Mateusz Tajstra1, Adam Sokal2, Elżbieta Gadula-Gacek1, Anna Kurek1, Aleksandra Wozniak2, Jacek Niedziela1, Elżbieta Adamowicz-Czoch1, Piotr Rozentryt1, Krzysztof Milewski3,4, Wojciech Jachec5, Zbigniew Kalarus2, Lech Poloński1, Mariusz Gasior1. 1. 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland. 2. Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases in Zabrze, Zabrze, Poland. 3. Centre for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland. 4. The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland. 5. 2nd Department of Cardiology, School of Medicine with Dentistry Division in Zabrze, Medical University of Silesia, 10 Curie-Sklodowska str, 41-808 Zabrze, Poland.
Abstract
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 withimplantable 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). Published on behalf of the European Society of Cardiology. All rights reserved.
RCT Entities:
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 HFpatients 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 HFpatients 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). Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Cheyenne S L Chiu; Ivy Timmermans; Henneke Versteeg; Edgar Zitron; Philippe Mabo; Susanne S Pedersen; Mathias Meine Journal: Europace Date: 2022-02-02 Impact factor: 5.214
Authors: Pei Xuan Kuan; Weng Ken Chan; Denisa Khoo Fern Ying; Mohd Aizuddin Abdul Rahman; Kalaiarasu M Peariasamy; Nai Ming Lai; Nicholas L Mills; Atul Anand Journal: Lancet Digit Health Date: 2022-09