Multiple Cardiac Sensors for the Management of Heart Failure

Phase I of the MANAGE-HF trial is not randomized, and is intended to evaluate the clinical integration of HeartLogic for managing patients with heart failure. There are no endpoints.

Phase II of the MANAGE-HF trial will assess the clinical effectiveness of remote monitoring of heart failure patients with implanted CRT-D or ICD cardiac devices that contain the diagnostic feature HeartLogic. This feature uses S1 and S3 heart sounds, night time heart rate, thoracic impedance, and respiration to alert clinicians when a patient's heart failure is worsening. The MANAGE-HF study will compare remote monitoring using HeartLogic alerts to drive heart failure care against patients with remote monitoring but without HeartLogic alerts.

Inclusion criteria

• Subject is age 18 or above, or of legal age to give informed consent
• Implanted with an cardiac resynchronization therapy defibrillator (CRT-D) or implantable cardioverter-defibrillator (ICD) device that has HeartLogic
• Current symptomatic heart failure or New York Heart Association Class II or III at the time of enrollment
• Remotely monitored by LATITUDE 5.0 (or future versions)
• Willing and capable of participating in all study visits and complying with medication/treatment requirements associated with this clinical study at an approved clinical study center.
• Meet at least one of the three following conditions:

• At least one documented hospitalization with a primary diagnosis of worsening for heart failure during the 12 months prior to enrollment; or
• Unscheduled outpatient visit with IV diuretic therapy for acute worsening of HF during 90 days prior to enrollment; or
• N-terminal-pro brain natriuretic peptide (NT-proBNP) greater than 600 pg/mL or brain natriuretic peptide (BNP) greater than 150 pg/mL at any time during 90 days prior to enrollment

Exclusion criteria

• The subject is unable to sign or refuses to sign the patient informed consent
• Symptomatic heart failure at rest or New York Heart Association Class IV at the time of enrollment
• The subject is implanted with unipolar right atrial or right ventricular leads
• Subject has received or is scheduled to receive a heart transplant or ventricular assist device within the next 6 months
• Subject is pregnant or planning to become pregnant during the study
• Subject is enrolled in any other concurrent study (without prior written approval from Boston Scientific, excluding registries)
• Glomerular filtration rate <25 mL/min who are non-responsive to diuretic therapy or are on chronic renal dialysis
• Regularly scheduled intravenous heart failure therapy (for example inotropes or diuretics)
• A life expectancy of less than 12 months per clinician discretion
• APPLICABLE TO PHASE II ONLY: Subject enrolled in Phase I of MANAGE-HF
• APPLICABLE TO PHASE II ONLY: Subject has been managed with HeartLogic Alerts ON at anytime within the past 6 months.