Remote management of heart failure using implantable electronic devices.

Autor:	Morgan JM; Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK., Kitt S; Wessex Cardiology Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK., Gill J; Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London SE1 9RT, UK., McComb JM; Department of Cardiology, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne NE7 7DN, UK., Ng GA; NIHR Leicester Cardiovascular Biomedical Research Unit, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK., Raftery J; Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK., Roderick P; Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK., Seed A; Department of Cardiology, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool FY3 8NR, UK., Williams SG; Department of Cardiology, University Hospitals of South Manchester NHS Foundation Trust, Manchester M13 9WL, UK., Witte KK; Multidisciplinary Cardiovascular Research Centre, University of Leeds, Leeds, UK., Wright DJ; Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool L14 3PE, UK., Harris S; Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK., Cowie MR; Imperial College London (Royal Brompton Hospital), Dovehouse Street, London SW3 6LY, UK.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2017 Aug 07; Vol. 38 (30), pp. 2352-2360.
DOI:	10.1093/eurheartj/ehx227
Abstrakt:	Aims: Remote management of heart failure using implantable electronic devices (REM-HF) aimed to assess the clinical and cost-effectiveness of remote monitoring (RM) of heart failure in patients with cardiac implanted electronic devices (CIEDs). Methods and Results: Between 29 September 2011 and 31 March 2014, we randomly assigned 1650 patients with heart failure and a CIED to active RM or usual care (UC). The active RM pathway included formalized remote follow-up protocols, and UC was standard practice in nine recruiting centres in England. The primary endpoint in the time to event analysis was the 1st event of death from any cause or unplanned hospitalization for cardiovascular reasons. Secondary endpoints included death from any cause, death from cardiovascular reasons, death from cardiovascular reasons and unplanned cardiovascular hospitalization, unplanned cardiovascular hospitalization, and unplanned hospitalization. REM-HF is registered with ISRCTN (96536028). The mean age of the population was 70 years (range 23-98); 86% were male. Patients were followed for a median of 2.8 years (range 0-4.3 years) completing on 31 January 2016. Patient adherence was high with a drop out of 4.3% over the course of the study. The incidence of the primary endpoint did not differ significantly between active RM and UC groups, which occurred in 42.4 and 40.8% of patients, respectively [hazard ratio 1.01; 95% confidence interval (CI) 0.87-1.18; P = 0.87]. There were no significant differences between the two groups with respect to any of the secondary endpoints or the time to the primary endpoint components. Conclusion: Among patients with heart failure and a CIED, RM using weekly downloads and a formalized follow up approach does not improve outcomes. (© The Author 2017. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu