%0 Journal Article %@ 2561-1011 %I JMIR Publications %V 1 %N 1 %P e1 %T Bioimpedance-Based Heart Failure Deterioration Prediction Using a Prototype Fluid Accumulation Vest-Mobile Phone Dyad: An Observational Study %A Darling,Chad Eric %A Dovancescu,Silviu %A Saczynski,Jane S %A Riistama,Jarno %A Sert Kuniyoshi,Fatima %A Rock,Joseph %A Meyer,Theo E %A McManus,David D %+ UMass Memorial Health Care, Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, United States, 1 508 421 1464, chad.darling@umassmed.edu %K telemedicine %K outpatient monitoring %K heart failure %K electric impedance %D 2017 %7 13.03.2017 %9 Original Paper %J JMIR Cardio %G English %X Background: Recurrent heart failure (HF) events are common in patients discharged after acute decompensated heart failure (ADHF). New patient-centered technologies are needed to aid in detecting HF decompensation. Transthoracic bioimpedance noninvasively measures pulmonary fluid retention. Objective: The objectives of our study were to (1) determine whether transthoracic bioimpedance can be measured daily with a novel, noninvasive, wearable fluid accumulation vest (FAV) and transmitted using a mobile phone and (2) establish whether an automated algorithm analyzing daily thoracic bioimpedance values would predict recurrent HF events. Methods: We prospectively enrolled patients admitted for ADHF. Participants were trained to use a FAV–mobile phone dyad and asked to transmit bioimpedance measurements for 45 consecutive days. We examined the performance of an algorithm analyzing changes in transthoracic bioimpedance as a predictor of HF events (HF readmission, diuretic uptitration) over a 75-day follow-up. Results: We observed 64 HF events (18 HF readmissions and 46 diuretic uptitrations) in the 106 participants (67 years; 63.2%, 67/106, male; 48.1%, 51/106, with prior HF) who completed follow-up. History of HF was the only clinical or laboratory factor related to recurrent HF events (P=.04). Among study participants with sufficient FAV data (n=57), an algorithm analyzing thoracic bioimpedance showed 87% sensitivity (95% CI 82-92), 70% specificity (95% CI 68-72), and 72% accuracy (95% CI 70-74) for identifying recurrent HF events. Conclusions: Patients discharged after ADHF can measure and transmit daily transthoracic bioimpedance using a FAV–mobile phone dyad. Algorithms analyzing thoracic bioimpedance may help identify patients at risk for recurrent HF events after hospital discharge. %M 31758769 %R 10.2196/cardio.6057 %U http://cardio.jmir.org/2017/1/e1/ %U https://doi.org/10.2196/cardio.6057 %U http://www.ncbi.nlm.nih.gov/pubmed/31758769