Key result
Remote monitoring of heart failure patients with an ICD or CRT-D reduced the composite of all-cause death and cardiovascular hospitalization compared to standard care (39.5% vs 48.5%; P=0.048).
Why the study?
Studies investigating the efficacy of remote monitoring in patients with heart failure and cardiac implantable electronic devices have shown mixed findings.
Does remote monitoring care reduce the composite of all-cause death and cardiovascular hospitalization in patients with heart failure and de novo ICD or CRT-D implantation?
RCT (n=600)
randomized
No
Does remote monitoring care reduce the composite of all-cause death and cardiovascular hospitalization in patients with heart failure and de novo ICD or CRT-D implantation?
Absolute Event Rate: 39.5% vs 48.5%
p-value: p=0.048
Remote monitoring of heart failure patients with newly implanted ICDs or CRT-Ds significantly reduces the combined rate of all-cause death and cardiovascular hospitalization compared to standard in-office care.
Supports remote monitoring in HF patients with new ICD/CRT-D; reinforces telemonitoring efficacy in device recipients.
AIMS: The number of patients with heart failure (HF) and implantable cardiac electronic devices has been growing steadily. Remote monitoring care (RC) of cardiac implantable electronic devices can facilitate patient-healthcare clinical interactions and prompt preventive activities to improve HF outcomes. However, studies that have investigated the efficacy of remote monitoring have shown mixed findings, with better results for the system including daily verification of transmission. The purpose of the RESULT study was to analyse the impact of remote monitoring on clinical outcomes in HF patients with implantable cardioverter-defibrillator [ICD/cardiac resynchronization therapy-defibrillator (CRT-D)] in real-life conditions. METHODS AND RESULTS: The RESULT is a prospective, single-centre, randomized trial. Patients with HF and de novo ICD or CRT-D implantation were randomized to undergo RC vs. in-office follow-ups (SC, standard care). The primary endpoint was a composite of all-cause death and hospitalization due to cardiovascular reasons within 12 months after randomization. We randomly assigned 600 eligible patients (299 in RC vs. 301 in SC). Baseline clinical and echocardiographic characteristics were well-balanced and similar in both arms. The incidence of the primary endpoint differed significantly between RC and SC and involved 39.5% and 48.5% of patients, respectively, (P = 0.048) within the 12-month follow-up. The rate of all-cause mortality was similar between the studied groups (6% vs. 6%, P = 0.9), whereas hospitalization rate due to cardiovascular reasons was higher in SC (37.1% vs. 45.5%, P = 0.045). CONCLUSION: Remote monitoring of HF patients with implanted ICD or CRT-D significantly reduced the primary endpoint rate, mostly as a result of a lower hospitalization rate in the RC arm (ClinicalTrials.gov Identifier: NCT02409225).
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Tajstra et al. (2020) conducted an RCT in Heart failure with implantable cardioverter-defibrillator or CRT-D (n=600). Remote monitoring care vs. In-office follow-ups (standard care) was evaluated on Composite of all-cause death and hospitalization due to cardiovascular reasons (p=0.048). Remote monitoring of heart failure patients with an ICD or CRT-D reduced the composite of all-cause death and cardiovascular hospitalization compared to standard care (39.5% vs 48.5%; P=0.048).
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