@article{d66a5f262eec413bab280dfc4995347f,
title = "Early use of remote dielectric sensing after hospitalization to reduce heart failure readmissions",
abstract = "Aims: Readmission after hospitalization for acute decompensated heart failure (HF) remains a major public health problem. Use of remote dielectric sensing (ReDS) to measure lung water volume allows for an objective assessment of volume status and may guide medical optimization for HF. We hypothesized that the use of ReDS would lower 30 day readmission in patients referred to rapid follow-up (RFU) clinic after HF discharge. Methods and results: We conducted a retrospective analysis of the use of ReDS for patients scheduled for RFU within 10 days post-discharge for HF at Mount Sinai Hospital between 1 July 2017 and 31 July 2018. Diuretics were adjusted using a pre-specified algorithm. The association between use of ReDS and 30 day readmission was evaluated. A total of 220 patients were included. Mean age was 62.9 ± 14.7 years, and 36.4% were female. ReDS was performed in 80 (36.4%) and led to medication adjustment in 52 (65%). Use of ReDS was associated with a lower rate of 30 day cardiovascular readmission [2.6% vs. 11.8%, hazard ratio (HR): 0.21; 95% confidence interval (CI): 0.05–0.89; P = 0.04] and a trend towards lower all-cause readmission (6.5% vs. 14.1%, HR: 0.43; 95% CI: 0.16–1.15; P = 0.09) as compared with patients without a ReDS assessment. Conclusions: ReDS-guided HF therapy during RFU after HF hospitalization may be associated with lower risk of 30 day readmission.",
keywords = "Congestion, Heart failure, Readmissions, Remote dielectric sensing",
author = "Anuradha Lala and Barghash, {Maya H.} and Gennaro Giustino and Jesus Alvarez-Garcia and Swiri Konje and Aditya Parikh and Jennifer Ullman and Brendan Keith and John Donehey and Mitter, {Sumeet S.} and Trivieri, {Maria Giovanna} and Contreras, {Johanna P.} and Daniel Burkhoff and Noah Moss and Mancini, {Donna M.} and Pinney, {Sean P.}",
note = "Funding Information: Fundaci{\'o} Privada Daniel Bravo Andreu (ES) Icahn School of Medicine at Mount Sinai We conducted a retrospective observational cohort study including adult patients (age ≥ 18 years) who presented to a HF rapid follow-up (RFU) clinic within 10 days of discharge after a hospitalization for HF between 1 July 2017 and 31 July 2018 at the Mount Sinai Hospital in New York, New York. Patients with HFpEF and HFrEF were included (Figure 1). Baseline characteristics, co-morbid conditions, ReDS application, medication changes, 30 day readmission, and cause of readmission were collected for all patients. The study was approved by the Institutional Review Board at the Icahn School of Medicine at Mount Sinai Hospital. The RFU clinic is staffed by a specialized HF nurse practitioner with physician oversight. During this visit, HF signs and symptoms were assessed; guideline-directed medical therapy (GDMT) was reviewed and optimized; adherence, lifestyle changes, and education were reinforced. These changes and interventions were communicated to the primary care physician or cardiologist. ReDS testing was considered for all patients as part of routine care in RFU clinic. ReDS technology has been described previously.11,12 The system employs low-power electromagnetic signals emitted into the body to measure the dielectric properties of tissues. The ReDS{\texttrademark} Wearable System consists of two sensors in a wearable vest positioned on the front and back of the patient's thorax without requiring direct skin contact, allowing measurements to be performed through light clothing. These signals are emitted through the right mid-thorax and received posteriorly after passing through tissue. The characteristics of the received signals are affected by the fluid content of tissue in the path of the signal. Publisher Copyright: {\textcopyright} 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology",
year = "2021",
month = apr,
doi = "10.1002/ehf2.13026",
language = "English",
volume = "8",
pages = "1047--1054",
journal = "ESC heart failure",
issn = "2055-5822",
publisher = "The Heart Failure Association of the European Society of Cardiology",
number = "2",
}