{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:01:49Z","timestamp":1780372909613,"version":"3.54.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,10,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Diagnostic variables from insertable cardiac monitors may be useful in identifying patients at increased risk of heart failure (HF) events. High\u2010risk alerts must be coupled with interventions to improve outcomes. We aim to assess the safety of a predefined protocolized intervention pathway activated by insertable cardiac monitor high\u2010risk alerts.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">ALLEVIATE\u2010HF (Algorithm Using LINQ Sensors for Evaluation and Treatment of Heart Failure) Phase 1 was a randomized interventional study enrolling patients with New York Heart Association class II\/III and a recent HF event. A HF risk score based on insertable cardiac monitor diagnostics, including impedance, respiration rate, atrial fibrillation burden, heart rate during atrial fibrillation, heart rate variability, and activity duration, was calculated. A protocolized intervention pathway was activated when high\u2010risk scores were detected that involved physician\u2010prescribed nurse\u2010implemented uptitration of diuretic for 4\u2009days, unless safety rule\u2010out conditions were met. Interventions could be repeated if high\u2010risk scores persisted and did not require worsening symptoms. In total, 59 patients were randomized (mean age 68.2\u00b111.8\u2009years; 59.3% male); 67.8% with ejection fraction \u226550%. The mean follow\u2010up was 11.8\u00b18.1\u2009months. Overall, 146 high\u2010risk scores were recorded in 33 patients and 118 interventions occurred in 75 (51.4%) high\u2010risk alerts that did not meet safety rule\u2010out criteria. There were no serious adverse events and 13 adverse events related to interventions. In patients with symptoms at intervention initiation, symptoms resolved in 37 interventions (80%) and worsened in 8 (17%). In asymptomatic patients, symptoms developed in 3 interventions (7%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">A personalized medication intervention based on insertable cardiac monitor risk score can be safely instituted in patients with HF, irrespective of symptoms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique Identifier: NCT04452149.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.035501","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T11:19:52Z","timestamp":1728645592000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Personalized Intervention Strategy Based on a Risk Score Generated From Subcutaneous Insertable Cardiac Monitor: Results From Phase 1 of ALLEVIATE\u2010HF"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5009-2909","authenticated-orcid":false,"given":"Rami","family":"Kahwash","sequence":"first","affiliation":[{"name":"The Ohio State University Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7076-221X","authenticated-orcid":false,"given":"Michael R.","family":"Zile","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina Charleston SC USA"},{"name":"Ralph H. Johnson Department of Veterans Affairs Health Care System Charleston SC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasad","family":"Chalasani","sequence":"additional","affiliation":[{"name":"Florida Heart Center Fort Pierce FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Bertolet","sequence":"additional","affiliation":[{"name":"Cardiology Associates Research LLC North Mississippi Medical Center Tupelo MS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9209-351X","authenticated-orcid":false,"given":"Laura","family":"Gravelin","sequence":"additional","affiliation":[{"name":"Mount Carmel Health System Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Shahzeb","family":"Khan","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Durham NC 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