P340 REMOTE MONITORING IN HEART FAILURE: EFFECTIVE TOOL TO REDUCE HOSPITALIZATIONS AND MORTALITY

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Abstract Introduction The prevalence of heart failure in the general population in the idustrialized countries is estimated to be around 2%, a prevalence that increases with age until it reaches 10% at 70 aa of age. The disease is burdened by a high mortality rate and high expense related mainly to repeated hospitalizations. Patients with low ejection fraction heart failure are often implanted with devices, which have the ability to be monitored remotely. The Ministry of Health‘s 2017 annual report on hospitalization activity shows dramatic data: 60% of patients with heart failure are re–hospitalized within one year of discharge and in 14% of cases even within one month of discharge with an annual mortality rate of 18%. The aim of our study is to investigate whether remote monitoring allows improving the outcome of patients with heart failure in terms of reduction of hospitalizations and reduction of all–cause mortality. Materials and Methods In the year 2021, 241 patients with heart failure and reduced ejection fraction, implanted with devices of mean age 73 yr (+/– 11 yr) were remotely monitored in our center; Other population data: see Table 1. On the occasion of transmissions presenting with alarm events, our operational flow chart provides: first telephone contact and possible subsequent outpatient follow–up within 24 h working hours. Results During the year 2021, all–cause mortality in our population was 10.7% (26 patients), while re–hospitalizations were 70 (28.8%). As a result of alarms reported to remote monitoring, 83 patients were contacted whose therapy was changed or device reprogrammed. The causes of alarms were in order: reduced thoracic impedance, arrhythmic events, and reduced biventricular pacing rate. Conclusions The use of remote monitoring in heart failure patients and device wearers allows early and timely diagnosis of clinical changes that anticipate heart failure exacerbation and active intervention by modifying the clinical course, often avoiding hospitalization, with a significant social and economic impact. Thanks to the operational organization of our center, the management of remote monitoring has allowed a low rate of hospitalization and low mortality year compared with literature data.

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