Authors: Giovanni B Forleo Luca Santini Massimiliano Campoli Mario Malavasi Alberto Scaccia Maurizio Menichelli Umberto Riva Filippo Lamberti Giovanni Carreras Serafino Orazi Valentina Ribatti Luigi Di Biase Mariolina Lovecchio Andrea Natale Sergio Valsecchi Francesco Romeo
Publish Date: 2015/04/28
Volume: 43, Issue: 2, Pages: 135-144
Abstract
Monitoring respiratory rate RR is recommended at the time of hospital presentation for acute decompensation in heart failure HF Devicebased continuous monitoring of RR may be helpful for diagnostic and prognostic stratification after implantable cardioverterdefibrillator ICD implantation This study was undertaken to analyze short and longterm changes in ICDmeasured RR and to relate RR with the patient’s clinical status and the occurrence of HF eventsAt the baseline the proportion of New York Heart Association NYHA class III–IV was higher among patients with daily maximum RR 27 breaths/min third tertile than those with 24 breaths/min first tertile 43 vs 23 p 005 Moreover the ejection fraction was lower 27 ± 7 vs 34 ± 8 p 005 In patients with HF hospitalizations 33 events and urgent visits for HF 15 events the weekly average of RR calculated over the 7 days preceding hospital accesses did not differ from values recorded at the baseline and before scheduled followup visits However the weekly variation in RR ie the difference between maximum and minimum values collected over the week was significantly higher prior to hospitalization p 005 A weekly variation 3 breaths/min in maximum RR predicted an impending hospital admission for HF with sensitivity of 73 and specificity of 57 In this study elevated values of ICDmonitored RR identified patients with worse functional status and lower systolic function The weekly variation in RR increased before HF exacerbation This monitoring technology may represent a useful tool in the clinical management of patients with HFThe following Italian institutions and investigators participated in the study—Policllinico Tor Vergata Rome GB Forleo G Magliano G Panattoni V Ribatti D Sergi L Santini and F Romeo Ospedale Belcolle Viterbo M Campoli M Malavasi and M Sassara Ospedale SS Trinità Sora A Scaccia Ospedale F Spaziani Frosinone L Carbonardi and M Menichelli Ospedale S Eugenio Roma F Lamberti Ospedale Santa Maria Terni C Marini and G Carreras and Ospedale San Camillo de Lellis Rieti S Orazi and A Menè
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