Pilot Study of the CoVa™ Monitoring of Patients With Congestive Heart Failure

The study proposes to utilize the CoVa™ Monitoring System, a novel body-worn sensor that
remotely monitors thoracic fluid, heart rate, heart rate variability, respiration rate, skin
temperature, posture, and, using transmitted waveforms, stroke volume and cardiac output to
evaluate the system's monitoring capabilities in individuals recently hospitalized for
congestive heart failure. The data acquired through this study will play a critical roll in
developing future interventional studies that will allow patients with HF to potentially
receive better and more timely treatment in the home setting, decreasing hospitalizations
and improving quality of life.

Inclusion Criteria:

- Adults over age 18

- Have wireless internet access within their homes.

- Acute hospitalization with a primary diagnosis of acute decompensated heart failure
(ADHF) diagnosed on the basis of all of the following:

1. Symptoms:

- Onset or worsening of dyspnea within the past 2 weeks

2. Physical exam (at least 1 present):

- Rales/ Crackles on auscultation

- Elevated JVP > 8 cmH2O

- Weight gain

- LE edema

3. Diagnostic imaging/ labs (at least 1 present):

- Evidence of pulmonary congestion or edema on chest X-ray/ chest CT

- Elevated NT-pro-BNP (age-adjusted) (>1000)

- Patients of particular interest will be those who already have a Medtronic
Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy device
with the OptiVol feature that tracks transthoracic impedance.

Exclusion Criteria:

- Allergy to ECG electrodes

- Psychological or social situation that would make the study difficult for the patient

- Inability to consent

- Pregnant women

- Pneumonia - currently, or within the past 30 days

- Non-cardiogenic pulmonary edema (e.g. ARDS)

- Interstitial lung disease

- End-stage renal disease and on hemodialysis

- For any reason unable to wear or place the CoVa™ device, e.g. pectus excavatum,
fragile skin, severe arthritis.