Early detection of worsening heart failure using continuous non-invasive measurements

Abstract of the Project

Chronic Heart Failure (HF) is an endemic disease affecting an estimated 1 – 2% of the general population in Europe and representing 1 – 2% of the combined healthcare budget. During the course of the disease HF patients regularly experience periods of acute worsening symptoms that require hospitalisation. These visits account for a major cost in HF management and are associated with increased mortality. Monitoring patients at home could provide caregivers with early warning signs of a worsening condition, enabling timely and tailored interventions. Current guidelines for HF treatment recommend patients to monitor signs of fluid retention through symptom assessments and weight. However, weight is not very sensitive [1] and symptom reporting is highly subjective and alert caregivers too late. Comparisons with fluid accumulation measurements using thoracic impedance from implanted devices have shown promising results [2].

The aim of this project is to develop robust algorithms for non-invasive thoracic impedance measurements and to develop both uni- and multi-parametric algorithms to provide accurate and early alarms of worsening HF.

Research Achievements to date

• Patent filled on improvement of bioimpedance measurements: “Method and device for correcting breathing artifacts in bioimpedance spectrography measurements”.
• Conference abstract ICEBI 2013: “Removing Respiratory Artefacts from Transthoracic Bioimpedance Spectroscopy Measurements”.
• Conference abstract ESC HF 2012: “Telemonitoring prediction alarms for detecting acute heart failure events: comparing daily weight and trans-thoracic impedance measures.”.
• Journal paper prepared “Early detection of decompensated heart failure in patients on home-telemonitoring: A comparison of prediction algorithms based on daily weight and trans-thoracic bio-impedance.”

References

[1] Zhang J, Goode KM, Cuddihy PE, Cleland JGF. Predicting hospitalization due to worsening heart failure using daily weight measurement: analysis of the Trans-European Network-Home-Care Management System (TEN-HMS) study. European Journal of Heart Failure. 2009;11(4):420 –427.

[2] Yu C-M, Wang L, Chau E, et al. Intrathoracic Impedance Monitoring in Patients With Heart Failure. Circulation. 2005;112(6):841 –848.

[3] Whellan DJ, Ousdigian KT, Al-Khatib SM, et al. Combined Heart Failure Device Diagnostics Identify Patients at Higher Risk of Subsequent Heart Failure Hospitalizations: Results From PARTNERS HF (Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients With Heart Failure) Study. Journal of the American College of Cardiology. 2010;55(17):1803–1810.