Fig. 1

Preemptive detection of worsening heart failure related adverse events with the help of a predefined alert based workflow. Major criteria in the alert based detection algorithm were sustained ventricular arrhythmia or ventricular shock event, anti-tachycardia pacing event or new onset atrial fibrillation burden exceeding 6 h a day. At least two minor detection criteria positivity resulted in a consecutive telephone contact to the patient. Unscheduled in-office patient evaluations were arranged at major criteria positivity and/or at least 2 minor criteria positivity and presence of patient complaint