Virtual Conference

Konstantine Merzon

Cardiac Rehabilitation Institute, Israel

Title: The Ambulatory Management of Patients with Decompensated Heart Failure (HF)


Background: Decreasing heart failure (HF) readmission in HF patients is the unmet goal.
To compare the rate of re-admissions for HF and quality of life (QOL) during 1-year before and after starting the ambulatory IV treatment in a day-care HF unit setting.
Method and results:
Clinical data and the number of HF hospitalizations of 66 patients with severe decompensated HF were collected. All patients were defined as NYHA class 3-4 at the treatment beginning. The average age of the patients was 75.5±11.1 years, 49 were men (74%). There were 52 (79%) patients with HFrEF and 14 with HFpEF. The average number of day-care treatments (IV diuretics/inotropes/iron) was 12±14 during the year. The mean LVEF at the 1st visit was 38.8% (29±6% in the HFrEF group) and the mean NT-pro BNP level was 6310±7241pg/mL. The QOL Minnesota questionnaire score improved from 65±18 to 46±20 (p<0.001) during the 1st  year IV ambulatory treatment. The number of HF hospitalization during 1st year before the beginning of the day-care treatment was 107 and during the following year of the treatment was 33 (a 3.2 times reduction, p<0.001)
Outpatient ambulatory management of decompensated HF with IV treatment given in the day-care heart failure unit setting is effective resulting in a significant reduction of HF readmissions and improved QOL. The delivery of such service may be especially important during the COVID-19 pandemic for our patients with severe HF to prevent hospitalizations as well as for the hospitals which are running short of space and staff with non-COVID patients.