Contributed in part by: Chelsea Christensen, PA-C

Can We Reduce Heart Failure Readmissions to Single Digits?

At ACC.26, Chelsea Christensen presented real-world evidence for proactive heart failure management. In this article, learn how non-invasive fluid monitoring dropped her hospital's HF readmission rates to single digits, review clinical use cases, and see how the program was successfully implemented at a major heart failure program.

Female physicians reviewing a document in a hospital

Real-World Evidence from the ACC.26 Innovation Stage

Quick Summary

The Problem: 1 in 5 Heart Failure (HF) patients are readmitted within 30 days.¹
The Discovery: Sentara Virginia Beach General Hospital achieved <2% 30-day HF readmissions using ZOLL HFMS.
The Key: Detecting fluid buildup before symptoms appear.

One in five heart failure patients will be back in a hospital bed within 30 days of discharge. Nationally, that number jumps to one in three by day 90.² It is a "revolving door" cycle that creates immense stress for both patients and clinical teams.

However, at the American College of Cardiology (ACC) 2026 Innovation Stage, a new narrative emerged. Chelsea Christensen, PA-C, shared how her team at Sentara Virginia Beach General Hospital utilized the ZOLL Heart Failure Management System (HFMS) to achieve a heart-failure-specific readmission rate of less than 2% at 30 days and less than 4% at 90 days.

How it Works: Moving the "Intervention Window"

Traditional monitoring relies on symptoms like weight gain or swelling, indicators that often appear too late. HFMS is a non-invasive wearable patch that measures thoracic fluid index (TFI), or lung tissue hydration, using radiofrequency.

"HFMS catches it sooner than these patients even realize they’re starting to retain fluid," Christensen explained. This "early warning" gives providers a window to adjust medications at home, preventing the crisis before it reaches the ER.

From the Clinic: Three Patients, Three Saved Admissions

The clinical utility of HFMS is evident when evaluating its impact on individual patient management. The following cases demonstrate how radiofrequency-derived thoracic fluid index (TFI) data serves as an indicator of fluid buildup, enabling clinicians to proactively manage decompensation in the outpatient setting.

Patient Cohort	Clinical Presentation & Diagnostic Challenge	Therapeutic Intervention & Outcome
High-Risk Post-CABG / HFpEF	Sub-clinical fluid accumulation. The device identified a significant TFI deviation while the patient remained asymptomatic, precluding the use of traditional symptom-based tracking.	Guided Diuresis: Based on TFI trends, a 3-day diuretic titration was initiated. The patient successfully returned to baseline without requiring an emergency department (ED) evaluation.
New-Onset HFrEF (EF 27%)	Diagnostic ambiguity. The patient presented with cough and dyspnea, which he attributed to a viral upper respiratory infection—a frequent cause of delayed HF treatment.	Differential Diagnosis: TFI data confirmed pulmonary congestion rather than infection. Immediate medication adjustment helped keep the patient ambulatory.
Recurrent HFpEF / AFib	Poor therapeutic compliance due to procedural anxiety. In preparation for an ablation, the patient self-discontinued diuretics, leading to rapid volume expansion.	Early Detection: The monitor flagged the deviation. Early clinical contact corrected the dosing error, maintaining ambulatory status through the perioperative period.

A Sustainable Workflow for Clinicians

A common concern with remote monitoring is "data fatigue." Christensen noted that her program’s HFMS workflow is remarkably lean:

One-Minute Ordering: Seamless integration into the discharge process.
Managed Alerts: Providers only review trends that trigger specific thresholds.
Low Staff Burden: ZOLL cardiac techs review the data 24/7, reducing staff burden.
High Activation: Over 88% of patients in the hospital successfully started the device at home.

Conclusion

The data from Sentara Virginia Beach General Hospital shows that the 30-day HF readmission "revolving door" is not an inevitability. By combining real-world data with proactive clinical intervention, the use of ZOLL HFMS has the potential to move the needle from the national heart failure readmission average of 20% down into the single digits.

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References (TBD)

Boehmer, J, Cremer, S, Abo-Auda, W. et al. Impact of a Novel Wearable Sensor on Heart Failure Rehospitalization: An Open-Label Concurrent-Control Clinical Trial. J Am Coll Cardiol HF. 2024 Dec, 12 (12) 2011–2022. https://doi.org/10.1016/j.jchf.2024.07.022
Greene, S, Butler, J, Albert, N. et al. Medical Therapy for Heart Failure With Reduced Ejection Fraction: The CHAMP-HF Registry. 2018 Jul, 72 (4) 351–366. https://doi.org/10.1016/j.jacc.2018.04.070
Do et al. 2024. Comorbidities and determinants of heath on heart failure guideline-directed medical therapy adherence: All of us. https://doi.org/10.1016/j.ijcrp.2024.200351
Khan MS, Sreenivasan J, Lateef N, et al. Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circ Heart Fail. 2021;14(4):e008335.
Fonarow GC, Abraham WT, Albert NM, et al. Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE-HF. Arch Intern Med. 2008;168(8):847-854.
Centers for Medicare & Medicaid Services. (2024, September 10). Hospital Readmissions Reduction Program (HRRP).
Boehmer, J. (2025) Reduced heart failure rehospitalization at 1 year for patients wearing a radiofrequency based sensor [Abstract]. In Proceedings of the THT 2025 Conference. Boston, MA.

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