Results of the Precision Event Monitoring for Patients With Heart Failure Using HeartLogic Study (PREEMPT-HF)

Background: Improved patient monitoring and management after heart failure (HF) hospitalizations are needed to reduce readmissions significantly. Objectives: The aim of this study was to investigate the association between monitoring data and readmissions. Methods: PREEMPT-HF (PRecision Event Monitoring for PatienTs with Heart Failure using HeartLogic) was a global, observational, single-arm study enrolling adult HF patients remotely monitored with HeartLogic-capable implantable cardioverter-defibrillator and cardiac resynchronization therapy devices. Patients and clinicians were blinded to the index and alerts. Participants were followed for 12 months for site reporting of events. Results: A total of 2,155 patients were enrolled at 103 sites and were monitored remotely (39% implantable cardioverter-defibrillators and 61% cardiac resynchronization therapy-defibrillators). There were 243 hospitalizations for HF, of which 156 (64%) were index hospitalizations. There were 25 (28%) unplanned all-cause readmissions in the 30 days after discharge and 45 (46%) all-cause readmissions within 90 days. Alert sensitivity for outpatient visits and hospitalizations for HF was 78.3%, and the false-positive rate was 1.18/year. The HeartLogic index was higher before index hospitalizations for HF when followed by HF or readmission for all causes. Index hospitalizations for HF were also more likely to be followed by readmission for HF in 90 days if the patient was in an alert state (vs out-of-alert state) 1 or 2 weeks before or 2 weeks after the index admission. Conclusions: HeartLogic index trends were significantly different for patients who were readmitted for HF. These trends suggest that individuals at risk for readmission have had a more sustained worsening and/or insufficient intervention during the initial hospitalization for HF.