Key Points
- The NOTIFY-HF was the first trial that evaluated the feasibility and acceptability of patient-directed notifications from a multisensor remote HF monitoring algorithm embedded in their implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator, HeartLogic (HL).
- Patient-facing HeartLogic alerts cut the risk of a first heart failure hospitalization by 65% in NOTIFY-HF. Patients receiving alerts were 49% less likely to be hospitalized for any cause during follow-up (HR 0.51).
Heart failure can worsen long before patients feel it. The challenge has never been detected alone. It has been turning early warning into early action. NOTIFY-HF tested whether sending device alerts directly to patients could help close that gap.
At the 2026 American College of Cardiology (ACC) Scientific Sessions, Dr. Joseph Assad, MD, presented NOTIFY-HF (ACTRN12623000059662), a prospective, pragmatic, single-centre pilot randomized trial of adults with heart failure and a HeartLogic-capable ICD or CRT-D. Patients were randomized 1:1 to standard care or to a patient-facing mHealth pathway that delivered weekly HeartLogic-triggered notifications, symptom screening, and plain-language guidance. Median follow-up was 1.82 years, and analyses were intention-to-treat. Early results of this trial were published in EHJ in November 2025.
HeartLogic is a multisensor algorithm embedded in Boston Scientific ICD and CRT-D devices for heart failure diagnostics. In the intervention arm, values below threshold generated a reassurance message, while higher values triggered a questionnaire about symptoms such as breathlessness, swelling, weight gain, fatigue, and nocturnal breathlessness, followed by graded guidance based on the responses.
A total of 160 patients were enrolled, with 81 assigned to the intervention arm and 79 to control. Mean age was 65±11 years, and 77% of patients were male. Feasibility and acceptability were strong, with high retention, symptom-screen completion of 80%, MAUQ scores of 5.7–5.9 out of 7, and no mHealth-related adverse events.
The intervention reduced HeartLogic alert burden, with fewer alerts overall and more time spent out of alert status, while time to normalization was similar between groups. Hospitalization outcomes were exploratory in this pilot study, but favored the intervention, including lower hazards of first heart failure and all-cause hospitalization. Recurrent heart failure hospitalization was also lower.
The investigators noted several limitations, including the pilot design, single-centre setting, lack of power for clinical endpoints, open-label design, and nonstandardized outpatient care-process measures across study arms.
According to Dr. Assad, “Early detection alone is insufficient- the way a signal is communicated and acted upon may be equally important. Involving patients in that process appears to create a different pathway for intervention”. NOTIFY-HF is the first randomized trial to test patient-facing HeartLogic alerts. In this pilot study, giving patients the warning signal, not just clinicians, was associated with fewer alerts and fewer hospitalizations, turning remote monitoring into something closer to real-time care.