{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T15:08:54Z","timestamp":1783177734899,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>HeartLogic algorithm combines data from multiple implantable defibrillators (ICD)\u2010based sensors to predict impending heart failure (HF) decompensation. A treatment protocol to manage algorithm alerts is not yet known, although decongestive treatment adjustments are the most frequent alert\u2010triggered actions reported in clinical practice. We describe the implementation of HeartLogic for remote monitoring of HF patients, and we evaluate the approach to diuretic dosing and timing of the intervention in patients with device alerts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The algorithm was activated in 229 ICD patients at eight centers. The median follow\u2010up was 17\u2009months (25th\u201375th percentile: 11\u201324). Remote data reviews and patient phone contacts were undertaken at the time of HeartLogic alerts, to assess the patient's status and to prevent HF worsening. We analyzed alert\u2010triggered augmented HF treatments, consisting of isolated increases in diuretics dosage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We reported 242 alerts (0.8 alerts\/patient\u2010year) in 123 patients, 137 (56%) alerts triggered clinical actions to treat HF. The HeartLogic index decreased after the 56 actions consisting of diuretics increase. Specifically, alerts resolved more quickly when the increases in dosing of diuretics were early rather than late: 28\u2009days versus 62\u2009days, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001. The need of hospitalization for further treatments to resolve the alert condition was associated with higher HeartLogic index values on the day of the diuretics increase (odds ratio: 1.11, 95% CI: 1.02\u20131.20, <jats:italic>p<\/jats:italic>\u2009=\u2009.013) and with late interventions (odds ratio: 5.11, 95% CI: 1.09\u201324.48, <jats:italic>p<\/jats:italic>\u2009=\u2009.041). No complications were reported after drug adjustments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Decongestive treatment adjustments triggered by alerts seem safe and effective. The early use of decongestive treatment and the use of high doses of diuretics seem to be associated with more favorable outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23832","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T09:00:44Z","timestamp":1651568444000},"page":"670-678","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Decongestive treatment adjustments in heart failure patients remotely monitored with a multiparametric implantable defibrillators algorithm"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5394-1312","authenticated-orcid":false,"given":"Federico","family":"Guerra","sequence":"first","affiliation":[{"name":"Cardiology and Arrhythmology Clinic Marche Polytechnic University, \u201cOspedali Riuniti\u201d Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"D'Onofrio","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie, Monaldi Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermenegildo","family":"De Ruvo","sequence":"additional","affiliation":[{"name":"Policlinico Casilino Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Manzo","sequence":"additional","affiliation":[{"name":"OO.RR. San Giovanni di Dio Ruggi d'Aragona Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9048-2039","authenticated-orcid":false,"given":"Luca","family":"Santini","sequence":"additional","affiliation":[{"name":"\u201cGiovan Battista Grassi\u201d Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Giubilato","sequence":"additional","affiliation":[{"name":"\u201cSpaziani\u201d Hospital Frosinone Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2692-7333","authenticated-orcid":false,"given":"Carmelo","family":"La Greca","sequence":"additional","affiliation":[{"name":"Fondazione Poliambulanza Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Petracci","sequence":"additional","affiliation":[{"name":"IRCCS Policlinico San Matteo Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7095-5732","authenticated-orcid":false,"given":"Giulia","family":"Stronati","sequence":"additional","affiliation":[{"name":"Cardiology and Arrhythmology Clinic Marche Polytechnic University, \u201cOspedali Riuniti\u201d Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valter","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie, Monaldi Hospital Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Martino","sequence":"additional","affiliation":[{"name":"Policlinico Casilino Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Franculli","sequence":"additional","affiliation":[{"name":"OO.RR. 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