【正文】 toring may predict arrhythmic events, especially ventricular arrhythmias in patients with HF and provides an additional management tool Circ J. 2020。33(1):6473. Intrathoracic and ventricular impedances are associated with changes in ventricular volume in patients receiving defibrillators for CRT ?282 pts with III or IV HF implanted with a CRTD w/ a fluid index ?2 groups: based on fluid index threshold crossings or not ?4,725 tachyarrhythmic events in 129 pts (46%) ?221 fluid index crossing events in 145 pts (51%) during 177。 d resulted in sensitivity of % and falsepositive rate of falsepositives per ptsyear of monitoring Conclusion Intrathoracic impedance is inversely correlated with PWCP and fluid balance and decreased before the onset of patient symptoms and before hospital admission for fluid overload. Regular monitoring of impedance may provide early warning of impending depensation and diagnostic information for titration of medication. The Chronicle Offers Management to Patients with Advanced Signs and Symptoms of Heart Failure (COMPASSHF study) ?To evaluate whether an implantable hemodynamic monitor (IHM) was safe and effective in reducing HFrelated events (HFRE) in CHF ?70 pts with an EF or =50% (ie, DHF)， randomized to IHMguided care vs. control for 6 months ?The HFRE rate in DHF pts in treatment was events/6 months，in control was events/6 months ? 20% nonsignificant reduction in the overall HFRE rate in the treatment group， 29% nonsignificant reduction in the relative risk of a HF hospitalization in the DHF pts treatment pared with control ?The IHM was safe and associated with a very low systemrelated and procedurerelated plication rate in DHF patients. showing a nonsignificant 21% decrease of all heart failure related events after 6 month J Card Fail. 2020 。112:841848 Algorithm performance on validation data set Yu C et al. Circulation 2020。112:841848 Two occasions in which fluid index exceeded nominal threshold of 60 Ω 112:841848 Comparison of intrathoracic impedance at reference baseline and 1 day before admission for 24 hospitalizations resulting from worsening heart failure in 9 patients Yu C et al. Circulation 2020。 1) Cause of heart failure, n (%) Ischemic heart disease 4 (17) 7 (70)* Nonischemic (idiopathic, hypertensive, or valvular) 19 (83) 3 (30)* Atrial fibrillation, n (%) 13 (56) 4 (40) Medications at baseline, n (%) Aspirin 10 (43) 6 (60) Loop diuretics 23 (100) 10 (100) βBlockers 12 (52) 4 (40) ACE inhibitors 18 (78) 8 (80) Calcium antagonists 2 (9) 2 (20) Amiodarone 2 (9) 0 Digoxin 11 (48) 3 (30) Statins 4 (17) 4 (40) Yu C et al. Circulation 2020。 SD, %) 17 (31177。 12) 2 (75177。 4 Male, n (%) 14 (61) 7 (70) NYHA class, n (%) II 1 (4) 1 (10) III 21 (92) 9 (90) IV 1 (4) 0 Ejection fraction 50%, n (mean177。112:841848 Intrathoracic impedance monitoring in CHF: correlation with fluid status and feasibility of early warning preceding hospitalization (midhftrial) Parameters Nonhospitalized (n=23) Hospitalized (n=10) *P vs nonhospitalized. Age, y 77177。 Biotronic Heart Failure Monitor174。95(9):1104110. 病人活動度 （ patient activity） 各級醫(yī)生根據(jù)病人臨床表現(xiàn)評估液體潴留的能力 Accurate assessment (%) 55 75 Heart Failure Specialists Stevenson et al Primary Car