Reducing Number of Hospitalization from Increment of Congestive Heart Failure by an Implanted Intrathoracic Impedance Monitoring System, Optivol

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Abstract

Case Report: The patient was a 73-year-old male with dilated phase of hypertrophic cardiomyopathy. He was frequently hospitalized for fluid overload and implantated cardiac resynchronization therapy plus defibrillation (Consulta, Medtronic, Inc.) and Carelink (remote monitoring system) in June 2010. He was hospitalized for congestive heart failure (CHF) exacerbation in October 2010. OptiVol Fluid Index (OFI) which calculated from a intrathoracic impedance was 40, and B-type natriuretic peptide (BNP) was 1236 pg/ml by blood sample. We confirmed alert of OptiVol by Carelink in December 2010 and January 2011, which had similar data on OFI and BNP to the last hospitalization. In each event, OFI and BNP were around 35 and 800 pg/ml right after the alert and then they decreased to 0 and 400 pg/ml after the diuretic remedy which result to avoid hospitalization. Conclusion: We could reduce hospitalization rates from increment of CHF by OptiVol and Carelink system. It has possibility to cause false alert depending on the programmed threshold and reference impedance which may be able to prevent by using the data of first hospitalization.

Journal

  • Journal of Arrhythmia

    Journal of Arrhythmia 27 (Supplement), PJ2_054-, 2011

    Japanese Heart Rhythm Society

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