Remote management of heart failure using implantable electronic devices
| Autor: | Simon G. Williams, Jas Gill, Martin R. Cowie, Paul Roderick, G.A. Ng, Scott Harris, Alison Seed, Janet M. McComb, David J. Wright, Klaus K. Witte, John M. Morgan, Sue Kitt, James Raftery |
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| Přispěvatelé: | Imperial College Trust, Royal Brompton & Harefield NHS Foundation Trust |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Cardiac & Cardiovascular Systems HF 030204 cardiovascular system & hematology Cardiac Resynchronization Therapy 0302 clinical medicine DESIGN Clinical endpoint PROGRAM Medicine 030212 general & internal medicine 1102 Cardiorespiratory Medicine and Haematology RISK Aged 80 and over education.field_of_study Incidence (epidemiology) Hazard ratio Heart Failure/Cardiomyopathy Middle Aged RANDOMIZED CONTROLLED-TRIAL TIME Defibrillators Implantable Cardiology TRIAL Female Cardiology and Cardiovascular Medicine Life Sciences & Biomedicine Adult medicine.medical_specialty Population ESC Monitoring Ambulatory Heart failure 03 medical and health sciences Clinical Research Internal medicine Humans Cardiac Resynchronization Therapy Devices education Remote management Survival analysis Aged Science & Technology business.industry Remote Consultation Implantable devices 1103 Clinical Sciences medicine.disease Confidence interval Editor's Choice ALERTS Remote monitoring Cardiovascular System & Hematology Emergency medicine Cardiovascular System & Cardiology Patient Compliance Electronics HOSPITALIZATIONS business |
| Zdroj: | European Heart Journal |
| ISSN: | 0195-668X |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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