Ambulatory Heart Failure Service Model Study

The Reduction of Decompensation and Unnecessary Cardiac Failure Emergency Admissions: Ambulatory Heart Failure Service Model

The aim of the study is to assess the efficacy of this new ambulatory service model in reducing heart failure hospitalization (HHF), improving clinical as well as functional outcomes of post-discharge patients with Heart Failure of reduced ejection fraction (HFrEF) and Heart failure with preserved Ejection Fraction (HFpEF).

Inclusion Criteria:

• Dyspnoea (exertional or at rest) and 2 of the following signs:
• Congestion on chest X-ray
• Rales on chest auscultation
• Clinically relevant oedema (e.g. ≥1+ on a 0 to 3+ scale)
• Elevated jugular venous pressure
• NT-proBNP ≥300 pg/mL (Patients with AF: NT-proBNP ≥900 pg/mL)
• Heart failure hospitalization that requires the treatment of a minimum single dose of 40 mg of i.v. furosemide (or equivalent i.v loop diuretics)
• Ambulatory patients

Exclusion Criteria:

• Cardiogenic shock required inotropics
• Cardiac mechanical support implantation like LVAD
• Life expectancy less than 1 year due to underlying significant comorbidities like metastatic cancer or end-stage COPD
• Haemodynamically severe uncorrected primary cardiac valvular disease planned for surgery or intervention during the course of the study.
• End stage renal failure or eGFR <15 mL/min/1.73m2 as measured during index hospitalization or requiring dialysis