Key result
Remote monitoring did not reduce the primary composite endpoint of worsening heart failure, arrhythmia, and device-related adverse events compared to conventional follow-up over 12 months.
Why the study?
Heart failure patients with implanted cardiac devices require close follow-up despite COVID-19 pandemic-related healthcare restrictions.
Does remote monitoring reduce adverse events and heart failure hospitalizations in heart failure patients with cardiac implantable electronic devices during the COVID-19 pandemic?
Observational (n=132)
No
Does remote monitoring reduce adverse events and heart failure hospitalizations in heart failure patients with cardiac implantable electronic devices during the COVID-19 pandemic?
Answers are grounded in this paper and cite their sources.
Remote monitoring with a specified alert-based algorithm in device-implanted heart failure patients may facilitate early detection of worsening heart failure and reduce hospitalizations during pandemic-related healthcare restrictions.
BACKGROUND: Coronavirus disease 2019 (COVID-19) had spread into a pandemic affecting healthcare providers worldwide. Heart failure patients with implanted cardiac devices require close follow-up in-spite of pandemic related healthcare restrictions. METHODS: Patients were retrospectively registered and clinical outcomes were compared of 61 remote monitored (RMG) versus 71 conventionally (in-office only) followed (CFG) cardiac device implanted, heart failure patients. Follow-up length was 12 months, during the COVID-19 pandemic related intermittent insitutional restrictions. We used a specified heart failure detection algorithm in RMG. This investigation compared worsening heart failure-, arrhythmia- and device related adverse events as primary outcome and heart failure hospitalization rates as secondary outcome in the two patient groups. RESULTS: No significant difference was observed in the primary composite end-point during the first 12 months of COVID-19 pandemic (p = 0.672). In RMG, patients who had worsening heart failure event had relative modest deterioration in heart failure functional class (p = 0.026), relative lower elevation of N terminal-pro BNP levels (p < 0.01) at in-office evaluation and were less hospitalized for worsening heart failure in the first 6 months of pandemic (p = 0.012) compared to CFG patients. CONCLUSIONS: Specified remote monitoring alert-based detection algorithm and workflow in device implanted heart failure patients may potentially indicate early worsening in heart failure status. Preemptive adequate intervention may prevent further progression of deteriorating heart failure and thus prevent heart failure hospitalizations.
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Ezer et al. (2022) conducted an observational in Heart failure with cardiac implantable electronic devices (n=132). Remote monitoring vs. Conventional in-office follow-up was evaluated on Composite of worsening heart failure, arrhythmia, and device-related adverse events (p=0.672). Remote monitoring did not reduce the primary composite endpoint of worsening heart failure, arrhythmia, and device-related adverse events compared to conventional follow-up over 12 months.
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