Study Shows Fluid Monitoring in HF Patients Leads to Increased Hospital Visits


September 20, 2011

September 20, 2011 – A recent study sought to determine if monitoring fluid build-up in the chest of heart failure patients would lead to earlier detection of problems and prevent repeat hospitalizations. The results, released as part of the late-breaking trials at the 15th annual scientific meeting of the Heart Failure Society of America (HFSA), actually showed an increase in hospital visits.

D.J. van Veldhuisen, M.D., UMC Groningen, the Netherlands, presented the results.

Fluid builds up in the heart, which is unable to manage the increase in fluid. This results in patients requiring a hospital stay to correct the issue. The problem can cause weight gain, fatigue and shortness of breath.

The study focused on strategies for early detection of fluid overflow in order to avoid lengthy and costly hospital stays. Doctors studied 350 patients who had implantable cardioverter defibrillators (ICDs) with or without cardiac resynchronization; they were fitted with diagnostic systems to monitor intrathoracic impedance, which reflects fluid in the chest, a sign of (impeding) decompensation.

The systems are designed to emit a beep when fluid levels reach a certain threshold, signaling the patient to contact their doctor.

Doctors sought to determine if these systems would provide detection early enough to prevent the need for later hospitalization. The patients who were fitted with active diagnostic systems actually saw an increase in hospital visits, rather than the decrease doctors had hoped for.

As van Veldhuisen points out, patients may have become nervous about the alarm going off, which resulted in visits to the hospital rather than a phone call to their doctor. He also notes the human body naturally fluctuates from day to day, so the question becomes how quickly should doctors respond to slight changes

"Early detection of fluid buildup is the key to reducing hospital stays and improving quality of life for patients," van Veldhuisen said. "This study, among others, is aimed at finding the best ways to identify problems early, and monitoring patients remotely seems to be the best option. The question becomes which method we should use to monitor patients."

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