HeartLogic™ in Patients With Heart Failure.
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Alert-guided remote follow-up, Traditional follow up.
- Who it may be relevant to
- Registry conditions: Heart Failure. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- France
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
HeartLogic™ Evaluation for Remote Monitoring vs. Office-based Follow-up in Patients With Heart Failure.
Overview
This randomized, multicenter clinical trial will evaluate whether remote management guided by the HeartLogic™ algorithm improves outcomes compared with traditional face-to-face follow-up in adult patients with heart failure recently implanted with a HeartLogic™-enabled ICD or CRT-D device. The primary objective is to determine whether this strategy reduces, at 12 months, the proportion of patients with death, unscheduled hospitalization for heart failure, or deterioration in quality of life. Secondary objectives include assessment of hospitalization, mortality, quality of life, safety, and cost-effectiveness.
Detailed description
Heart failure is associated with recurrent decompensation, frequent hospitalization, impaired quality of life, and substantial healthcare costs. HeartLogic™ is a multisensor algorithm available in compatible Boston Scientific ICD and CRT-D devices that integrates device-derived parameters, including heart sounds, thoracic impedance, respiratory rate, heart rate, and activity level, to identify early signs of worsening heart failure.
Although previous studies have shown that HeartLogic™ alerts may precede heart failure events, the benefit of a structured management strategy based on these alerts has not been established in a randomized trial. The HERO study is a prospective, multicenter, open-label, randomized, parallel-group trial designed to evaluate this strategy in routine practice.
Participants will be randomized to either HeartLogic™-guided remote management or conventional face-to-face follow-up without use of HeartLogic™ alerts. In the intervention group, alerts transmitted through the Latitude™ platform may trigger patient contact, clinical assessment, and therapeutic adjustment according to a predefined management pathway and local practice. In both groups, patient-reported outcomes and clinical events will be collected during 12 months of follow-up.
The study also includes a health economic evaluation to compare the cost-effectiveness of the 2 management strategies.
Interventions
- Other Alert-guided remote follow-up
Participants assigned to this intervention will receive alert-guided remote follow-up for heart failure. Device-generated alerts suggestive of worsening heart failure will be reviewed by the study team through the remote monitoring platform. When an alert occurs, patients may be contacted for symptom assessment and clinical evaluation, and treatment may be adjusted preemptively according to a predefined care pathway and local clinical practice. - Other Traditional follow up
Patients will be monitored every 6 months as recommended by the guidelines
Primary outcome measures
- Proportion of patients who are alive with no unscheduled hospitalization for heart failure and no deterioration in quality of life. [Time frame: 12-month follow-up]
Secondary outcome measures (11)
- Win ratio [Time frame: 12-month follow-up]
- Cumulative incidence of unscheduled hospitalization for heart failure [Time frame: 12-month follow-up]
- Cumulative incidence of heart failure-related death [Time frame: 12-month follow-up]
- Cumulative incidence of cardiovascular death [Time frame: 12-month follow-up]
- Number of all-cause death [Time frame: 12-month follow-up]
- Change in quality of life [Time frame: Change between baseline and 12 months of follow-up]
- The efficiency of patient care in terms of cost-utility [Time frame: 12-month follow-up]
- Total number of hospitalization [Time frame: 12-month follow-up]
- Total hospitalization duration [Time frame: 12-month follow-up]
- Total number of outpatient clinic consultations [Time frame: 12-month follow-up]
- Proportion of patients with a safety criteria [Time frame: 12-month follow-up]
Eligibility criteria
Inclusion criteria
- Patients aged ≥18 years old;
- Patients implanted with a cardiac defibrillator for less than 6 months, with or without resynchronization, enabling the HeartLogic™ algorithm;
- Patients with a history of HF (left ventricular ejection fraction ≤40%; or at least one episode of clinical HF with NT-proBNP blood concentration ≥450 ng/L);
- Patients with New York Heart Association Class II or III HF;
- Patient able to comply with the protocol, including Latitude™ transmissions (including adequate connectivity), and study visits.
- Patients with compulsory health insurance
Exclusion criteria
- Patients not consenting and non-compliant with remote care directions.
- Patients with invasive remote HF monitoring device (such as CardioMems);
- Patients with a concomitant HF device other than cardiac resynchronization, such as a ventricular assist devices or cardiac contractility modulation devices;
- Patients on heart transplant list, or patients with a heart transplant;
- Patients with a glomerular filtration rate <30 ml/min/m2;
- Participation to a concomitant study evaluating management of HF decompensation, or diuretic titration.
- Patients enable to consent.
- Patients receiving State Medical Aid (Aide Médicale d'Etat).
- Pregnant or breastfeeding women.
- Persons benefiting from a reinforced protection, namely minors, persons deprived of liberty by a judicial or administrative decision, adults under legal protection, and finally patients in emergency situations
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
France · 15 centers
- University hospital of Amiens — Amiens
- University hospital of Brest — Brest
- University hospital of Caen — Caen
- University hospital of Grenoble — Grenoble
- University hospital of Lille — Lille
- La Timone University hospital — Marseille
- Hopital du Confluent — Nantes
- University hospital of Nantes — Nantes
- … and 7 more centers
Publications
- Garcia R, Gras D, Mansourati J, Defaye P, Bisson A, Boveda S, Gandjbakhch E, Gras M, Gueffet JP, Himbert C, Jacon P, Khattar P, Lequeux B, Li A, Mansourati V, Minois D, Marijon E, Pierre B, Probst V, Degand B; HeartLogic France Cohort Study Investigators. Pre-emptive treatment of heart failure exacerbations in patients managed with the HeartLogic algorithm. ESC Heart Fail. 2024 Apr;11(2):1228-1235 PMID 38234123
- Garcia R, Gras D, Mansourati J, Defaye P, Bisson A, Boveda S, Durocher L, Gandjbakhch E, Gras M, Gueffet JP, Himbert C, Jacon P, Khattar P, Lequeux B, Li A, Mansourati V, Minois D, Marijon E, Pierre B, Ragot S, Probst V, Degand B. Impact and safety of remote monitoring of heart failure patients managed with the HeartLogic algorithm: the HeartLogic France Cohort Study. Eur Heart J Digit Health. 202 PMID 41624570
Identifiers
NCT: NCT07544771 · HERO