed the predictive value of baseline variables on the count of days in high HFRS in a negative binomial regression model. The device settings: Optivol CareAlert switched ON vs OFF were compared. Results: 200 patients with CRT-D were followed up for 2.6 [1.0-2.8] years (Figure). Baseline characteristics and their effect on the incidence rate ratio (IRR) of days in high HFRS are presented in Table. A total of 3,486 transmissions were assessed, median 7.3 [5.9-10.0] per patient-year; 591 high HFRS episodes occurred in 115 (58%) pts. Optivol OFF increased the rate of high HFRS being transmitted >30 days after its end (45% vs 35%, P=0.018) and increased the time from episode start to transmission (36 [16-68] vs 24 [8-53] days, P<0.001). Of 21 hospitalisations for decompensated HF, 15 were predicted by high HFRS within 30 days whereas 6 were predated by medium HFRS. Conclusion: Patients who have not had a single high HFRS during follow-up did not need admission for decompensated HF.