Heart failure algorithms for remote monitoring in people with cardiac implantable electronic devices

Outcomes

Implementation of the TriageHF Plus clinical pathway was associated with a 58% reduction in all-cause hospitalisations.

The TriageHF Plus clinical pathway is cost effective, equivalent to a net monetary benefit of £4,158 (£1,935 to £5,781) per patient over their lifetime.

Learning

The TriageHF Plus project at Manchester Royal Infirmary, which is part of a wider Greater Manchester collaboration, has been a great success. Despite significant challenges, including the COVID-19 pandemic, the pathway has continued to run with minimal disruption for over 5 years. Our main challenge to operations has been staffing, a widespread issue within HF services across the country. Although the overall framework of the pathway has not changed since its implementation, a regular review of data and feedback to staff has led to iterative improvements. This includes opportunistic patient education and medication reviews to ensure that as well as addressing acute issues, we routinely take the opportunity to ensure people receive class 1 guideline-recommended medical treatment for HF.