JACC. Heart failure
July 10, 2026 · via Europe PMC
NOTIFY-HF: A Randomized Pilot Trial of Patient-Facing Alerts for Worsening Heart Failure Using Multiparameter Monitoring.
Assad J, Briggs NE, Lo S, Rajaratnam R, Femia G, Leung D, Dimitri H.
AI summary — for doctors, generated from the abstract only
A pilot trial found that sending heart failure patients direct alerts and self-care guidance based on their implanted defibrillator's monitoring data (rather than only alerting their doctor) was feasible, well-accepted, and associated with fewer overall alert episodes, supporting further testing in a larger trial.
What was studied
A single-center, pragmatic, randomized pilot trial of 160 heart failure patients with a HeartLogic-capable implantable cardioverter-defibrillator, randomized 1:1 to usual care (clinician-facing alerts only) or usual care plus a patient-facing mobile health pathway delivering weekly notifications with symptom screening and self-care guidance when the HeartLogic algorithm indicated risk, assessing feasibility, acceptability, and exploratory clinical associations over 12-24 months.
Key findings
- Recruitment reached 160 of a 200-participant target (80%), with high retention and acceptable usability scores (Mobile App Usability Questionnaire) throughout follow-up; engagement was high, with 80% symptom-screen completion during alerts.
- Compared with usual care, the intervention was associated with lower HeartLogic alert incidence (incidence rate ratio 0.78, 95% CI 0.62-0.99) and 13% more monitored days outside the alert state (rate ratio 1.13, 95% CI 1.02-1.25).
- A tiered 'traffic-light' response pathway supported risk-based patient action, with more self-reported healthcare contact following higher-risk ('red') alerts than lower-risk ('amber') alerts; exploratory clinical outcomes trended favorably but the pilot was not powered to test them definitively.
Clinical relevance
These findings suggest that empowering heart failure patients with direct, actionable information from their implanted device monitoring (rather than relying solely on clinician-facing alerts) is feasible and well-accepted, and may help reduce the burden of worsening heart failure episodes, supporting evaluation of this patient-facing approach in a larger, adequately powered multicenter trial.
Who should care
Limitations
This is a small, single-center pilot trial explicitly not powered to detect differences in clinical outcomes like hospitalization or mortality; the exploratory clinical findings, while directionally favorable, require confirmation in a larger trial before they can inform practice.
Giving heart failure patients direct, easy-to-understand alerts from their defibrillator's built-in monitoring system, along with self-care tips, was well-received and linked to fewer warning episodes overall, setting the stage for a larger trial.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Worsening heart failure is often preceded by days-to-weeks of physiological deterioration; yet, remote-monitoring alerts are clinician-facing and may not translate into timely action. The authors evaluated a patient-facing HeartLogic-guided Mobile Health (mHealth) pathway designed to augment usual care.
Objectives
The purpose of this study was to assess feasibility, acceptability, and exploratory clinical associations of a patient-facing HeartLogic-triggered early-warning pathway.
Methods
This single-center, pragmatic, randomized pilot trial recruited adults with heart failure and a HeartLogic-capable implantable cardioverter-defibrillator, randomized 1:1 to usual care or usual care plus weekly patient-facing HeartLogic-triggered notifications via an mHealth platform with symptom screening and self-care guidance. Coprimary outcomes were feasibility/acceptability and HeartLogic recovery metrics. Follow-up ranged from 12 to 24 months.
Results
A total of 160 participants were randomized (81 intervention, 79 control); median follow-up was 1.82 years. Recruitment reached 160 of 200 participants (80% of target), retention was high, and mean Mobile App Usability Questionnaire scores demonstrated acceptability throughout follow-up. Engagement was high with 80% symptom-screen completion during alerts. Compared with usual care, the intervention was associated with lower HeartLogic alert incidence (IRR: 0.78 [95% CI: 0.62-0.99]) and 13% more monitored days outside alert state (RR: 1.13 [95% CI: 1.02-1.25]), whereas time to alert normalization was similar. The traffic-light pathway supported risk-tiered patient response, with greater self-reported health care contact following red than amber alerts. Exploratory clinical outcomes were directionally favorable, but the study was not powered for these endpoints.
Conclusions
In this randomized pilot trial, a patient-facing HeartLogic-guided mHealth pathway was feasible, acceptable, and associated with lower alert burden, supporting evaluation in a larger multicenter trial.
DOI
10.1016/j.jchf.2026.103184
PMID
42435023
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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