Usefulness of intrathoracic fluids accumulation monitoring with an implantable biventricular defibrillator in reducing hospitalizations in patients with heart failure: A case-control study

Background The reduction of hospitalizations in patients with heart failure (HF) may have clinical and economical implications. Materials and methods In a case-control study, we compared the number of hospital admissions for congestive HF during the same follow-up period in two homogeneous groups of patients, each consisting of 27 consecutive patients treated with biventricular pacing and back-up defibrillator (B-ICD) in our institution. The first group was implanted with an InSync Sentry (R), (Medtronic Inc, Minneapolis, MN, US), a B-ICD device with the OptiVol (R) feature for monitoring intrathoracic fluid accumulation and equipped with an active acoustic alarm (Group 1); the second group was implanted with an InSync III Marquis (TM)(Medtronic), a B-ICD device with similar features except for the absence of the OptiVol (Group 2). Follow-up visits were performed at 3 month interval or in case of acoustic alarm. Results The patient clinical characteristics of the two groups were similar. In Group 1, with 359 +/- 98 days follow-up, 12 of the 27 patients, experienced 18 OptiVol alarms with only one hospital admission for congestive HF occurring in a patient who ignored the acoustic alarm for 13 days. In Group 2, eight HF hospitalizations occurred in seven patients (p < 0.05). Conclusions The OptiVol feature is a useful tool for the clinical management of HF patients as it can result in early treatment during the pre-clinic stage of HF decompensation and in a significant reduction of hospital admissions for congestive HF.