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Remote management of heart failure using implantable electronic devices
John M Morgan1, Sue Kitt2, Jas Gill3
1Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK.
European Heart Journal
|June 3, 2017
Summary
Remote monitoring (RM) for heart failure patients with cardiac implanted electronic devices (CIEDs) did not significantly reduce death or hospitalizations. This study found no improvement in outcomes with formalized RM compared to usual care.
Area of Science:
- Cardiology
- Biomedical Engineering
- Health Services Research
Background:
- Heart failure management often involves implantable electronic devices (CIEDs).
- Remote monitoring (RM) offers potential for improved patient care and outcomes.
- Assessing the effectiveness of formalized RM protocols in CIED patients is crucial.
Purpose of the Study:
- To evaluate the clinical and cost-effectiveness of remote monitoring (RM) in patients with heart failure and CIEDs.
- To compare outcomes between active RM with formalized protocols and usual care (UC).
Main Methods:
- 1650 patients with heart failure and CIEDs were randomized to active RM or UC.
- Active RM involved weekly downloads and formalized follow-up protocols.
- The primary endpoint was death or unplanned cardiovascular hospitalization.
Main Results:
- No significant difference in the primary endpoint between active RM (42.4%) and UC (40.8%) groups.
- Hazard ratio for the primary endpoint was 1.01 (95% CI 0.87-1.18).
- No significant differences were observed for any secondary endpoints or time to primary endpoint events.
Conclusions:
- Formalized remote monitoring using weekly downloads does not improve outcomes for heart failure patients with CIEDs.
- Current RM strategies may require further refinement to demonstrate clinical benefit in this population.
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