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Worsening Heart Failure due to Conducted AT/AF Detected by HeartLogic

Summary

 
test

70-year-old female, implanted with a Resonate X4 CRT-D device, in 2018

(A) Day 64: After implant, HeartLogic detected increased AT/AF, experienced by the patient as several days of paroxysmal atrial fibrillation with rapid ventricular conduction. The AF episodes were less than 24 hours/day and therefore did not trigger the AF Burden alert.

(B) Day 73: HeartLogic Alert crossed the threshold level

  • nHR and S3/S1 were also elevated
  • Complained of feeling “crummy”
  • Beta blocker dosage increased      

    Day 80: nHR dropped immediately, AT/AF dropped after 7 days
    Day 90: S3/S1 stayed elevated for 17 more days
    Day 98: HeartLogic alert below threshold

(C) Day 101: A subsequent episode of paroxysmal atrial fibrillation had minimal affect on the night heart rate and heart sounds, without triggering a HeartLogic alert. This demonstrates the importance of a multi-sensor approach in evaluating worsening heart failure.

In summary, HeartLogic was able to be more predictive of worsening heart failure than the presence of conducted AT/AF.  In the initial alert, AT/AF occurred during an episode of worsening heart failure, but after that period resolved, the second instance of Conducted AT/AF was not associated with worsening of heart failure.


 

 

Clinical Data

 

HeartLogic™ Heart Failure Index

trend chart
trend chart

     S3

S1 chart

     S1

thoracic impedence

     Thoracic Impedence

respiratory rate

     Respiratory Rate

Night heart rate

     Night Heart Rate

sleep incline

     Sleep Incline

weight

     Weight

Blood pressure

     Blood Pressure

Activity level

     Activity Level

AT/AF Burden

     AT/AF Burden

HeartLogic Trend Graph for V Therapy

     V Therapy

HeartLogic Trend Graph for Mean Heart Rate

     RV Rate during AT/AF

HeartLogic Trend Graph for Mean Heart Rate

     Mean Heart Rate

HeartLogic Trend Graph for Heart Rate Variability (SDANN)

     % LV Paced

HeartLogic Trend Graph for Heart Rate Variability (SDANN)

     Heart Rate Variability (SDANN)

LATITUDE® Patient Management - Heart Failure Management Report

LATITUDE Patient Management Heart Failure Management Report
LATITUDE Patient Management Heart Failure Management Report
 

Next Steps

 

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Results from the case studies are not necessarily predictive of results in other cases. Results in other cases may vary.
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