Association of remote monitoring with survival in heart failure patients undergoing cardiac resynchronization therapy: Retrospective observational study
| Autor: | Mate Vamos, Róbert Gábor Kiss, Balázs Muk, Peter Bogyi, Noemi Nyolczas, Zsolt Bari, Gabor Z. Duray, Balazs Polgar |
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| Přispěvatelé: | Eysenbach, Gunther |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty 020205 medical informatics medicine.medical_treatment Population Cardiac resynchronization therapy Health Informatics 02 engineering and technology survival Cardiac Resynchronization Therapy 0202 electrical engineering electronic engineering information engineering medicine CRT-D Outpatient clinic Humans ddc:610 education Survival rate remote monitoring Aged Retrospective Studies Heart Failure education.field_of_study Original Paper business.industry Hazard ratio Retrospective cohort study Atrial fibrillation Middle Aged medicine.disease Telemedicine Survival Rate Treatment Outcome Heart failure Emergency medicine Female business |
| Zdroj: | Journal of Medical Internet Research |
| Popis: | Background: Remote monitoring is an established, guideline-recommended technology with unequivocal clinical benefits; however, its ability to improve survival is contradictory. Objective: The aim of our study was to investigate the effects of remote monitoring on mortality in an optimally treated heart failure patient population undergoing cardiac resynchronization defibrillator therapy (CRT-D) implantation in a large-volume tertiary referral center. Methods: The population of this single-center, retrospective, observational study included 231 consecutive patients receiving CRT-D devices in the Medical Centre of the Hungarian Defence Forces (Budapest, Hungary) from January 2011 to June 2016. Clinical outcomes were compared between patients on remote monitoring and conventional follow-up. Results: The mean follow-up time was 28.4 (SD 18.1) months. Patients on remote monitoring were more likely to have atrial fibrillation, received heart failure management at our dedicated heart failure outpatient clinic more often, and have a slightly lower functional capacity. Crude all-cause mortality of remote-monitored patients was significantly lower compared with patients followed conventionally (hazard ratio [HR] 0.368, 95% CI 0.186-0.727, P=.004). The survival benefit remained statistically significant after adjustment for important baseline parameters (adjusted HR 0.361, 95% CI 0.181-0.722, P=.004). Conclusions: In this single-center, retrospective study of optimally treated heart failure patients undergoing CRT-D implantation, the use of remote monitoring systems was associated with a significantly better survival rate. |
| Databáze: | OpenAIRE |
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