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Predicting and Preventing Heart Failure Rehospitalizations: Is There a Role for Implantable Device Diagnostics?

Published:October 04, 2012DOI:https://doi.org/10.1016/j.amjcard.2012.08.052
      HF imposes a staggering economic burden on the healthcare system, with most of the costs for the care of patients with HF attributable to hospitalizations.
      • Dunlay S.M.
      • Shah N.D.
      • Shi Q.
      • Morlan B.
      • VanHouten H.
      • Long K.H.
      • Roger V.L.
      Lifetime costs of medical care after heart failure diagnosis.
      More than 1 million hospitalizations for HF occur in the United States annually.
      • Roger V.L.
      • Go A.S.
      • Lloyd-Jones D.M.
      • Benjamin E.J.
      • Berry J.D.
      • Borden W.B.
      • Bravata D.M.
      • Dai S.
      • Ford E.S.
      • Fox C.S.
      • Fullerton H.J.
      • Gillespie C.
      • Hailpern S.M.
      • Heit J.A.
      • Howard V.J.
      • Kissela B.M.
      • Kittner S.J.
      • Lackland D.T.
      • Lichtman J.H.
      • Lisabeth L.D.
      • Makuc D.M.
      • Marcus G.M.
      • Marelli A.
      • Matchar D.B.
      • Moy C.S.
      • Mozaffarian D.
      • Mussolino M.E.
      • Nichol G.
      • Paynter N.P.
      • Soliman E.Z.
      • Sorlie P.D.
      • Sotoodehnia N.
      • Turan T.N.
      • Virani S.S.
      • Wong N.D.
      • Woo D.
      • Turner M.B.
      Heart disease and stroke statistics–2012 update: a report from the American Heart Association.
      Also, HF has the greatest 30-day rehospitalization rate of any diagnosis among Medicare beneficiaries.
      • Jencks S.F.
      • Williams M.V.
      • Coleman E.A.
      Rehospitalizations among patients in the Medicare fee-for-service program.
      Accordingly, the initial and subsequent hospitalizations among patients with HF constitute a major public health problem and have been a recent focus in the healthcare reform debate.
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      Linked Article

      • Development of a Method to Risk Stratify Patients With Heart Failure for 30-Day Readmission Using Implantable Device Diagnostics
        American Journal of CardiologyVol. 111Issue 1
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          The aim of the present study was to evaluate whether diagnostic data collected after a heart failure (HF) hospitalization can identify patients with HF at risk of early readmission. The diagnostic data from cardiac resynchronization therapy defibrillator (CRT-D) devices can identify outpatient HF patients at risk of future HF events. In the present retrospective analysis of 4 studies, we identified patients with CRT-D devices, with a HF admission, and 30-day postdischarge follow-up data. The evaluation of the diagnostic data for impedance, atrial fibrillation, ventricular heart rate during atrial fibrillation, loss of CRT-D pacing, night heart rate, and heart rate variability was modeled to simulate a review of the first 7 days after discharge on the seventh day.
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