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DECODE

 
DECODE overview
Data from the decompensation detection

Are external sensors useful to alert impending HF decompensation event?
DECODE: Patients (699) with CRT-D devices programmed to non-rate-responsive pacing modes were enrolled for a total of 759.5 pt-yrs.

Weights, BP and symptoms were collected by remote-monitoring during normal LATITUDE usage. There were 178 events from 103 patients (121.9 pt-yrs). Data from day of event and 14-days afterwards (or after hospital discharge) were excluded from analysis. Daily change from a 28-day moving baseline was determined (Weight, BP). Symptoms were expresses as % symptomatic responses. These were compared between 14-day pre-event windows and other times.
Patient weight and the fatigue and waking breathless symptoms are significantly increased in the 14-days prior to HF events.
These values may be useful for alerting worsening HF events.

DECODE weight sub-analysis: Relationship of Weight with Heart Failure Decompensation

Methods: Data were from 79 pts (92.0 pt-yrs). The last weight within 4 days before an episode was used to find relative weights for a 28-day pre-episode period.
Results: Relative weights were different by pre-episode day (p<0.0001, Kruskal-Wallis) and increased (p<0.0001, ANOVA) at 0.175 lbs/day over the 28-day pre-episode period.

Weight increase prior to HF episodes and may start about 2 to 3 week before the episode.

Conclusions:

Remote weight monitoring and symptoms analysis may be useful for alerting to worsening HF events.

References:

• HRS 09 DECODE Pre-event external sensors values.pdf