A Virtual Heart Failure Optimization Program for Guideline Directed Medical Therapy and Cardiac Rehabilitation

Cambridge Cardiac Care Centre400 enrolled

Overview

The goal of this study is to test the impact of a virtual heart failure optimization program on uptake of guideline directed medical therapy, participation in cardiac rehabilitation \& impact on echocardiographic parameters.

This is a single center, prospective pre-post cohort study testing a virtual, multi-disciplinary heart failure optimization program for up-titration of guideline directed medical therapy. This nurse and kinesiologist-led program will start and up-titrate patients on GDMT and offer virtual cardiac rehabilitation over a 3-month period. The investigators hypothesize that this program could safely achieve higher rates of maximally tolerated ARNI, Beta-blocker, MRA and SGLT2i rates, as well as participation in cardiac rehabilitation among HFrEF patient participants. The investigators hypothesize that participation will lead to improved Left Ventricular Ejection Fraction on Echocardiogram.

Study Type

OBSERVATIONAL

Enrollment

400

Conditions

Heart Failure With Reduced Ejection Fraction

Interventions

Virtual Heart Failure Optimization ProgramOTHER

Participants referred to the "Virtual Heart Failure Optimization Program" will be seen for initial consultation by a HF program nurse and cardiologist within 1 week. Patients will be offered the opportunity to participate in virtual cardiac rehabilitation. Following this, patients will be assessed virtually every two weeks by a HF program nurse for addition and up-titration of medical therapy. All medication changes will be performed algorithmically and reviewed with the overseeing cardiologist. Following all medication changes, appropriate monitoring will be performed algorithmically as well. All participants will be asked if they would like to participate in cardiac rehabilitation and an automatic referral will be sent by the overseeing cardiologist. Virtual cardiac rehabilitation will be conducted weekly with phone follow-up appointments with a program kinesiologist and virtual education programming.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * HFrEF (ejection fraction less than 40%) with New York Heart Association (NYHA) class II or III symptoms * Adults (\>18 years of age), capable of providing informed consent, English-proficient and with access to a telephone Exclusion Criteria: * Patients who are pregnant * Patients who who are incarcerated * Cardiac Transplant Patients * Patients with Left Ventricular Assist Devices

Locations (1)

Cambridge Cardiac Rehab

Cambridge, Ontario, Canada

RECRUITING

Outcomes

Primary Outcomes

Change from baseline Doses of GDMT

Beta-blocker, ACE-inhibitor/Angiotensin receptor blocker/Valsartan-Sacubitril, Mineralocorticoid Receptor Antagonist, SGLT2 inhibitor